Prostate cancer is the second most prevalent solid tumor diagnosed in men in the United States and Western Europe.
Conventionally fractionated external beam radiation therapy (1.8-2.0Gy/fraction) is an established treatment modality for men in all disease risk groups. Emerging evidence from experimental and clinical studies suggests that the α/β ratio for prostate cancer may be as low as 1.5Gy, which has prompted investigators around the world to explore moderately hypofractionated radiation therapy (2.1-3.5Gy/fraction). We review the impetus behind moderate hypofractionation and the current clinical evidence supporting moderate hypofractionated radiation therapy for prostate cancer. Although hypofractionated radiation therapy has many theoretical advantages, there is no clear evidence from prospective, randomized, controlled trials showing that hypofractionated schedules have improved outcomes or lower toxicity than conventionally fractionated regimens. Currently, hypofractionated schedules should only be used in the context of clinical trials. High dose rate brachytherapy and stereotactic body radiation therapy (fraction size 3.5Gy and greater) are alternative approaches to hypofractionation, but are beyond the scope of this report.
Written by:
Zaorsky NG, Ohri N, Showalter TN, Dicker AP, Den RB. Are you the author?
Department of Radiation Oncology, Jefferson Medical College & Kimmel Cancer Center, Thomas Jefferson University, 111 S, 11th Street, Bodine Center for Cancer Treatment, Philadelphia, PA 19107, USA.
Reference: Cancer Treat Rev. 2013 Feb 28. pii: S0305-7372(13)00031-5.
doi: 10.1016/j.ctrv.2013.01.008
PubMed Abstract
PMID: 23453861
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