open access

Vol 21, No 3 (2016)
Original research articles
Published online: 2016-05-01
Submitted: 2015-08-24
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Image-guided hypofractionated proton beam therapy for low-risk prostate cancer: Analysis of quality of life and toxicity, PCG GU 002

Carlos Enrique Vargas, William Fred Hartsell, Megan Dunn, Sameer Ramchandra Keole, Lucius Doh, John Chang, Gary Lynn Larson
DOI: 10.1016/j.rpor.2016.01.002
·
Rep Pract Oncol Radiother 2016;21(3):207-212.

open access

Vol 21, No 3 (2016)
Original research articles
Published online: 2016-05-01
Submitted: 2015-08-24

Abstract

Aim

This interim analysis evaluated changes in quality of life (QOL), American Urological Association Symptom Index (AUA), or adverse events (AEs) among prostate cancer patients treated with hypofractionation.

Background

Results for hypofractionated prostate cancer with photon therapy are encouraging. No prior trial addresses the role of proton therapy in this clinical setting.

Materials and methods

Forty-nine patients with low-risk prostate cancer received 38-Gy relative biologic effectiveness in 5 treatments. They received proton therapy at 2 fields a day, magnetic resonance imaging registration, rectal balloon, and fiducial markers for guidance pre-beam. We evaluated AEs, Expanded Prostate Index Composite (EPIC) domains, and AUA at pretreatment and at 3, 6, 12, 18, and 24 months. An AUA change >5 points and QOL change of half a standard deviation (SD) defined clinical significance.

Results

Median follow-up was 18 months; 17 patients reached follow-up of ≥24 months. For urinary function, statistically and clinically significant change was not seen (maximum change, 3). EPIC urinary QOL scores did not show statistically and clinically significant change at any end point (maximum, 0.45 SD). EPIC bowel QOL scores showed small but statistically and clinically significant change at 6, 12, 18, and 24 months (SD range, 0.52–0.62). EPIC sexual scores showed small but statistically and clinically significant change at 24 months (SD, 0.52). No AE grade ≥3 was seen.

Conclusions

Patients treated with hypofractionated proton therapy tolerated treatment well, with excellent QOL scores, persistently low AUA, and no AE grade ≥3.

Abstract

Aim

This interim analysis evaluated changes in quality of life (QOL), American Urological Association Symptom Index (AUA), or adverse events (AEs) among prostate cancer patients treated with hypofractionation.

Background

Results for hypofractionated prostate cancer with photon therapy are encouraging. No prior trial addresses the role of proton therapy in this clinical setting.

Materials and methods

Forty-nine patients with low-risk prostate cancer received 38-Gy relative biologic effectiveness in 5 treatments. They received proton therapy at 2 fields a day, magnetic resonance imaging registration, rectal balloon, and fiducial markers for guidance pre-beam. We evaluated AEs, Expanded Prostate Index Composite (EPIC) domains, and AUA at pretreatment and at 3, 6, 12, 18, and 24 months. An AUA change >5 points and QOL change of half a standard deviation (SD) defined clinical significance.

Results

Median follow-up was 18 months; 17 patients reached follow-up of ≥24 months. For urinary function, statistically and clinically significant change was not seen (maximum change, 3). EPIC urinary QOL scores did not show statistically and clinically significant change at any end point (maximum, 0.45 SD). EPIC bowel QOL scores showed small but statistically and clinically significant change at 6, 12, 18, and 24 months (SD range, 0.52–0.62). EPIC sexual scores showed small but statistically and clinically significant change at 24 months (SD, 0.52). No AE grade ≥3 was seen.

Conclusions

Patients treated with hypofractionated proton therapy tolerated treatment well, with excellent QOL scores, persistently low AUA, and no AE grade ≥3.

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Keywords

AE; AUA; EPIC; OTV; RBE; RT; SD; Adverse events; American Urological Association Symptom Index; Expanded Prostate Index Composite; Quality of life; Stereotactic body radiation therapy

About this article
Title

Image-guided hypofractionated proton beam therapy for low-risk prostate cancer: Analysis of quality of life and toxicity, PCG GU 002

Journal

Reports of Practical Oncology and Radiotherapy

Issue

Vol 21, No 3 (2016)

Pages

207-212

Published online

2016-05-01

DOI

10.1016/j.rpor.2016.01.002

Bibliographic record

Rep Pract Oncol Radiother 2016;21(3):207-212.

Keywords

AE
AUA
EPIC
OTV
RBE
RT
SD
Adverse events
American Urological Association Symptom Index
Expanded Prostate Index Composite
Quality of life
Stereotactic body radiation therapy

Authors

Carlos Enrique Vargas
William Fred Hartsell
Megan Dunn
Sameer Ramchandra Keole
Lucius Doh
John Chang
Gary Lynn Larson

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