Late Outcomes Following Hypofractionated Conformal Radiotherapy vs. Standard Fractionation for Localized Prostate Cancer: A Nonrandomized Contemporary Comparison

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

“…Therefore, although there is no doubt that HF offers major potential advantages to patients and to the economy of health systems, their development should not be at the expense of a lower likelihood of tumour control as well as of an unacceptable late toxicity. Published data shows that HF protocols seem not to be associated with an unacceptable late toxicity as documented by our [12] and other groups [7][8][9][10][11][13][14][15]. The analysis carried out in the present study provides some clinical evidence to further justify trends already emerging toward HF conformal technology in clinically localized prostate cancer.…”

“…However, at the present the main concern is the uncertainty about normal tissue toxicity of such HF protocols. Although clinical reports [7][8][9][10][11][12][13][14][15] have found acceptable levels of morbidity and reasonable PSA control rates using doses of 2.5-3 Gy, clinical data are sparse and, although promising, require further validation. If the hypothesis that the prostate cancer α / β ratio is lower than normal tissue is correct, then the optimal fractional dose is likely to be even higher than the doses tested thus far, but if incorrect, the result may be increased normal tissue toxicity.…”

Adaptive radiotherapy strategies for pelvic tumors – a systematic review of clinical implementations

“…Regarding the Beaumont trial, outcome was favorable or similar to the large non-ART trials using similar prescription delivered with 3DCRT [16,108,109,110] or IMRT [16,111,110] but toxicity was generally higher in the Beaumont trial [16,111,110]. Non-ART with gold marker-based set-up has indicated further improvement in toxicity to be possible [112,113]. For the more recent implementations of adaptations in prostate as well as bladder cancer, longer follow-up is needed to assess the potential clinical gain of ART.…”

Stereotactic Body Radiation Therapy for Patients with Early-stage Prostate Cancer

“…Four studies reporting outcome data for early stage prostate cancer treated with CF-EBRT with a combined patient cohort of n=1778 were included in this review (27)(28)(29)(30). This cohort consisted of 407 low-risk, 1,111 intermediate-risk and 254 high-risk patients.…”