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A Randomized Trial Comparing Hypofractionated and Conventionally Fractionated Three-Dimensional External-Beam Radiotherapy for Localized Prostate Adenocarcinoma
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A Randomized Trial Comparing Hypofractionated and Conventionally Fractionated Three-Dimensional External-Beam Radiotherapy for Localized Prostate Adenocarcinoma
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A Randomized Trial Comparing Hypofractionated and Conventionally Fractionated Three-Dimensional External-Beam Radiotherapy for Localized Prostate Adenocarcinoma
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Journal Article
A Randomized Trial Comparing Hypofractionated and Conventionally Fractionated Three-Dimensional External-Beam Radiotherapy for Localized Prostate Adenocarcinoma
2009
Overview
Purpose:
To compare acute gastrointestinal (GI) and genitourinary (GU) toxicity between patient groups with localized prostate adenocarcinoma, treated with conventionally fractionated (CFRT) and hypofractionated (HFRT) three-dimensional conformal external-beam radiotherapy (3D-CRT).
Patients and Methods:
91 patients were enrolled into a randomized study with a minimum follow-up of 3 months. 44 men in the CFRT arm were irradiated with 74 Gy in 37 fractions at 2 Gy per fraction for 7.5 weeks. 47 men in the HFRT arm were treated with 57 Gy in 17 fractions for 3.5 weeks, given as 13 fractions of 3 Gy plus four fractions of 4.5 Gy. The clinical target volume (CTV) included the prostate and the base of seminal vesicles. The CTV-to-PTV (planning target volume) margin was 8–10 mm. Study patients had portal imaging and/or simulation performed on the first fractions and repeated at least weekly.
Results:
No acute grade 3 or 4 toxicities were observed. The grade 2 GU acute toxicity proportion was significantly lower in the HFRT arm: 19.1% versus 47.7% (χ
2
-test, p = 0.003). The grade 2 GU acute toxicity-free survival was significantly better in the HFRT arm (log-rank test, p = 0.008). The median duration of overall GI acute toxicity was shorter with HFRT: 3 compared to 6 weeks with CFRT (median test, p = 0.017).
Conclusion:
In this first evaluation, the HFRT schedule is feasible and induces acceptable or even lower acute toxicity compared with the toxicities in the CFRT schedule. Extended follow-up is needed to justify this fractionation schedule’s safety in the long term.
Publisher
Urban and Vogel,Springer Nature B.V
Subject
/ Adenocarcinoma - radiotherapy
/ Aged
/ Gastrointestinal Tract - radiation effects
/ Humans
/ Male
/ Medicine
/ Oncology
/ Prostate - radiation effects
/ Prostate-Specific Antigen - blood
/ Prostatic Neoplasms - mortality
/ Prostatic Neoplasms - pathology
/ Prostatic Neoplasms - radiotherapy
/ Radiation Injuries - etiology
/ Radiotherapy Planning, Computer-Assisted - methods
/ Seminal Vesicles - radiation effects
