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Early closure of phase II prospective study on acute and late tolerance of hypofractionated radiotherapy in low-risk prostate cancer patients
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Abstract
Aim
To assess acute and late toxicity of hypofractionated radiotherapy, its efficacy and impact on quality of life in patients with low-risk prostate cancer.
Materials and methods
Since August 2006 to October 2007, 15 prostate cancer patients with favorable clinical features, aged 54–74 years (mean 67 years) entered the study. Tumor stage in the majority (73%) of patients was T2a, the mean pretreatment PSA value was 7.2[[ce:hsp sp="0.25"/]]ng/ml (range 5–10.9[[ce:hsp sp="0.25"/]]ng/ml). The study group was treated 3 times a week with 4[[ce:hsp sp="0.25"/]]Gy per fraction to the total dose of 60[[ce:hsp sp="0.25"/]]Gy within 5 weeks. 3D conformal treatment planning was used with no fiducial markers. Acute and late toxicity was evaluated using modified EORTC/RTOG/LENT scoring systems. Patients regularly filled the EORTC QLQ-PR25 questionnaires.
Results
All patients completed radiotherapy according to the plan. During radiotherapy, 26% of patients had grade 1–2 rectal symptoms. The incidence of acute urinary toxicity score was 26%, 60%, and 14% for grade 0–1, 2 and 3, respectively. One year after RT, the incidence of grade 2 GI toxicity was 27%, which was the reason for an early closure of the accrual. Grade 2 late urinary toxicity was noted in 20% of patients. The mean PSA level was 0.61[[ce:hsp sp="0.25"/]]ng/ml after 24 months and 0.47[[ce:hsp sp="0.25"/]]ng/ml after 36 months (range: 0.06–1.54[[ce:hsp sp="0.25"/]]ng/ml).
Conclusions
Low number of patients does not allow to determine the influence of hypofractionation on unsatisfactory tolerance of this regimen. Suboptimal (from the present day's perspective) target localization (no fiducial markers) could potentially explain higher than expected late GI reactions in our series.
Abstract
Aim
To assess acute and late toxicity of hypofractionated radiotherapy, its efficacy and impact on quality of life in patients with low-risk prostate cancer.
Materials and methods
Since August 2006 to October 2007, 15 prostate cancer patients with favorable clinical features, aged 54–74 years (mean 67 years) entered the study. Tumor stage in the majority (73%) of patients was T2a, the mean pretreatment PSA value was 7.2[[ce:hsp sp="0.25"/]]ng/ml (range 5–10.9[[ce:hsp sp="0.25"/]]ng/ml). The study group was treated 3 times a week with 4[[ce:hsp sp="0.25"/]]Gy per fraction to the total dose of 60[[ce:hsp sp="0.25"/]]Gy within 5 weeks. 3D conformal treatment planning was used with no fiducial markers. Acute and late toxicity was evaluated using modified EORTC/RTOG/LENT scoring systems. Patients regularly filled the EORTC QLQ-PR25 questionnaires.
Results
All patients completed radiotherapy according to the plan. During radiotherapy, 26% of patients had grade 1–2 rectal symptoms. The incidence of acute urinary toxicity score was 26%, 60%, and 14% for grade 0–1, 2 and 3, respectively. One year after RT, the incidence of grade 2 GI toxicity was 27%, which was the reason for an early closure of the accrual. Grade 2 late urinary toxicity was noted in 20% of patients. The mean PSA level was 0.61[[ce:hsp sp="0.25"/]]ng/ml after 24 months and 0.47[[ce:hsp sp="0.25"/]]ng/ml after 36 months (range: 0.06–1.54[[ce:hsp sp="0.25"/]]ng/ml).
Conclusions
Low number of patients does not allow to determine the influence of hypofractionation on unsatisfactory tolerance of this regimen. Suboptimal (from the present day's perspective) target localization (no fiducial markers) could potentially explain higher than expected late GI reactions in our series.
Keywords
Hypofractionated radiotherapy; Tolerance; Low-risk prostate cancer
About this articleTitle
Early closure of phase II prospective study on acute and late tolerance of hypofractionated radiotherapy in low-risk prostate cancer patients
Journal
Reports of Practical Oncology and Radiotherapy
Issue
Pages
337-342
Published online
2014-09-01
DOI
10.1016/j.rpor.2014.02.006
Bibliographic record
Rep Pract Oncol Radiother 2014;19(5):337-342.
Keywords
Hypofractionated radiotherapy
Tolerance
Low-risk prostate cancer
Authors
Katarzyna Behrendt
Elżbieta Nowicka
Marzena Gawkowska-Suwińska
Grzegorz Plewicki
Beata Smolska-Ciszewska
Monika Giglok
Rafał Suwiński
Aleksander Zajusz