Dose-Escalated Hypofractionated Intensity-Modulated Radiotherapy in High-Risk Carcinoma of the Prostate: Outcome and Late Toxicity. (20th June 2012)

• Record Type: Journal Article
• Authors: Thomson, David; Merrick, Sophie; Swindell, Ric; Coote, Joanna; Kelly, Kay; Stratford, Julie; Wylie, James; Cowan, Richard; Elliott, Tony; Logue, John; Choudhury, Ananya; Livsey, Jacqueline
• Other Names: Ben-Yosef Rami Academic Editor.
• Is Part Of: Prostate cancer. Volume 2012(2012)
• Publication Date: 2012-06-20
• Subjects: Prostate -- Cancer -- Periodicals; Prostate -- Cancer -- Surgery -- Periodicals; 616.99463
• DOI: 10.1155/2012/450246
• Languages: English
• ISSNs: 2090-3111

Abstract

Abstract : 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.