Dose-Escalated Hypofractionated Intensity-Modulated Radiotherapy in High-Risk Carcinoma of the Prostate: Outcome and Late Toxicity
Background. The benefit of dose-escalated hypofractionated radiotherapy using intensity-modulated radiotherapy (IMRT) in prostate cancer is not established. We report 5-year outcome and long-term toxicity data within a phase II clinical trial. Materials and Methods. 60 men with predominantly high-ri...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | Prostate Cancer |
| Online Access: | http://dx.doi.org/10.1155/2012/450246 |
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| _version_ | 1832548448747913216 |
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| author | David Thomson Sophie Merrick Ric Swindell Joanna Coote Kay Kelly Julie Stratford James Wylie Richard Cowan Tony Elliott John Logue Ananya Choudhury Jacqueline Livsey |
| author_facet | David Thomson Sophie Merrick Ric Swindell Joanna Coote Kay Kelly Julie Stratford James Wylie Richard Cowan Tony Elliott John Logue Ananya Choudhury Jacqueline Livsey |
| author_sort | David Thomson |
| collection | DOAJ |
| description | Background. The benefit of dose-escalated hypofractionated radiotherapy using intensity-modulated radiotherapy (IMRT) in prostate cancer is not established. We report 5-year outcome and long-term toxicity data within a phase II clinical trial. Materials and Methods. 60 men with predominantly high-risk prostate cancer were treated. All patients received neoadjuvant hormone therapy, completing up to 6 months in total. Thirty patients were treated with 57 Gy in 19 fractions and 30 patients with 60 Gy in 20 fractions. Acute and 2-year toxicities were reported and patients followed longitudinally to assess 5 year outcomes and long-term toxicity. Toxicity was measured using RTOG criteria and LENT/SOMA questionnaire.
Results. Median followup was 84 months. Five-year overall survival (OS) was 83% and biochemical progression-free survival (bPFS) was 50% for 57 Gy. Five-year OS was 75% and bPFS 58% for 60 Gy. At 7 years, toxicity by RTOG criteria was acceptable with no grade 3 or above toxicity. Compared with baseline, there was no significant change in urinary symptoms at 2 or 7 years. Bowel symptoms were stable between 2 and 7 years. All patients continued to have significant sexual dysfunction. Conclusion. In high-risk prostate cancer, dose-escalated hypofractionated radiotherapy using IMRT results in encouraging outcomes and acceptable late toxicity. |
| format | Article |
| id | doaj-art-194e278be3fa4a37946029a1b499e46c |
| institution | Kabale University |
| issn | 2090-3111 2090-312X |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Prostate Cancer |
| spelling | doaj-art-194e278be3fa4a37946029a1b499e46c2025-02-03T06:14:05ZengWileyProstate Cancer2090-31112090-312X2012-01-01201210.1155/2012/450246450246Dose-Escalated Hypofractionated Intensity-Modulated Radiotherapy in High-Risk Carcinoma of the Prostate: Outcome and Late ToxicityDavid Thomson0Sophie Merrick1Ric Swindell2Joanna Coote3Kay Kelly4Julie Stratford5James Wylie6Richard Cowan7Tony Elliott8John Logue9Ananya Choudhury10Jacqueline Livsey11Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester M20 4BX, UKUniversity of Manchester, Manchester M13 9PL, UKDepartment of Clinical Oncology, The Christie NHS Foundation Trust, Manchester M20 4BX, UKDepartment of Clinical Oncology, The Christie NHS Foundation Trust, Manchester M20 4BX, UKDepartment of Clinical Oncology, Raigmore Hospital, Inverness IV2 3UJ, UKDepartment of Clinical Oncology, The Christie NHS Foundation Trust, Manchester M20 4BX, UKDepartment of Clinical Oncology, The Christie NHS Foundation Trust, Manchester M20 4BX, UKDepartment of Clinical Oncology, The Christie NHS Foundation Trust, Manchester M20 4BX, UKDepartment of Clinical Oncology, The Christie NHS Foundation Trust, Manchester M20 4BX, UKDepartment of Clinical Oncology, The Christie NHS Foundation Trust, Manchester M20 4BX, UKDepartment of Clinical Oncology, The Christie NHS Foundation Trust, Manchester M20 4BX, UKDepartment of Clinical Oncology, The Christie NHS Foundation Trust, Manchester M20 4BX, UKBackground. The benefit of dose-escalated hypofractionated radiotherapy using intensity-modulated radiotherapy (IMRT) in prostate cancer is not established. We report 5-year outcome and long-term toxicity data within a phase II clinical trial. Materials and Methods. 60 men with predominantly high-risk prostate cancer were treated. All patients received neoadjuvant hormone therapy, completing up to 6 months in total. Thirty patients were treated with 57 Gy in 19 fractions and 30 patients with 60 Gy in 20 fractions. Acute and 2-year toxicities were reported and patients followed longitudinally to assess 5 year outcomes and long-term toxicity. Toxicity was measured using RTOG criteria and LENT/SOMA questionnaire. Results. Median followup was 84 months. Five-year overall survival (OS) was 83% and biochemical progression-free survival (bPFS) was 50% for 57 Gy. Five-year OS was 75% and bPFS 58% for 60 Gy. At 7 years, toxicity by RTOG criteria was acceptable with no grade 3 or above toxicity. Compared with baseline, there was no significant change in urinary symptoms at 2 or 7 years. Bowel symptoms were stable between 2 and 7 years. All patients continued to have significant sexual dysfunction. Conclusion. In high-risk prostate cancer, dose-escalated hypofractionated radiotherapy using IMRT results in encouraging outcomes and acceptable late toxicity.http://dx.doi.org/10.1155/2012/450246 |
| spellingShingle | David Thomson Sophie Merrick Ric Swindell Joanna Coote Kay Kelly Julie Stratford James Wylie Richard Cowan Tony Elliott John Logue Ananya Choudhury Jacqueline Livsey Dose-Escalated Hypofractionated Intensity-Modulated Radiotherapy in High-Risk Carcinoma of the Prostate: Outcome and Late Toxicity Prostate Cancer |
| title | Dose-Escalated Hypofractionated Intensity-Modulated Radiotherapy in High-Risk Carcinoma of the Prostate: Outcome and Late Toxicity |
| title_full | Dose-Escalated Hypofractionated Intensity-Modulated Radiotherapy in High-Risk Carcinoma of the Prostate: Outcome and Late Toxicity |
| title_fullStr | Dose-Escalated Hypofractionated Intensity-Modulated Radiotherapy in High-Risk Carcinoma of the Prostate: Outcome and Late Toxicity |
| title_full_unstemmed | Dose-Escalated Hypofractionated Intensity-Modulated Radiotherapy in High-Risk Carcinoma of the Prostate: Outcome and Late Toxicity |
| title_short | Dose-Escalated Hypofractionated Intensity-Modulated Radiotherapy in High-Risk Carcinoma of the Prostate: Outcome and Late Toxicity |
| title_sort | dose escalated hypofractionated intensity modulated radiotherapy in high risk carcinoma of the prostate outcome and late toxicity |
| url | http://dx.doi.org/10.1155/2012/450246 |
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