Background:The benefit of dose-escalated hypofractionated radiotherapy using intensity-modulated radiotherapy (IMRT) in prostate cancer is not established.
We report 5-year outcome and long-term toxicity data within a phase II clinical trial.
Materials and Methods:60 men with predominantly high-risk prostate cancer were treated. All patients received neoadjuvant hormone therapy, completing up to 6 months in total. Thirty patients were treated with 57 Gy in 19 fractions and 30 patients with 60 Gy in 20 fractions. Acute and 2-year toxicities were reported and patients followed longitudinally to assess 5 year outcomes and long-term toxicity. Toxicity was measured using RTOG criteria and LENT/SOMA questionnaire.
Results:Median followup was 84 months. Five-year overall survival (OS) was 83% and biochemical progression-free survival (bPFS) was 50% for 57 Gy. Five-year OS was 75% and bPFS 58% for 60 Gy. At 7 years, toxicity by RTOG criteria was acceptable with no grade 3 or above toxicity. Compared with baseline, there was no significant change in urinary symptoms at 2 or 7 years. Bowel symptoms were stable between 2 and 7 years. All patients continued to have significant sexual dysfunction.
Conclusion: In high-risk prostate cancer, dose-escalated hypofractionated radiotherapy using IMRT results in encouraging outcomes and acceptable late toxicity.
Written by:
Thomson D, Merrick S, Swindell R, Coote J, Kelly K, Stratford J, Wylie J, Cowan R, Elliott T, Logue J, Choudhury A, Livsey J. Are you the author?
Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester M20 4BX, UK.
Reference: Prostate Cancer. 2012;2012:450246.
doi: 10.1155/2012/450246
PubMed Abstract
PMID: 22792470
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