. 2018 Mar 27;6(3):75–87. doi: 10.1016/j.prnil.2018.03.005

Table 1.

Literature summary of prostate irradiation with intraprostatic directed boost

Author	N	IDN identification modality	Treatment technique	NCCN	Median PSA (μg/L)	Median follow-up time	Volume delineation and margins	Boost technique	Dose (Gy/fr)	ADT	5-year bDFS (phoenix)	Survival (DSS, OS)
Zelefsky et al²⁸	4	1,5T ERC MRSI (elevated choline + elevated creatine-to-citrate ratio)	LDR B (I125)	LR (2) IR (2) HR (0)	4.5	NR	PTVb = GTV PTVpr = prostate	LDR B (I125)	PTVb = 150% of PTVpr PTVpr = 100–145 Gy	No	NR	NR
DiBiase et al²⁹	15	1,5T ERC MRSI (elevated choline + elevated creatine-to-citrate ratio)	LDR B (I125)	LR (15) IR (0) HR (0)	7.1	NR	PTVb = GTV PTVpr = prostate + 2 mm	LDR B (I125)	PTVb = 188 Gy PTVpr = 145 Gy	No	NR	NR
De Meerleer et al³⁰	15	1,5T ERC MRI (T2W) + biopsy	IMRT (3 field, Step and Shoot)	LR (2) IR (8) HR (5)	10.2	NR	PTVb = GTV PTVpr= (prostate + SV)+ 7–10 mm	IMRT	PTVb = 80 Gy/37 PTVpr = 74 Gy/37	Yes (73%) neoadj + adj (6–36 mo)	NR	NR
Singh et al³¹	3	3T ERC MRI (T2W + DCE + DWI) + biopsy	IMRT	NR	NR	3–18	PTVb = GTV + 3 mm PTVpr = prostate + 7 mm		PTVb = 94,5 Gy/42 PTVpr = 75,6 Gy/42	No	NR	NR
Fonteyne et al³²	230	1,5T ERC MRI (T2W + T1W) or MRSI	IMRT (3 field, Step and Shoot)	LR (17) IR (97) HR (116)	11.2	NR	PTVb = GTV + 4 mm PTVpr = (prostate ± SV) + 4 mm	IMRT	PTVb = 80 Gy/39 PTVpr = 78 Gy/39	No	NR	NR
Ares et al³³	77	ERC MRI (T2W + DCE) +biopsy	3DCRT + HDR B (Ir192)	LR (6) IR (25) HR (46)	NR	41.2	PTVb = boost prostate volume PTVpr = prostate + VS PLN	HDR B (Ir192)	PTVb = 85.6-99.2 Gy PTVpr = 64 Gy/32	Yes (>80%) neoadj/adj (18–24 mo)	78.8%	90% 5-year DSS
Miralbell et al³⁴	50	ERC MRI (T2W + DCE) +biopsy	3DCRT/IMRT (Step and shoot, sliding window and VMAT)	LR (5) IR (12) HR (33)	NR	NR	PTVb = GTV + 3 mm PTVpr = prostate + SV PLN	SBRT	PTVb = 80-99 Gy PTVpr = 64 Gy/32	Yes (66%) neoadj + adj (6-30 mo)	98%	100% 5-year DSS
Schick et al³⁵	77	ERC MRI (T2W + DCE) +biopsy	3DCRT + HDR B (Ir192)	LR (7) IR (9) HR (61)	NR	62–67	PTVb = hemi prostate PTVpr = prostate + vs PLN	HDR B (Ir192)	PTVb = 88-104 Gy PTVpr = 64.4 Gy/32	Yes (81%) neoadj + adj (18–24 mo)	70.5–79.7%	NR
Ellis et al³⁶^,³⁷	239	111In-Capromab SPECT Imaging	LDR prostate +3DCRT in 37%	LR (116) IR (94) HR (29)	7.6	84	PTVb = GTV + 5 mm PTVpr = prostate + 2–5 mm ±PLN	LDR prostate (Pd103 or I125)	PTVb = 150% of PTVpr PTVpr = 108–144 Gy (I125) PTVpr = 100–125 Gy (Pd103)	Yes (21%) neoadj	84.6%	97.7% 10-year DSS 84.8% 10-year OS
Wong et al³⁸	71	111In-Capromab SPECT Imaging	IMRT	LR (31) IR (30) HR (10)	6.1	66	PTVb = GTV PTVpr = prostate + SV (when involved) + 6 mm	IMRT	PTVb = 82 Gy (SIB) PTVpr = 75.6 Gy/42	Yes (24%) adj (6–12 mo)	94%	93% 5-year OS
Pinkawa et al³⁹	66	18F-Fluorocholine PET CT	IMRT	LR (23) IR (21) HR (22)	14	19	PTVb = GTV + 3-4 mm PTVpr = prostate + SV + 4–8 mm	IMRT	PTVb = 80 Gy (SIB) PTVpr = 76 Gy/38	Yes (16%) (NR)	NR	NR
Ippolito et al⁴⁰	40	1,5T ERC MRI + biopsy	IMRT	LR (4) IR (17) HR (19)	7	19	PTVb= (GTV + 5 mm)+1 cm PTVpr = prostate + SV + 1 cm	IMRT	PTVb = 80 Gy (SIB) PTVpr = 72 Gy/40	Yes (100%) neoadj + adj(24 mo)	100%	NR
Myers et al⁴¹	26	TRUS	IMRT+ HDR B (Ir192)	LR (7) IR(19) HR (0)	6.1	53	PTVb = peripheral zone PTVpr = (prostate+1.5 cm + VS + 5 mm) + 5 mm PLN	HDR B (Ir192)	PTVb = 9 Gy + 63 Gy/28 PTVpr = 6Gy + 63 Gy/28	Yes (73%) neoadj + adj(4 mo)	100%	NR
Aluwini et al⁴²	50	1.5 T MRI (T1W + T2W)	SBRT (Cyberknife)	LR (30) IR (20) HR (0)	8.2	23	PTVb = GTV PTVpr = prostate + 3 mm	SBRT (Cyberknife)	PTVb = 44 Gy (SIB) PTVpr = 38 Gy/4, daily	No	100% 2-year bDFS	NR
Schild et al⁴³	78	1.5 T MRI (T2W + DCE + DWI)	IMRT (sliding window and VMAT)	LR (18) IR (43) HR (17)	6.7	36	PTVb = GTV PTVpr = prostate + 3 mm	IMRT (sliding window and VMAT)	PTVb = 81-83 Gy (SIB) PTVpr = 77,4 Gy/43	Yes (41%) adj(6–30 mo)	92% 3-year bDFS	95% 3-year OS
Gomez-Iturriaga et al⁴⁴	15	1.5 T MRI (T2W + DCE + DWI)	IMRT + HDR B (Ir192)	LR (0) IR and HR: not specified	9	18	PTVb = GTV PTVpr = prostate	HDR B (Ir192)	PTVb = 18.75 Gy + 37.5 Gy/15 PTVpr = 15 Gy + 37.5 Gy/15	No	NR	NR
King et al⁴⁵	47	MRSI (elevated choline + elevated creatine-to-citrate ratio)	LDR (I125or Pd103) + IMRT PLN for 1 patient	LR (35) IR (12) HR (0)	5.1	86.4	PTVb = GTV PTVpr = prostate PLN	LDR (I125 or Pd103)	PTVb = 150% of PTVpr PTVpr = 144 Gy (I125) or 140 Gy (Pd103)	Yes (17%) neoadj	98% 10-year bDFS	84% 10-year OS
Sundahl et al⁴⁶	225	1,5T ERC MRI or 3T MRI (T1W + T2W)	IMRT	LR (5) IR (97) HR (123)	NR	72	PTVb = GTV PTVpr = prostate ± SV + 7 mm	IMRT	PTV1 = 82 Gy (SIB) PTV2 = 78 Gy/38	No	84% 6-year bDFS	NR
Kotecha et al⁴⁷	24	MRI (no specification)	SBRT (Cyberknife)	LR (0) IR (11) HR (13)	NR	25	PTVb = GTV PTVpr = prostate + SV+3 mm(0 mm posteriorly)	SBRT (Cyberknife)	PTVb = 50 Gy (SIB) PTVpr = 36.25 Gy/5	Yes (67%) Adj(4–30 mo)	95.8% 2-year bDFS	NR
Uzan et al ⁴⁸	11	MRI (T2W + DCE + DWI) + biopsy	IMRT (VMAT)	NR	15.9	36	PTVb = GTV + 5 mm PTVpr 1 = prostate + SV + 9 mm PTVpr 2 = prostate and base of SV + 5 mm	IMRT (VMAT)	PTVb = 85–105 Gy (SIB) PTVpr1 = 64 Gy/37 PTVpr2 = 74 Gy/37	Yes (100%) neoadj + adj (6–36 mo)	NR	NR
Garibaldi et al⁴⁹	15	1.5 ERC MRI (T2W + DWI + DCE)	IMRT (VMAT)	LR (0) IR (14) HR (1)	6.5	16	PTVb = GTV + 6 mm PTVpr 1 = prostate + 7 mm (5 mm posteriorly) PTVpr 2 = SV + 5–7 mm	IMRT (VMAT)	PTVb = 83.2 Gy (SIB) PTVpr1 = 75.2 Gy/32 PTVpr2 = 67.2 Gy/32	Yes (80%) neoadj + adj (6–24 mo)	100%	NR

3DCRT, 3-D conformational radiation therapy; ADT, androgen deprivation therapy; Adj, adjuvant ADT; bDFS, biochemical disease-free survival; CTCAE v2, Common Terminology Criteria of Adverse Events version 2, CTCAE v4, Common Terminology Criteria of Adverse Events version 4; DCE, dynamic contrast enhancement; DSS, disease-specific survival; EORTC, European Organization for Research and Treatment for Cancer; DWI, diffusion-weighted imaging; EPIC, Expanded Prostate Cancer Index Composite questionnaire; ERC, endorectal coil; Fr, fraction; GI, gastrointestinal; GTV, Gross tumor volume (=dominant intraprostatic lesion); GU, genitourinary; Gy, gray; HDR, high–dose rate brachytherapy; HR, high risk; IDN, intraprostatic dominant nodule; IMRT, intensity-modulated radiation therapy; IR, intermediate risk; LDR B, low–dose rate brachytherapy; LR, low risk; MRI, magnetic resonance imaging; mpMRI, multiparametric MRI [T2 weighed + dynamic contrast enhancement (DCE) + diffusion-weighted imaging (DWI)]; MRSI, magnetic resonance spectroscopic imaging; NCCN, National Comprehensive Cancer Network; Neoadj, neoadjuvant ADT; NR, not reported; OS, overall survival; PET CT, positron emission tomography–computed tomography; PLN, pelvic lymph nodes irradiation; PLND, pelvic lymph nodes dissection; PSA, prostate-specific antigen; PTV, planning target volume; PTVb, boost; PTVpr, whole prostate; SBRT, stereotactic body radiation therapy; SPECT, single-photon emission computed tomography; SV, seminal vesicles; TRUS, transrectal ultrasound; VMAT, volumetric modulated arc therapy.