title: Treatment of low-risk prostate cancer with radical hypofractionated accelerated radiotherapy with cytoprotection (HypoARC): an interim analysis of toxicity and efficacy.
abstract: OBJECTIVE
  Radiobiological analysis of clinical data suggests that prostate cancer has a low α/β ratio, implying that large radiotherapy fractions may better control the disease. Acceleration of radiotherapy may be also of importance in a subset of tumors. In this study we assessed the feasibility and efficacy of a highly accelerated and hypofractionated scheme of radiotherapy (HypoARC), for the treatment of localized low risk prostate cancer.
  
  
  METHODS
  Fifty-five patients with prostate cancer (T1-2 stage, Gleason score <7 and prostate specific antigen (PSA) <10 ng/ml) were treated with localized conformal 4-field radiotherapy to the prostate and seminal vesicles: 51 Gy were delivered (3.4 Gy/fraction, within 19 days). The biological dose to the prostate ranged from 67.9-91.7 Gy. Amifostine (0-1000 mg depending upon tolerance) was delivered daily for cytoprotection. The median follow-up of patients is 30 (6-69) months.
  
  
  RESULTS
  Early toxicity was overall low, proctitis being the most frequent side-effect (23.6% grade II). High dose amifostine significantly protected against proctitis (p=0.005). Grade 2 frequency and dysurea occurred in 1.8% and 3.7% of cases, respectively. There was no late toxicity ≥grade 2. Amifostine significantly protected against chronic frequency (p=0.02). Within a median follow-up of 30 months, one patient (1.8%) experienced a biochemical relapse.
  
  
  CONCLUSIONS
  HypoARC is feasible and safe for patients with low-risk prostate cancer and, considering also the high efficacy noted, a strong rationale is provided for the further evaluation of HypoARC in randomized trials.
authors: Department of Radiotherapy-Oncology, Democritus University of Thrace, University Hospital of Alexandroupolis, Greece. targ@her.forthnet.gr
authors: Michael I
authors: MI
authors: Koukourakis
authors: George
authors: G
authors: Kyrgias
authors: Aikaterini
authors: A
authors: Papadopoulou
authors: Marianthi
authors: M
authors: Panteliadou
authors: Alexandra
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authors: Giatromanolaki
authors: Efthimios
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authors: Sivridis
authors: Sophia
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authors: Mavropoulou
authors: Kriton
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authors: Kalogeris
authors: Pavlos
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authors: Nassos
authors: Nicolaos
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authors: Milioudis
authors: Stavros
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authors: Touloupidis