Abstract
Background
Hypofractionated radiotherapy using fewer and larger fractional doses may be more beneficial than conventional external-beam radiotherapy for localized prostate cancer. We evaluated the 5-year outcomes of moderately hypofractionated radiotherapy for localized prostate cancer.
Methods
We retrospectively evaluated 195 patients with localized prostate cancer (T1–3N0M0) who underwent intensity-modulated radiotherapy (IMRT) (66 Gy delivered in fractions of 3 Gy every other weekday) between May 2005 and December 2011. Patients received androgen deprivation therapy depending on the perceived intermediate or high risk of their disease. A prostate-specific antigen nadir +2.0 ng/ml indicated biochemical failure. We assessed toxicity using the Radiation Therapy Oncology Group and the European Organization for Research and Treatment of Cancer (RTOG/EORTC) criteria, and patient-reported outcomes using the Expanded Prostate Cancer Index Composite (EPIC).
Results
The risk classifications (proportion) were low risk (13.8%), intermediate risk (35.9%), and high risk (50.3%). The median follow-up was 69 months. Thirteen (6.66%) patients experienced biochemical failure within a median of 40 months (interquartile range, 25–72 months). The 5-year overall survival rate and no biological evidence of disease rate were 97.7% and 92.4%, respectively. Based on the RTOG/EORTC criteria, no patient experienced acute or late toxicity of grade 3 or higher. The EPIC scores revealed significant differences in the average value of all domains (p < 0.01). At 1 month postradiotherapy completion, the general urinary and bowel domain scores had decreased, but these scores returned to baseline level by 3 months post radiotherapy.
Conclusions
The moderately hypofractionated radiotherapy protocol yielded short-term satisfactory clinical outcomes with acceptable toxicity.
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Abbreviations
- ADT:
-
Androgen deprivation therapy
- ANOVA:
-
Analysis of variance
- BED:
-
Biologically effective dose
- bNED:
-
No biochemical evidence of disease
- CHHiP:
-
Conventional or hypofractionated high-dose intensity-modulated radiotherapy for prostate cancer
- CTCAE:
-
Common terminology criteria for adverse events
- EORTC:
-
European Organization for Research and Treatment of Cancer
- EPIC:
-
Expanded Prostate Cancer Index Composite
- HYPRO:
-
HYpofractionated irradiation for PROstate cancer
- OS:
-
Overall survival
- OTT:
-
Overall treatment time
- PROFIT:
-
PROstate fractionated irradiation trial
- PRO:
-
Patient-reported outcome
- PSA:
-
Prostate-specific antigen
- QOL:
-
Quality of life
- RTOG:
-
Radiation Therapy Oncology Group
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Editage (www.editage.jp) provided English language editing for this manuscript.
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The protocol of this study was approved by the institutional review board of Tokyo Women’s Medical University in Tokyo, Japan (protocol number 637). All participants provided informed consent.
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Hashimoto, Y., Motegi, A., Akimoto, T. et al. The 5-year outcomes of moderately hypofractionated radiotherapy (66 Gy in 22 fractions, 3 fractions per week) for localized prostate cancer: a retrospective study. Int J Clin Oncol 23, 165–172 (2018). https://doi.org/10.1007/s10147-017-1175-1
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DOI: https://doi.org/10.1007/s10147-017-1175-1