open access

Vol 19, No 5 (2014)
Original research articles
Published online: 2014-09-01
Submitted: 2013-02-14
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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

Katarzyna Behrendt, Elżbieta Nowicka, Marzena Gawkowska-Suwińska, Grzegorz Plewicki, Beata Smolska-Ciszewska, Monika Giglok, Rafał Suwiński, Aleksander Zajusz
DOI: 10.1016/j.rpor.2014.02.006
·
Rep Pract Oncol Radiother 2014;19(5):337-342.

open access

Vol 19, No 5 (2014)
Original research articles
Published online: 2014-09-01
Submitted: 2013-02-14

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.

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Keywords

Hypofractionated radiotherapy; Tolerance; Low-risk prostate cancer

About this article
Title

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

Vol 19, No 5 (2014)

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

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