title: Stereotactic body radiotherapy with flattening filter-free beams for prostate cancer: assessment of patient-reported quality of life.
abstract: OBJECTIVE
  Stereotactic body radiotherapy (SBRT) is an emerging treatment approach reported as safe and effective strategy for low- and intermediate-risk prostate cancer patients. End point of the current study is to appraise the patient-reported quality of life according to the expanded prostate cancer index composite (EPIC) questionnaire.
  
  
  METHODS
  In the framework of a prospective mono-institutional phase II trial, EPIC questionnaire was dispensed (up to 1 year after treatment) to a cohort of 46 patients of 72 treated with 5 fractions of 7 Gy each to the prostate. SBRT was delivered with RapidArc VMAT with 10 MV flattening filter-free photon beams.
  
  
  RESULTS
  Median follow-up of patients was 14.5 months (range: 6-23). Acute rectal toxicity was mild (only 23/72 cases with G1-2 and no G3-4) as well as urinary (50/72 G1-2 and no G3-4). At the moment, four cases of G1 late rectal toxicity and 22 cases of G1 urinary (1 of G2) were reported. Urinary, rectal, sexual, and hormonal scores resulted stable over time: 1 year scores resulted, respectively, in -0.3, +2.8, -1.7, and -2.8 % variations with respect to baseline. No significant differences were observed also when data were stratified according to functional and bother sub-scales.
  
  
  CONCLUSIONS
  Stereotactic body radiotherapy (SBRT) treatment of prostate with RapidArc and high-intensity photon beams resulted to be well tolerated by patients with mild toxicity profiles and good patient-reported quality of life perception for the first year after treatment. Longer follow-up in the trial cohort is in progress.
authors.affiliation: Department of Radiotherapy and Radiosurgery, Istituto Clinico Humanitas Cancer Center, Rozzano, Milan, Italy, angelo.tozzi@humanitas.it.
authors.forename: Marta
authors.initials: M
authors.lastname: Scorsetti
authors.forename: Filippo
authors.initials: F
authors.lastname: Alongi
authors.forename: Elena
authors.initials: E
authors.lastname: Clerici
authors.forename: Tiziana
authors.initials: T
authors.lastname: Comito
authors.forename: Antonella
authors.initials: A
authors.lastname: Fogliata
authors.forename: Cristina
authors.initials: C
authors.lastname: Iftode
authors.forename: Pietro
authors.initials: P
authors.lastname: Mancosu
authors.forename: Piera
authors.initials: P
authors.lastname: Navarria
authors.forename: Giacomo
authors.initials: G
authors.lastname: Reggiori
authors.forename: Stefano
authors.initials: S
authors.lastname: Tomatis
authors.forename: Elisa
authors.initials: E
authors.lastname: Villa
authors.forename: Luca
authors.initials: L
authors.lastname: Cozzi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D007172:Erectile Dysfunction / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D017785:Photons / Q000627:therapeutic use*; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000532:radiotherapy*; D011788:Quality of Life; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods*; D012007:Rectum / Q000528:radiation effects; D057566:Self Report; D011795:Surveys and Questionnaires; D014555:Urination Disorders / Q000209:etiology
chemical_list: D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen