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

Abstract

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

Prostate Hypofractionated Radiation Therapy With Injection of Hyaluronic Acid: Acute Toxicities in a Phase 2 Study

“…Except in 2 studies (31,34), the rates of grade !2 rectal toxicity were always higher than 10%. With doses per fraction higher than 3 Gy, this rate increased by between 21% and 38% (34)(35)(36)(37)(38)(39)(40)(41). In the present study, using a dose per fraction of 3.1 Gy, the rate of grade 2 acute rectal toxicity was 2.8%.…”

“…Eleven studies have already reported acute tolerance to HR (30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41). Except in 2 studies (31,34), the rates of grade !2 rectal toxicity were always higher than 10%.…”

Who benefits from hypofractionated radiation therapy for clinically localized prostate cancer: evidence from meta-analysis

“…We identified 606 records, of which 13 reports of 12 comparative trials (6 randomized-controlled trials [3,10,11,[19][20][21][22][23], 3 cohort studies [22,[24][25][26], and 3 retrospective case-control studies [22,27,28]) with a total of 4,572 participants (see Fig. S1).…”

Defining a dose–response relationship for prostate external beam radiotherapy

“…A total of 3037 men from eight studies, containing 38 samples met the inclusion criteria . Data from the studies are summarised in Tables and .…”