The efficacy and tolerability of ultra-hypofractionated radiotherapy in low-intermediate risk prostate cancer patients: single center experience

Abstract

Background: We aimed to investigate the efficacy and tolerability of ultra-hypofractionated radiotherapy (UHRT) in the treatment of low and intermediate-risk prostate cancer patients. Methods: This retrospective study was conducted using data derived from 44 patients who underwent UHRT, and toxicity assessment and clinical response were investigated. Treatment consisted of 35-36.25 Gy in 5 fractions using stereotactic ablative radiotherapy (SABR) with the Linac-based delivery system. Results: The median duration of follow-up was 52 months (8-68 months) and the median age was 71.5 years (54-85 years). Twenty-seven patients were assigned as intermediate-risk, whereas 17 patients had low-risk. The 5-year overall survival rate was 87.8%, while the 5-year biochemical recurrence-free survival (bRFS) rate was 97.4%. Acute grade 3 genitourinary (GU) side effect was not observed in any patient, whereas acute gastrointestinal (GI) system grade 3 side effect was seen in 6.8% of the patients. Late grade 3 GU and GI side effects were seen in 4.6% and 6.8% of the patients, respectively. In patients with planning target volume (PTV) !85 ml, acute grade !2 GU side effects were more common (p¼.034). Conclusion: Our data demonstrated that UHRT administered with volumetric arc therapy (VMAT) can be recommended for selected patients with low-intermediate risk prostate cancer. Further prospective, multicentric, controlled trials on larger series are warranted to reach more accurate conclusions.

Dosimetric Predictors of Toxicity after Prostate Stereotactic Body Radiotherapy: A Single-Institutional Experience of 145 Patients

“…Regarding acute GU toxicity, our study detected prostate volume as a risk factor. Dincer et al likewise reported PTV as a risk factor for acute GU toxicity [6]. In addition, Wang et al reported baseline urinary quality of life (QOL) as a risk factor for acute urinary incontinence [9].…”

“…Compared to GI toxicity, GU toxicity was more frequent. Table 4 shows previous reports regarding the relationships between toxicities and risk factors [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. In addition, compared to the IMRT, the SBRT has similar toxicity profiles, like the National Comprehensive Cancer Network (NCCN) guidelines suggested.…”

“…Compared to GI toxicity, GU toxicity was more frequent. Table 4 shows previous reports regarding the relationships between toxicities and risk factors [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. In addition, compared…”

SP-0346 How may shorter fractionation schedules affect patient care?

“…Moderate hypofractionation should therefore be considered for those patient who are younger and who might experience long terms effects 13 . More studies are now investigating the tolerability of ultra-hypofractionated radiotherapy in an attempt to improve the therapeutic gain in the management of cancer suggesting that these approaches are well-tolerated and showed no statistical difference in toxicity 14 .…”