@Article{,
AUTHOR = {Andrew M. Fang, Zachary R. Burns, Alexander P. Nocera, Rex A. Cardan, Jeffrey W. Nix, Kristin K. Porter, Andrew M. McDonald, Soroush Rais-Bahrami},
TITLE = {Stereotactic body radiation therapy with simultaneous integrated boost for prostate cancer: does MRI-targeted biopsy alter the  boost field?},
JOURNAL = {Canadian Journal of Urology},
VOLUME = {28},
YEAR = {2021},
NUMBER = {5},
PAGES = {10817--10823},
URL = {http://www.techscience.com/CJU/v28n5/60266},
ISSN = {1488-5581},
ABSTRACT = {<b>Introduction:</b> We aim to investigate if the addition of MRI-US fusion biopsy (FB) can aid in radiation planning and alter the boost field in cases of stereotactic body radiation therapy (SBRT) for prostate cancer with a simultaneous integrated boost (SIB) to a magnetic resonance imaging (MRI)-defined intraprostatic lesion.<br/>
<b>Materials and methods:</b> Patients undergoing SBRT with SIB for biopsy-proven prostatic adenocarcinoma and a pre-radiation MRI were retrospectively reviewed. 36.25 Gy in 5 fractions was delivered to the entire prostate along with SIB of 40 Gy to an MRI-defined intraprostatic lesion. Demographic, radiation planning details, and post-procedural outcomes were compared between patients undergoing systematic transrectal ultrasound (TRUS) biopsy followed by MRI to those undergoing an MRI followed by a FB prior to radiation planning.<br/>
<b>Results:</b> Forty-three patients underwent systematic TRUS biopsy followed by MRI, and 46 patients underwent FB prior to radiation planning. Patients undergoing systematic TRUS biopsy had a smaller prostate volume when compared to the FB cohort (37.58 ± 13.78 versus 50.28 ± 26.76 cc, p = 0.007). No differences in prostate planning target volume (PTVprostate) and boost volume (PTVboost) were noted, but those undergoing TRUS biopsy prior to MRI had a higher integrated boost volume density (IBVD = PTVboost/total prostate volume) (0.16 ± 0.09 versus 0.13 ± 0.06, p = 0.045). No differences were observed in genitourinary or gastrointestinal toxicity rates.<br/>
<b>Conclusions:</b> Compared to systematic TRUS biopsy, implementation of prebiopsy prostate MRI and FB allows for safe and feasible SBRT in patients with significantly larger prostate volumes without increasing SIB cancer-directed treatment volumes, oncologic outcomes, quality of life measures, or treatment-related toxicities.},
DOI = {}
}