title: Hypofractionated adjuvant radiotherapy with helical tomotherapy after radical prostatectomy: planning data and toxicity results of a Phase I-II study.
abstract: OBJECTIVE
  To report on planning and toxicity findings of hypofractionated adjuvant radiotherapy with helical Tomotherapy (HTT) after radical prostatectomy (RP) for prostate carcinoma (pCa).
  
  
  METHODS
  Fifty consecutive patients submitted to RP for pT2R1/pT3a/pT3b-pN0 pCa were enrolled in a Phase I-II trial to receive 58Gy/20 fractions (5/week) on tumoral bed. Endpoint was to verify a risk of toxicity and biochemical failure not exceeding that observed in our Institutional 3DCRT, conventionally fractionated series (153 patients). Toxicities were graded according the RTOG scoring system.
  
  
  RESULTS
  Excellent coverage of PTV and high homogeneity of dose distribution were always achieved. Median follow-up was 25 months. Acute G2-3 RTOG genitourinary (GU) and acute G2 intestinal toxicities were similar (12% vs 15.6% and 4% vs 7%, respectively), while acute G2 proctitis was 0% vs 9% in HTT and 3DCRT group, respectively. Similarly, late Grade 2 gastrointestinal sequelae were 0% vs 8.5%. The incidence of late urethral stricture, 8% and 9% in HTT and 3DCRT group, respectively, is comparable to that of RP-only series.
  
  
  CONCLUSIONS
  Acute toxicity and early late toxicity outcomes of a moderately hypofractionated regimen with HTT post-RP are excellent. A longer follow-up is needed to fully assess the validity of this approach.
authors.affiliation: Department of Radiotherapy, and Scientifc Institute H San Raffaele, Milan, Italy. cozzarini.cesare@hsr.it
authors.forename: Cesare
authors.initials: C
authors.lastname: Cozzarini
authors.forename: Claudio
authors.initials: C
authors.lastname: Fiorino
authors.forename: Nadia
authors.initials: N
authors.lastname: Di Muzio
authors.forename: Riccardo
authors.initials: R
authors.lastname: Valdagni
authors.forename: Andrea
authors.initials: A
authors.lastname: Salonia
authors.forename: Filippo
authors.initials: F
authors.lastname: Alongi
authors.forename: Sara
authors.initials: S
authors.lastname: Broggi
authors.forename: Giorgio
authors.initials: G
authors.lastname: Guazzoni
authors.forename: Francesco
authors.initials: F
authors.lastname: Montorsi
authors.forename: Patrizio
authors.initials: P
authors.lastname: Rigatti
authors.forename: Riccardo
authors.initials: R
authors.lastname: Calandrino
authors.forename: Ferruccio
authors.initials: F
authors.lastname: Fazio
mesh_terms: D000704:Analysis of Variance; D016009:Chi-Square Distribution; D019583:Dose Fractionation, Radiation; D005240:Feasibility Studies; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D015641:Radiography, Interventional; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects / Q000379:methods*; D036542:Tomography, Spiral Computed; D016896:Treatment Outcome