title: Image guided hypofractionated radiotherapy by helical tomotherapy for prostate carcinoma: toxicity and impact on Nadir PSA.
abstract: OBJECTIVE
  To evaluate the toxicity of a hypofractionated schedule for primary radiotherapy (RT) of prostate cancer as well as the value of the nadir PSA (nPSA) and time to nadir PSA (tnPSA) as surrogate efficacy of treatment.
  
  
  METHODS
  Eighty patients underwent hypofractionated schedule by Helical Tomotherapy (HT). A dose of 70.2 Gy was administered in 27 daily fractions of 2.6 Gy. Acute and late toxicities were graded on the RTOG/EORTC scales. The nPSA and the tnPSA for patients treated with exclusive RT were compared to an equal cohort of 20 patients treated with conventional fractionation and standard conformal radiotherapy.
  
  
  RESULTS
  Most of patients (83%) did not develop acute gastrointestinal (GI) toxicity and 50% did not present genitourinary (GU) toxicity. After a median follow-up of 36 months only grade 1 of GU and GI was reported in 6 and 3 patients as late toxicity. Average tnPSA was 30 months. The median value of nPSA after exclusive RT with HT was 0.28 ng/mL and was significantly lower than the median nPSA (0.67 ng/mL) of the conventionally treated cohort (P = 0.02).
  
  
  CONCLUSIONS
  Hypofractionated RT schedule with HT for prostate cancer treatment reports very low toxicity and reaches a low level of nPSA that might correlate with good outcomes.
authors.affiliation: Department of Radiation Oncology, IRCCS San Martino-IST, National Cancer Research Institute, 16100 Genoa, Italy.
authors.forename: Salvina
authors.initials: S
authors.lastname: Barra
authors.affiliation: Department of Radiation Oncology, IRCCS San Martino-IST, National Cancer Research Institute, 16100 Genoa, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Vagge
authors.affiliation: Department of Radiation Oncology, IRCCS San Martino-IST, National Cancer Research Institute, 16100 Genoa, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Marcenaro
authors.affiliation: University of Genoa, DISSAL, 16100 Genoa, Italy.
authors.forename: Gladys
authors.initials: G
authors.lastname: Blandino
authors.affiliation: University of Genoa, DISSAL, 16100 Genoa, Italy.
authors.forename: Giorgia
authors.initials: G
authors.lastname: Timon
authors.affiliation: University of Genoa, DISSAL, 16100 Genoa, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Vidano
authors.affiliation: University of Genoa, DISSAL, 16100 Genoa, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Agnese
authors.affiliation: Department of Medical Physics, IRCCS San Martino-IST, National Cancer Research Institute, Genova, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Gusinu
authors.affiliation: Department of Medical Physics, IRCCS San Martino-IST, National Cancer Research Institute, Genova, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Cavagnetto
authors.affiliation: Department of Radiation Oncology, IRCCS San Martino-IST, National Cancer Research Institute, 16100 Genoa, Italy ; University of Genoa, DISSAL, 16100 Genoa, Italy.
authors.forename: Renzo
authors.initials: R
authors.lastname: Corvò
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000954:Antigens, Surface / Q000097:blood; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000532:radiotherapy*; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D000954:Antigens, Surface; C468775:NPSA protein, human; D009363:Neoplasm Proteins
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