Moderate Hypofractionation in Patients with Low-risk Prostate Cancer: Long-term Outcomes

Anticancer Res. 2018 Mar;38(3):1671-1676. doi: 10.21873/anticanres.12400.

Abstract

Background/aim: To evaluate outcomes in patients with low-risk prostate cancer treated with hypofractionated radiotherapy (HyRT).

Patients and methods: Between April 2004 and December 2015, 175 patients with low-risk prostate cancer were treated with HyRT 60 Gy in 20 fractions with or without image guidance and reduction of margin from clinical target volume to planning target volume.

Results: The median follow-up was 66 months. The 8-year overall survival for the whole patient cohort was 88.9%. The 8-year biochemical no evidence of disease was higher in patients treated with image-guided HyRT (98.8% vs. 88%, p=0.023). During treatment, patients treated with image-guided HyRT presented a lower rate of grade 1-2 gastrointestinal toxicity (25.3% vs. 42.2%, p=0.001). At the last follow-up, the grade 1 Gastro-intestinal toxicity rate was 4.0% and the grade 1-2 genito-urinary toxicity rate was 25.1%.

Conclusion: Our study demonstrated the efficacy of the schedule used with a low rate of acute and late toxicities. Therefore, reduction of margins with image-guided HyRT is safe.

Keywords: Hypofractionation; image-guided radiotherapy; low-risk prostate cancer.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Follow-Up Studies
  • Gastrointestinal Diseases / etiology
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Prostatic Neoplasms / pathology
  • Prostatic Neoplasms / radiotherapy*
  • Radiation Dose Hypofractionation
  • Radiotherapy, Image-Guided / adverse effects
  • Radiotherapy, Image-Guided / methods*
  • Risk Factors
  • Time Factors
  • Treatment Outcome