title: Moderate hypofractionation and simultaneous integrated boost by helical tomotherapy in prostate cancer: monoinstitutional report of acute tolerability assessment with different toxicity scales.
abstract: BACKGROUND
  Based on radiobiology evidence, hypofractionated radiotherapy has the potential of improving treatment outcome in prostate cancer patients. In this study, we evaluated the safety, in terms of acutetoxicity, of using moderate hypofractionated radiotherapy delivered with Helical Tomotherapy (HT) to treat prostate cancer patients.
  
  
  METHODS
  Between December 2012 and April 2014, 42 consecutive patients were treated with hypofractionated radiotherapy using HT. All patients received 70 Gy in 28 fractions to PTV1, which included the prostate. In the intermediate risk group, 61.6 Gy were delivered to PTV2, which included the seminal vesicles. In high risk patients, the pelvic nodes were added (PTV3) and received 50.4 Gy. Acute toxicity was recorded prospectively with RTOG and Common Terminology Criteria for Adverse Events 3.0, retrospectively with CTCAE 4.0. Expanded Prostate Cancer Index Composite (EPIC) was measured at baseline and 3 months after end of treatment, to investigate health related quality of life with regards to bladder and gastrointestinal function.
  
  
  RESULTS
  Acute toxicity was acceptable, independently from the system used to score side effects. Moderate genitourinary toxicity was more frequent than gastrointestinal toxicity. No correlation between acute side effects and patients' characteristics or physical dose parameters was registered. EPIC evaluation showed a negligible difference in urinary and bowel function post-treatment, that did not reach statistical significance.
  
  
  CONCLUSIONS
  Our experience confirms the safety of moderate hypofractionation delivered with HT in prostate cancer patients with low, intermediate and high risk.
authors.affiliation: Radiation Oncology, ARNAS-Civico Hospital, Palermo, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Ferrera
authors.affiliation: Radiation Oncology, ARNAS-Civico Hospital, Palermo, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Mortellaro
authors.affiliation: University of Palermo, Palermo, Italy.
authors.forename: Mariella
authors.initials: M
authors.lastname: Mannino
authors.affiliation: Radiation Oncology School, University of Palermo, Palermo, Italy. giovannic2006@libero.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Caminiti
authors.affiliation: Radiation Oncology School, University of Palermo, Palermo, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Spera
authors.affiliation: Radiation Oncology School, University of Palermo, Palermo, Italy.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Figlia
authors.affiliation: Medical Physics, ARNAS-Civico Hospital, Palermo, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Iacoviello
authors.affiliation: Statistic Sciences Faculty, University of Palermo, Palermo, Italy.
authors.forename: Gioacchino
authors.initials: G
authors.lastname: Di Paola
authors.affiliation: Radiation Oncology School, University of Palermo, Palermo, Italy.
authors.forename: Rosario
authors.initials: R
authors.lastname: Mazzola
authors.affiliation: Radiation Oncology School, University of Palermo, Palermo, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Lo Casto
authors.affiliation: RadiationOncology, Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Alongi
authors.affiliation: Radiation Oncology, ARNAS-Civico Hospital, Palermo, Italy.
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Pappalardo
authors.affiliation: Radiation Oncology School, University of Palermo, Palermo, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Lagalla
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011788:Quality of Life; D000069473:Radiation Dose Hypofractionation; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects / Q000379:methods*
keywords: Prostate; Quality of Life; Side effects; Tomotherapy