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Title: Acute and Late Toxicity in a Randomized Trial of Conventional Versus Hypofractionated Three-Dimensional Conformal Radiotherapy for Prostate Cancer

Abstract

Purpose: To compare the toxicity between hypofractionation vs. conventional fractionation schedules in patients with high-risk prostate cancer. Methods and Materials: Between January 2003 and December 2007, 168 patients were randomized to receive either hypofractionated (62 Gy in 20 fractions within 5 weeks, 4 fractions/wk) or conventionally fractionated (80 Gy in 40 fractions within 8 weeks) three-dimensional conformal radiotherapy to the prostate and seminal vesicles. All patients had undergone a 9-month course of total androgen deprivation, with radiotherapy starting 2 months after initiation of the total androgen deprivation. Results: The median follow-up was 32 and 35 months in the hypofractionation and conventional fractionation arms, respectively. For the patients developing acute toxicity, no difference between the two fractionation groups was found in either severity or duration of gastrointestinal or genitourinary toxicity. Also, no difference was found in the incidence and severity of late gastrointestinal and genitourinary toxicity between the two treatment schedules, with a 3-year rate of Grade 2 or greater toxicity of 17% and 16% for the hypofractionation arm and 14% and 11% for the conventional fractionation arm, respectively. A statistically significant correlation between acute and late gastrointestinal toxicity was found only in the conventional fractionation group. Conclusion: Our findings suggestmore » that the hypofractionation regimen used in our study is safe, with only a slight, nonsignificant increase in tolerable and temporary acute toxicity compared with the conventional fractionation schedule. The severity and frequency of late complications was equivalent between the two treatment groups.« less

Authors:
 [1];  [2]; ; ; ;  [1]; ;  [3]
  1. Department of Radiation Oncology, Regina Elena National Cancer Institute, Rome (Italy)
  2. Emeritus, Departments of Human Oncology and Medical Physics, University of Wisconsin Medical School, Madison, WI (United States)
  3. Laboratory of Medical Physics and Expert Systems, Regina Elena National Cancer Institute, Rome (Italy)
Publication Date:
OSTI Identifier:
21491651
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 79; Journal Issue: 4; Other Information: DOI: 10.1016/j.ijrobp.2009.12.045; PII: S0360-3016(09)03726-2; Copyright (c) 2011 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ANDROGENS; FRACTIONATED IRRADIATION; NEOPLASMS; PROSTATE; RADIOTHERAPY; THREE-DIMENSIONAL CALCULATIONS; TOXICITY; ANDROSTANES; BODY; DISEASES; GLANDS; HORMONES; IRRADIATION; MALE GENITALS; MEDICINE; NUCLEAR MEDICINE; ORGANIC COMPOUNDS; ORGANS; RADIOLOGY; STEROID HORMONES; STEROIDS; THERAPY

Citation Formats

Arcangeli, Giorgio, Fowler, Jack, Gomellini, Sara, Arcangeli, Stefano, Saracino, Biancamaria, Petrongari, Maria Grazia, Benassi, Marcello, and Strigari, Lidia. Acute and Late Toxicity in a Randomized Trial of Conventional Versus Hypofractionated Three-Dimensional Conformal Radiotherapy for Prostate Cancer. United States: N. p., 2011. Web. doi:10.1016/j.ijrobp.2009.12.045.
Arcangeli, Giorgio, Fowler, Jack, Gomellini, Sara, Arcangeli, Stefano, Saracino, Biancamaria, Petrongari, Maria Grazia, Benassi, Marcello, & Strigari, Lidia. Acute and Late Toxicity in a Randomized Trial of Conventional Versus Hypofractionated Three-Dimensional Conformal Radiotherapy for Prostate Cancer. United States. https://doi.org/10.1016/j.ijrobp.2009.12.045
Arcangeli, Giorgio, Fowler, Jack, Gomellini, Sara, Arcangeli, Stefano, Saracino, Biancamaria, Petrongari, Maria Grazia, Benassi, Marcello, and Strigari, Lidia. 2011. "Acute and Late Toxicity in a Randomized Trial of Conventional Versus Hypofractionated Three-Dimensional Conformal Radiotherapy for Prostate Cancer". United States. https://doi.org/10.1016/j.ijrobp.2009.12.045.
@article{osti_21491651,
title = {Acute and Late Toxicity in a Randomized Trial of Conventional Versus Hypofractionated Three-Dimensional Conformal Radiotherapy for Prostate Cancer},
author = {Arcangeli, Giorgio and Fowler, Jack and Gomellini, Sara and Arcangeli, Stefano and Saracino, Biancamaria and Petrongari, Maria Grazia and Benassi, Marcello and Strigari, Lidia},
abstractNote = {Purpose: To compare the toxicity between hypofractionation vs. conventional fractionation schedules in patients with high-risk prostate cancer. Methods and Materials: Between January 2003 and December 2007, 168 patients were randomized to receive either hypofractionated (62 Gy in 20 fractions within 5 weeks, 4 fractions/wk) or conventionally fractionated (80 Gy in 40 fractions within 8 weeks) three-dimensional conformal radiotherapy to the prostate and seminal vesicles. All patients had undergone a 9-month course of total androgen deprivation, with radiotherapy starting 2 months after initiation of the total androgen deprivation. Results: The median follow-up was 32 and 35 months in the hypofractionation and conventional fractionation arms, respectively. For the patients developing acute toxicity, no difference between the two fractionation groups was found in either severity or duration of gastrointestinal or genitourinary toxicity. Also, no difference was found in the incidence and severity of late gastrointestinal and genitourinary toxicity between the two treatment schedules, with a 3-year rate of Grade 2 or greater toxicity of 17% and 16% for the hypofractionation arm and 14% and 11% for the conventional fractionation arm, respectively. A statistically significant correlation between acute and late gastrointestinal toxicity was found only in the conventional fractionation group. Conclusion: Our findings suggest that the hypofractionation regimen used in our study is safe, with only a slight, nonsignificant increase in tolerable and temporary acute toxicity compared with the conventional fractionation schedule. The severity and frequency of late complications was equivalent between the two treatment groups.},
doi = {10.1016/j.ijrobp.2009.12.045},
url = {https://www.osti.gov/biblio/21491651}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 4,
volume = 79,
place = {United States},
year = {Tue Mar 15 00:00:00 EDT 2011},
month = {Tue Mar 15 00:00:00 EDT 2011}
}