Toxicity report of once weekly radiation therapy for low-risk prostate adenocarcinoma: preliminary results of a phase I/II trial

Radiation Oncology

Carole Lambert¹  Bernard Fortin²  Thu Van Nguyen¹  Hugo Villeneuve¹  Marie-Claude Beauchemin¹  Marjory Jolicoeur¹  Jean-Paul Bahary¹  David HA Nguyen²  Nicolas Brochet³  Éric Vigneault⁴  Cathy Menkarios² 

[1] Department of Radiation Oncology, Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada;Department of Radiation Oncology, Hôpital Maisonneuve-Rosemont, Montréal, Québec, Canada;Department of Radiation Oncology, Complexe hospitalier de la Sagamie, Chicoutimi, Québec, Canada;Department of Radiation Oncology, Centre hospitalier universitaire de Québec, Québec, Québec, Canada

关键词: toxicity;    hypofractionation;    radiotherapy;    prostate cancer;   

Others  :  1223903
DOI  :  10.1186/1748-717X-6-112

 received in 2011-03-30, accepted in 2011-09-09,  发布年份 2011

【 摘 要 】

Background

Increasing clinical data supports a low α/β ratio for prostate adenocarcinoma, potentially lower than that of surrounding normal tissues. A hypofractionated, weekly radiation therapy (RT) schedule should result in improved tumour control, reduced acute toxicity, and similar or decreased late effects. We report the toxicity profile of such treatment.

Materials and Methods

We conducted a multi-institution phase I/II trial of three-dimensional conformal radiation therapy (3D-CRT) for favourable-risk prostate cancer (T1a-T2a, Gleason ≤ 6 and PSA < 10 ng/ml). RT consisted of 45 Gy in nine 5 Gy fractions, once weekly. Primary end-points were feasibility and late gastrointestinal (GI) toxicity (RTOG scale), while secondary end-points included acute GI toxicity, acute and late genitourinary (GU) toxicity, biochemical control, and survival.

Results

Between 2006 and 2008, 80 patients were treated. No treatment interruptions occurred. The median follow-up is 33 months (range: 20-51). Maximal grade 1, 2, and 3 acute (< 3 months) GU toxicity was 29%, 31% and 5% respectively (no grade 4). Acute GI grade 1 toxicity was reported in 30% while grade 2 occurred in 14% (no grade 3 or 4). Crude late grade ≥ 3 toxicity rates at 31 months were 2% for both GU and GI toxicity. Cumulative late grade ≥ 3 GI toxicity at 3 years was 11%. Two patients had PSA failure according to the Phoenix definition. The three-year actuarial biochemical control rate is 97%.

Conclusions

Weekly RT with 45 Gy in 9 fractions is feasible and results in comparable toxicity. Long term tumour control and survival remain to be assessed.

【 授权许可】

   
2011 Menkarios et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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