EBRT best in fewer, larger doses in delaying progression

[JimmyToowong]

A prospective phase III randomized trial of hypofractionation versus conventional fractionation in patients with high-risk prostate cancer - Abstract Show Comments PDF Print E-mail

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Thursday, 21 January 2010

Department of Radiotherapy, Regina Elena National Cancer Institute, Rome, Italy.

To compare the toxicity and efficacy of hypofractionated (62 Gy/20 fractions/5 weeks, 4 fractions per week) vs. conventional fractionation radiotherapy (80 Gy/40 fractions/8 weeks) in patients with high-risk prostate cancer.

From January 2003 to December 2007, 168 patients were randomized to receive either hypofractionated or conventional fractionated schedules of three-dimensional conformal radiotherapy to the prostate and seminal vesicles. All patients received a 9-month course of total androgen deprivation (TAD), and radiotherapy started 2 months thereafter.

The median (range) follow-up was 32 (8-66) and 35 (7-64) months in the hypofractionation and conventional fractionation arms, respectively. No difference was found for late toxicity between the two treatment groups, with 3-year Grade 2 rates of 17% and 16% for gastrointestinal and 14% and 11% for genitourinary in the hypofractionation and conventional fractionation groups, respectively. The 3-year freedom from biochemical failure (FFBF) rates were 87% and 79% in the hypofractionation and conventional fractionation groups, respectively (p = 0.035). The 3-year FFBF rates in patients at a very high risk (i.e., pretreatment prostate-specific antigen (iPSA) >20 ng/mL, Gleason score >/=8, or T >/=2c), were 88% and 76% (p = 0.014) in the former and latter arm, respectively. The multivariate Cox analysis confirmed fractionation, iPSA, and Gleason score as significant prognostic factors.

Our findings suggest that late toxicity is equivalent between the two treatment groups and that the hypofractionated schedule used in this trial is superior to the conventional fractionation in terms of FFBF.

Written by:

Arcangeli G, Saracino B, Gomellini S, Petrongari MG, Arcangeli S, Sentinelli S, Marzi S, Landoni V, Fowler J, Strigari L. Are you the author?

Reference:

Int J Radiat Oncol Biol Phys. 2010 Jan 2. Epub ahead of print.

doi:10.1016/j.ijrobp.2009.07.1691

PubMed Abstract

PMID:20047800 Forum: Other prostate cancer topics including radiation Title: EBRT best in fewer, larger doses in delaying progression

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