Long-term outcomes of a phase II trial of moderate hypofractionated image-guided intensity modulated radiotherapy (IG-IMRT) for localized prostate cancer

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• 作者：Hester Lieng^a ; ^b ; Melania Pintilie^c ; Andrew Bayley^a ; ^b ; Alejandro Berlin^a ; ^b ; Robert Bristow^a ; ^b ; Peter Chung^a ; ^b ; Mary Gospodarowicz^a ; ^b ; Roger Huang^a ; ^b ; ^d ; Cynthia Mé ; nard^a ; ^b ; ^e ; Padraig Warde^a ; ^b ; Charles Catton^a ; ^b ; ^{charles.catton@rmp.uhn.ca}
• 关键词：Prostate cancer ; Hypofractionation ; Radiotherapy ; Outcomes ; Late toxicity
• 刊名：Radiotherapy and Oncology
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：122
• 期：1
• 页码：93-98
• 全文大小：957 K
• 卷排序：122

文摘

To evaluate long-term radiation toxicity and biochemical control of two moderately hypofractionated radiotherapy regimens for prostate cancer.Material and methodsEligible men with localized prostate cancer received image-guided intensity modulated radiotherapy (IG-IMRT) to a dose of 60 or 66 Gy in 3 Gy fractions in a phase II trial. Endpoints included late gastrointestinal (GI) and genitourinary (GU) toxicity and biochemical failure (FFBF).ResultsNinety-six men received 60 Gy and 27 received 66 Gy. Accrual to the 66 Gy cohort terminated early due to excessive Grade 3–4 late toxicity. Median follow-up was 128 months (60 Gy) and 108 months (66 Gy). In the 60 Gy cohort, cumulative late Grade ⩾2 GI and GU toxicity at 8 years was 4% and 12% respectively. In the 66 Gy cohort, late Grade ⩾2 GI and GU toxicity was 21% and 4% respectively at 8 years. The 5- and 8-year FFBF for 60 Gy was 81% and 66%, and for 66 Gy was 88% and 80%.ConclusionsModerate hypofractionation with IG-IMRT to 60 Gy was associated with favorable late toxicity although late urinary toxicity and biochemical failures were observed beyond 5 years. Dose escalation to 66 Gy was associated with significantly worse late toxicity.