title: Role of the technical aspects of hypofractionated radiation therapy treatment of prostate cancer: a review.
abstract: The increasing use of moderate (<35 fractions) and extreme (<5 fractions) hypofractionated radiation therapy in prostate cancer is yielding favorable results, both in terms of maintained biochemical response and toxicity. Several hypofractionation (HF) schemes for the treatment of prostate cancer are available, although there is considerable variability in the techniques used to manage intra-/interfraction motion and deliver radiation doses. We performed a review of the published studies on HF regimens as a topic of interest for the Stereotactic Ablative Radiotherapy working group, which is part of the Italian Association of Medical Physics. Aspects of organ motion management (imaging for contouring, target volume definition, and rectum/bladder preparation) and treatment delivery (prostate localization, image guided radiation therapy strategy and frequency) were evaluated and categorized to assess outcome relative to disease control and toxicity. Despite the heterogeneity of the data, some interesting trends that emerged from the review might be useful in identifying an optimum HF strategy.
authors.affiliation: Istituto di Ricovero e Cura a Carattere Scientifico Centro di Riferimento Oncologico della Basilicata Rionero in Vulture, Potenza, Italy. Electronic address: clemente_stefania@libero.it.
authors.forename: Stefania
authors.initials: S
authors.lastname: Clemente
authors.affiliation: Azienda Sanitaria Locale Rieti, Roma, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Nigro
authors.affiliation: Istituto di Ricovero e Cura a Carattere Scientifico Centro di Riferimento Oncologico della Basilicata Rionero in Vulture, Potenza, Italy.
authors.forename: Caterina
authors.initials: C
authors.lastname: Oliviero
authors.affiliation: Azienda Sanitaria Locale Rieti, Roma, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Marchioni
authors.affiliation: Azienda Sanitaria, Firenze, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Esposito
authors.affiliation: Azienda Ospedaliera Città della Salute e della Scienza di Torino, Torino, Italy.
authors.forename: Francesca Romana
authors.initials: FR
authors.lastname: Giglioli
authors.affiliation: Humanitas Clinical and Research Hospital, Rozzano, Milano, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Mancosu
authors.affiliation: Humanitas Centro Catanese di Oncologia, Catania, Italy.
authors.forename: Carmelo
authors.initials: C
authors.lastname: Marino
authors.affiliation: Azienda Sanitaria, Firenze, Italy.
authors.forename: Serenella
authors.initials: S
authors.lastname: Russo
authors.affiliation: Azienda Ospedaliera Ordine Mauriziano di Torino, Torino, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Stasi
authors.affiliation: Istituto Nazionale Tumori Regina Elena, Roma, Italy.
authors.forename: Lidia
authors.initials: L
authors.lastname: Strigari
authors.affiliation: Universita' degli Studi di Milano, Milano, Italy.
authors.forename: Ivan
authors.initials: I
authors.lastname: Veronese
authors.affiliation: Istituto Nazionale Tumori Regina Elena, Roma, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Landoni
mesh_terms: D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D057918:Fiducial Markers; D041981:Gastrointestinal Tract / Q000528:radiation effects; D006801:Humans; D007103:Immobilization; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D009068:Movement; D058958:Organs at Risk / Q000528:radiation effects; D056888:Patient Positioning; D011471:Prostatic Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D011832:Radiation Injuries / Q000517:prevention & control; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods*; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods; D020266:Radiotherapy, Conformal / Q000009:adverse effects / Q000379:methods*; D012007:Rectum / Q000528:radiation effects; D014057:Tomography, X-Ray Computed; D001743:Urinary Bladder / Q000528:radiation effects; D014566:Urogenital System / Q000528:radiation effects