title: Acute toxicity profile in prostate cancer with conventional and hypofractionated treatment.
abstract: OBJECTIVE
  To compare the acute toxicities in radical treatment of prostate cancer between conventional schedule (C-ARM) with 78 Gy/39 fractions and hypofractionation conformal treatment (H-ARM) with 69 Gy/23 fractions.
  
  
  METHODS
  This prospective double arm study consisted of 217 patients with prostate cancer, 112 in H-ARM and 105 in C-ARM arm. C-ARM received conventional six- field conformal radiotherapy with 78 Gy in 39 fractions while H-ARM received hypofractionation with 69 Gy in 23 fractions. Weekly assessment of acute reactions was done during treatment and with one, and 3 months using RTOG scale. Univariated analysis was performed to evaluate differences between the incidences of acute reaction in the treatment arms. Variables with p value less than 0.1 were included in the multivariated logistic regression.
  
  
  RESULTS
  There was no difference between H-ARM versus C-ARM for severity and incidence in genitourinary (GU) and gastrointestinal (GI) acute toxicity. During the treatment comparing H-ARM with C-ARM no differences was observed for GI toxicity (grade 0-3; H-ARM=45.5%, 34%, 18.7% and 1.8% versus C-ARM=47.6%, 35.2%, 17.2% and 0). For acute GU toxicity no difference was detected between H-ARM (grade 0-3; 22.3%, 54.5%, 18.7% and 4.5%) and C-ARM (grade 0-3; 25.8%, 53.3%, 17.1% and 3.8%).At the 3- months follow-up, persistent Grade> =2 acute GU and GI toxicity were 2.5% and 1.8% in H-ARM versus 5.7% and 3% in C-ARM (p>0.05). In univariated and multivariated analyses, there was not any dosimetric predictor for GI and GU toxicity.
  
  
  CONCLUSIONS
  Our data demonstrate that hypofractionated radiotherapy achieving high biological effective dose using conformal radiotherapy is feasible for prostate cancer, being well tolerated with minimal severe acute toxicity.
authors.affiliation: Department of Radiation Oncology, Marilia Medical School, Marília, São Paulo, Brazil. gusviani@gmail.com
authors.forename: Gustavo Arruda
authors.initials: GA
authors.lastname: Viani
authors.forename: Lucas Bernardes Godoy
authors.initials: LB
authors.lastname: da Silva
authors.forename: Bruna Bueno
authors.initials: BB
authors.lastname: da Silva
authors.forename: Yuri Bonicelli
authors.initials: YB
authors.lastname: Crempe
authors.forename: Vinicius Spazzapan
authors.initials: VS
authors.lastname: Martins
authors.forename: Ricardo Jose Rambaiolo
authors.initials: RJ
authors.lastname: Ferrari
authors.forename: Mariana Colbachini
authors.initials: MC
authors.lastname: Pólo
authors.forename: Bruno Thiago
authors.initials: BT
authors.lastname: Rossi
authors.forename: Elton
authors.initials: E
authors.lastname: Suguikawa
authors.forename: Giseli Correa
authors.initials: GC
authors.lastname: Zulliani
authors.forename: Eduardo Jose
authors.initials: EJ
authors.lastname: Stefano
mesh_terms: D000368:Aged; D019583:Dose Fractionation, Radiation; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal / Q000009:adverse effects* / Q000379:methods*; D012062:Relative Biological Effectiveness