How low is the α/β ratio for prostate cancer?

Wang, Jian Z.; Guerrero, Mariana; Li, X.Allen

doi:10.1016/s0360-3016(02)03828-2

Cited by 294 publications

(307 citation statements)

References 34 publications

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“…Recent evidence has estimated the α / β ratio of prostate cancer to be as low as 1.5 Gy. However, this value may not be appropriate and several studies have concluded that this value might to be in the range of 1.0 to 3.0 Gy [4][5][6]. If these hypotheses are true, then the optimal therapeutic ratio for prostate cancer would be achieved using daily doses of > 2 Gy.…”

Section: Introductionmentioning

confidence: 99%

Late morbidity and oncological outcome after radical hypofractionated radiotherapy in men with prostate cancer

et al. 2010

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OBJECTIVE To test the hypothesis that three-dimensional hypofractionated radiotherapy (3D-HFRT) is well tolerated and not worse than 3-D conventional RT (3D-CRT) for oncological outcome. PATIENTS AND METHODS In all, 162 men with hystologically confirmed prostate adenocarcinoma were included in the analysis. In all, 82 men were treated with 3D-HFRT (15 fractions of 3.62 Gy delivered 3 times/week; a total dose of 54.3 Gy). This group was retrospectively compared with 80 men who met the same inclusion criteria and who were treated with 3D-CRT (39 fractions of 2 Gy delivered daily; a total dose of 78 Gy). A short course of hormone therapy was administered concomitantly with the RT. RESULTS Only one (1.7%) patient in the 3D-CRT group and two (4.0%) in the 3D-HFRT group had Grade 3 genitourinary toxicity. There was late gastrointestinal morbidity of >= grade 3 in only 5.1% of men treated with 3D-HFRT and in 4.0% of men treated with 3D-CRT. In both groups there was no Grade 4 toxicity. At the median (range) follow-up of 45 (39.4-51) months for the 3D-HFRT group and 57.5 (54.9-59.1) months for 3D-CRT group the progression rate was 18/82 (21.9%) and 20/80 (25.0%), respectively, with no significant worsening in the risk of biochemical failure (BCF; log-rank test, P = 0.222). CONCLUSIONS In the present study, men with clinically localized prostate cancer had similar levels of morbidity irrespective of whether they received HFRT or CRT without any worsening in the early risk of BCF. Thus, the present data provide some clinical evidence to justify trends already emerging toward HF regimens for treating clinically localised prostate cancer

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Section: Introductionmentioning

confidence: 99%

Late morbidity and oncological outcome after radical hypofractionated radiotherapy in men with prostate cancer

et al. 2010

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“…4,5 However, this is still the subject of much debate. 6,7 In addition, it is has been suggested that treatment schedules relying on fewer, larger daily fractions of radiotherapy may increase the therapeutic ratio. Such findings have renewed interests in using hypofractionated radiotherapy treatment in prostate cancer.…”

Section: Introductionmentioning

confidence: 99%

Subjective and objective measures of late genitourinary morbidity following hypofractionated radiotherapy in men with prostate cancer

Tombolini

Staso

Bonfili

et al. 2009

Prostate Cancer Prostatic Dis

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To value the late genitourinary (GU) morbidity in men treated with a hypofractionated radiotherapy regimen for prostate cancer. Patients with intermediate risk factors according to D'Amico's criteria were selected. The hypofractionated schedule consisted of 15 fractions of 3.63 Gy delivered three times per week for a total dose of 54.3 Gy. Significant changes in storage-symptoms were not found. A significant transient worsening in the score of late effects of normal tissue late effects normal tissue task force (LENT)-subjective, objective, management, analytic (SOMA) urinary-function domain was observed at 12 months with subsequent improvement at 28 months. The assessment of voiding-symptoms and maximum urinary flow rate (Qmax) showed that no significant difference was measurable at 12 and 28 months. For PVR, a transient increase at 12 months with a subsequent decrease at 28 months was measured. No significant increase in alphablockers usage and in the percentage of men with pathological nonintubated uroflowmetry (NIF) was observed at 12 and 28 months. Finally, patients did not perceive any clinical worsening in their quality of life (QoL) as attested by the International Prostate Symptom Score (IPSS)-QoL. Our study seems to suggest that our hypofractionated radiotherapy schedule for the treatment of prostate cancer is safe in terms of late urinary morbidity. Further study will be required to confirm our results.

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“…Some relate to the potential uncertainties surrounding permanent implant dosimetry 10 , as previously mentioned, others focus on the potential confounding role of tumor cell repopulation, 11 and still others suggest a confounding role of tumor hypoxia upon the estimation of α/β 12 . There are arguments that at least partially counter these concerns, however, and, with all information considered, a low α/β ratio for prostate cancer remains an attractive hypothesis supported by several lines of evidence.…”

Section: The Case For Hypofractionationmentioning

confidence: 99%

Hypofractionation for Prostate Cancer

Lawton¹

2010

Yearbook of Oncology

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How low is the α/β ratio for prostate cancer?

Cited by 294 publications

References 34 publications

Late morbidity and oncological outcome after radical hypofractionated radiotherapy in men with prostate cancer

Late morbidity and oncological outcome after radical hypofractionated radiotherapy in men with prostate cancer

Subjective and objective measures of late genitourinary morbidity following hypofractionated radiotherapy in men with prostate cancer

Hypofractionation for Prostate Cancer

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