Preliminary result of using intensity modulated radiation therapy (IMRT) as a primary treatment for prostate cancer at Siriraj Hospital in Thailand: toxicity and biochemical outcomes.

Objective: This study is a retrospective study of the outcome and the incidence of the toxicity of using intensity-modulated radiation therapy (IMRT) as the primary treatment for prostate cancer at Siriraj Hospital. Methods: Hospital records and radiotherapy medical records of prostate cancer patients treated with IMRT as the primary treatment between July 2004 and May 2009 at Siriraj Hospital were all reviewed. Seventy-five prostate cancer patients were included in the study. Patient’s biochemical failure was established at the time of prostatic specific antigen progression above the post-treatment nadir value +2 ng/ml according to the Phoenix definition. Acute and Late toxicity were assessed and scored according to the Radiotherapy Oncology Group grading system. Results: The median follow up time was 25 months (range 3 – 63 months). The two years overall survival (OS) and freedom from biochemical failure rate (FFBF) were 93.7 and 95.8%, respectively. Five patients (6.6%) developed prostatic specific antigen failure according to the Phoenix definition. The incidences of grade  2 of acute and late gastrointestinal toxicity were 12% and 2.7%, respectively. The incidences of grade  2 of acute and late genito-urinary toxicity were 61.3% and 41.3%, respectively. Conclusion: This preliminary result of using IMRT as the primary treatment for prostate cancer provides good outcomes. The FFBF and OS are comparable with other studies. The incidences of acute and late gastrointestinal toxicity are acceptable, but the incidences of acute and late genito-urinary toxicity are higher than other studies.

Results of cervical cancer patients treated according to clinical practice guideline in Siriraj Hospital.

Patients with cervical cancer stage Ib-IVa treated with curative intent at Siriraj Hospital between January and December 2002 were included in the study. There were 362 patients with an age range of 26-86 years old. We found that 65.3% of the patients were treaded according to Siriraj Hospital’s clinical practice guideline (CPG) and 34.7% were not treated according to the CPG. Early results of the treatment showed that 70.4% of the patients treated according to the CPG had complete response at 3 months. After further follow up and salvage treatments, five more patients treated according to CPG accomplished complete responses. The overall results of CPG treatment were comparable to the result of cervical cancer treatment in the literature.