title: Combined hypofractionated radiation and hormone therapy for the treatment of intermediate-risk prostate cancer.
abstract: OBJECTIVE
  Because of the low alpha/beta value of prostate cancer, a therapeutic gain may be possible with a hypofractionated radiation scheme, and this gain may be further increased with the adjunct of hormone therapy. A Phase II study was undertaken to study the toxicity of such a treatment.
  
  
  METHODS
  Forty-two patients with intermediate-risk prostate cancer were recruited for this study. Neoadjuvant and concomitant hormone therapy consisted of one injection of leuprolide acetate (4-month preparation) and 1 month of oral nonsteroidal, anti-androgen medication starting on the day of the injection. Radiation treatment was started 8 weeks after the injection and patients received 57 Gy in 19 fractions.
  
  
  RESULTS
  Median follow-up was 46 months. The treatment was well tolerated and no interruptions occurred. The majority (59%) had Grade 0 or 1 acute genitourinary (GU) toxicity, whereas 36% had Grade 2 and 5% had Grade 3 acute GU toxicity. Only Grade 1 or 2 gastrointestinal toxicity was seen. All chronic toxicity was of Grade 1 or 2 except for 3 patients (8%) with Grade 3 toxicity. Sixty-eight percent (68%) of patients had no long-term side effects from the treatment. At time of analysis, 79% showed no sign of treatment failure.
  
  
  CONCLUSIONS
  Hypofractionated radiation with neoadjuvant and concomitant hormone therapy is well tolerated with no significant short- or long-term morbidity. Control for this risk group is good, and comparative Phase III studies should be undertaken to determine whether this treatment is superior to new evolving treatments.
authors.affiliation: Department of Radiation Oncology, University of Montreal, CHUM - Notre-Dame Hospital, Montreal, Quebec, Canada.
authors.forename: Michael
authors.initials: M
authors.lastname: Yassa
authors.forename: Bernard
authors.initials: B
authors.lastname: Fortin
authors.forename: Marie-Andrée
authors.initials: MA
authors.lastname: Fortin
authors.forename: Carole
authors.initials: C
authors.lastname: Lambert
authors.forename: Thu
authors.initials: T
authors.lastname: Van Nguyen
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Bahary
mesh_terms: D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy / Q000379:methods; D019583:Dose Fractionation, Radiation; D005500:Follow-Up Studies; D041981:Gastrointestinal Tract / Q000528:radiation effects; D006801:Humans; D016729:Leuprolide / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000150:complications; D014566:Urogenital System / Q000528:radiation effects
chemical_list: D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D017430:Prostate-Specific Antigen; D016729:Leuprolide