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Dose-Escalated Hypofractionated Intensity-Modulated Radiotherapy in High-Risk Carcinoma of the Prostate: Outcome and Late Toxicity

Authors :
Julia Stratford
Richard A Cowan
Jacqueline E Livsey
Ric Swindell
S Merrick
John P Logue
Tony Elliott
James P Wylie
K Kelly
Ananya Choudhury
Joanna H Coote
David J Thomson
Source :
Prostate Cancer, Vol 2012 (2012), Prostate Cancer
Publication Year :
2012
Publisher :
Hindawi Limited, 2012.

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.

Details

Language :
English
ISSN :
20903111
Volume :
2012
Database :
OpenAIRE
Journal :
Prostate Cancer
Accession number :
edsair.doi.dedup.....3f57d189a5bc86c10147d25e826420c9