Hypofractionated Radiotherapy in Intermediate-Risk Prostate Cancer Patients: Long-Term Results.

Publisher: MDPI AG Country of Publication: Switzerland NLM ID: 101606588 Publication Model: Electronic Cited Medium: Print ISSN: 2077-0383 (Print) Linking ISSN: 20770383 NLM ISO Abbreviation: J Clin Med Subsets: PubMed not MEDLINE

Original Publication: Basel, Switzerland : MDPI AG, [2012]-

Background: To evaluate outcomes in terms of survival and toxicity in a series of intermediate-risk prostate cancer (PCa) patients treated with hypofractionated radiotherapy (HyRT) + hormonal therapy (HT) with or without image guidance (IGRT) and to investigate the impact of different variables. Methods: This is a multi-centric study. From January 2005 to December 2019, we treated 313 intermediate-risk PCa patients (T2b−T2c, Gleason score 7, or pre-treatment PSA 10 to 20 ng/mL) with HyRT. Patients received 54.75 Gy in 15 fractions in 5 weeks plus 9 months of neo-adjuvant, concomitant, and adjuvant HT with or without IGRT. Results: Median follow-up was 91.6 months (range 5.1−167.8 months). Median OS was not reached, and the 8- and 10-year OS was 81.9% and 72.4%, respectively. Median CSS was not reached, and the 8- and 10-year CSS was 97.9% and 94.5%, respectively. PSA at first follow-up <0.8 ng/mL was significantly related to better oncological outcomes (CSS, bRFS, LRFS, cPFS, and MFS) in both univariate and multivariate analysis. After Propensity Score matching, grade 2−3 acute and cumulative late GU (p = 0.153 and p = 0.581, respectively) and GI (p = 0.196 and p = 0.925, respectively) toxicity were not statistically different in patients treated with or without IGRT. Conclusions: HyRT is effective and safe regardless of the use of IGRT. PSA at first follow-up is an easily accessible prognostic factor that may help the clinicians to identify patients who require a treatment intensification.
Competing Interests: The authors declare no conflict of interest.

Acta Oncol. 2005;44(3):265-76. (PMID: 16076699)
Lancet Oncol. 2011 May;12(5):451-9. (PMID: 21440505)
Int J Radiat Oncol Biol Phys. 2018 Dec 1;102(5):1420-1429. (PMID: 30071296)
Int J Radiat Oncol Biol Phys. 2006 Jul 15;65(4):965-74. (PMID: 16798415)
Int J Radiat Oncol Biol Phys. 2009 Aug 1;74(5):1405-18. (PMID: 19616743)
Eur Urol. 2013 Dec;64(6):895-902. (PMID: 23541457)
Int J Radiat Oncol Biol Phys. 2020 Jan 1;106(1):108-115. (PMID: 31593756)
Lancet Oncol. 2012 Jun;13(6):e259-69. (PMID: 22652234)
J Clin Oncol. 2017 Jun 10;35(17):1884-1890. (PMID: 28296582)
Radiat Oncol. 2016 Jun 08;11:78. (PMID: 27276878)
J Clin Oncol. 2017 Jun 10;35(17):1891-1897. (PMID: 28355113)
J Clin Oncol. 2016 Jul 10;34(20):2325-32. (PMID: 27044935)
Lancet Oncol. 2016 Apr;17(4):464-474. (PMID: 26968359)
Int J Radiat Oncol Biol Phys. 1995 Mar 30;31(5):1341-6. (PMID: 7713792)
Eur Urol Oncol. 2021 Dec;4(6):980-992. (PMID: 34489210)
J Clin Oncol. 2004 Sep 15;22(18):3726-32. (PMID: 15365069)
Cancer Treat Rev. 2016 Nov;50:48-60. (PMID: 27631875)
Clin Oncol (R Coll Radiol). 2015 May;27(5):260-9. (PMID: 25797579)
Control Clin Trials. 1996 Aug;17(4):343-6. (PMID: 8889347)
J Clin Oncol. 2008 May 20;26(15):2497-504. (PMID: 18413638)
J Clin Oncol. 2020 May 20;38(15):1676-1684. (PMID: 32119599)
Brachytherapy. 2020 Jan - Feb;19(1):43-50. (PMID: 31813740)
Eur Urol. 2021 Feb;79(2):243-262. (PMID: 33172724)
JAMA. 2008 Jan 23;299(3):289-95. (PMID: 18212313)
Int J Radiat Oncol Biol Phys. 2003 Jul 15;56(4):1093-104. (PMID: 12829147)
BJU Int. 2017 Nov;120(5B):E87-E95. (PMID: 28464446)
Lancet Oncol. 2016 Aug;17(8):1047-1060. (PMID: 27339115)
N Engl J Med. 2011 Jul 14;365(2):107-18. (PMID: 21751904)

Keywords: 3D-CRT; PSA; hypofractionated radiotherapy; intermediate-risk prostate cancer; prognostic factors

Date Created: 20220826 Latest Revision: 20230308

20240829

PMC9410091

10.3390/jcm11164783

36013023