Hypofractionated intensity-modulated radiotherapy (70 gy at 2.5 Gy per fraction) for localized prostate cancer: Long-term outcomes

Journal Article · Thu Dec 01 04:00:00 EST 2005 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2005.0· OSTI ID:20788240

Kupelian, Patrick A ^[1]; Thakkar, Vipul V ^[2]; Khuntia, Deepak ^[3]; Reddy, Chandana A. M.S. ^[2]; Klein, Eric A ^[4]; Mahadevan, Arul ^[2]

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1. Department of Radiation Oncology, M.D. Anderson Cancer Center Orlando, Orlando, FL (United States)
2. Department of Radiation Oncology, Cleveland Clinic Foundation, Cleveland, OH (United States)
3. Department of Human Oncology, University of Wisconsin, Madison, WI (United States)
4. Department of Urology, Cleveland Clinic Foundation, Cleveland, OH (United States)

Purpose: To analyze the long-term relapse-free survival and toxicity rates in patients treated with hypofractionated intensity-modulated radiotherapy. Methods and Materials: The study sample includes the first 100 consecutive localized prostate cancer patients treated to 70.0 Gy at 2.5 Gy per fraction. The median follow-up was 66 months (range, 3 to 75 months). Biochemical failure was the study endpoint, using both the ASTRO definition (A-bRFS) and the alternate 'nadir + 2 ng/mL' definition (N-bRFS). RTOG scores were used to assess toxicity. Results: The 5-year A-bRFS and N-bRFS rates were 85% (95%CI, 78-93%) and 88% (95%CI, 82-95%) for all cases, respectively. For low, intermediate and high-risk disease, the 5-year A-bRFS rates were 97%, 88%, and 70%. The corresponding 5-year N-bRFS rates were 97%, 93%, and 75%, respectively. The acute rectal toxicity scores were 0 in 20, 1 in 61, and 2 in 19 patients. The acute urinary toxicity scores were 0 in 9, 1 in 76, and 2 in 15 patients. The late rectal toxicity scores were 0 in 71, 1 in 19, 2 in 7, and 3 in 3 patients. The actuarial late Grade 3 rectal toxicity rate at 5 years was 3%. A number of the toxicities observed either resolved spontaneously or were corrected. At last follow-up, the rate of combined Grades 2 and 3 late rectal toxicity at 5 years was only 5%. The late urinary toxicity scores were 0 in 75, 1 in 13, 2 in 11, and 3 in 1 patients. The actuarial late Grade 3 urinary toxicity rate at 5 years was 1%. Conclusion: With a median follow-up of 66 months, the long-term results after high-dose hypofractionation are excellent. Late toxicity, urinary and rectal, has been limited. High-dose hypofractionation is an alternative dose escalation method in the treatment of localized prostate cancer.

• OSTI ID: 20788240
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 5 Vol. 63; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
FAILURES
HEALTH HAZARDS
MODULATION
PATIENTS
PROSTATE
RADIATION DOSES
RADIOTHERAPY
TOXICITY