title: Early toxicity of hypofractionated radiotherapy for prostate cancer.
abstract: BACKGROUND
  Hypofractionated accelerated radiotherapy (HART) is now a feasible option for prostate cancer treatment apropos toxicity, biochemical control and shortening of treatment. The aim of this study was to investigate hypofractionated schedules in the treatment of patients with localized prostate cancer.
  
  
  METHODS
  Between 2011-2014, 158 patients were treated using the RapidArc technique with IGRT. The target volume for low risk patients was the prostate alone with a prescribed dose of 20x3.0 Gy (EQD2=77 Gy). Targets volumes for intermediate and high risk patients were prostate and two thirds of the seminal vesicles with a prescribed dose 21-22x3.0/2.1 Gy (EQD2=81/45.4-84.9/47.5). Based on radiobiological modelling of early toxicity, we used four fractions per week in the low risk group and four fractions in odd weeks and three fractions in even weeks in intermediate and high risk groups. The RTOG/EORTC toxicity scale was used.
  
  
  RESULTS
  Early genitourinary (GU) toxicity was observed for grades 0, 1, 2, 3 and 4 in 73 (46%), 60 (38%), 22 (14%), 0 and 3 (2%), respectively; early gastrointestinal (GI) toxicity was recorded for grades 0, 1, 2 and 3 in 119 (75%), 37 (23%), and 2 (1%) patients, respectively.
  
  
  CONCLUSIONS
  A combination of moderate hypofractionation, number of fractions per week adapted to target volume and precise dose delivery technique with image guidance appears safe with low early toxicity. Longer follow up is needed to assess late toxicity and tumor control probability.
authors.affiliation: Clinic of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic.|Regional Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic.
authors.forename: Pavel
authors.initials: P
authors.lastname: Krupa
authors.affiliation: Department of Medical Physics, Masaryk Memorial Cancer Institute, Brno, Czech Republic.
authors.forename: Hana
authors.initials: H
authors.lastname: Ticha
authors.affiliation: Clinic of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic.
authors.forename: Tomas
authors.initials: T
authors.lastname: Kazda
authors.affiliation: Clinic of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic.
authors.forename: Radana
authors.initials: R
authors.lastname: Dymackova
authors.affiliation: Clinic of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic.
authors.forename: Jana
authors.initials: J
authors.lastname: Zitterbartova
authors.affiliation: Department of Medical Physics, Masaryk Memorial Cancer Institute, Brno, Czech Republic.
authors.forename: Anna
authors.initials: A
authors.lastname: Odlozilikova
authors.affiliation: Clinic of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic.
authors.forename: Libor
authors.initials: L
authors.lastname: Kominek
authors.affiliation: Clinic of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic.
authors.forename: Lukas
authors.initials: L
authors.lastname: Bobek
authors.affiliation: Clinic of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic.
authors.forename: Ales
authors.initials: A
authors.lastname: Kudlacek
authors.affiliation: Clinic of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic.|Regional Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic.
authors.forename: Pavel
authors.initials: P
authors.lastname: Slampa
mesh_terms: D000368:Aged; D005240:Feasibility Studies; D005270:Femur Head / Q000528:radiation effects; D006801:Humans; D008297:Male; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D000069473:Radiation Dose Hypofractionation; D011832:Radiation Injuries / Q000517:prevention & control; D011878:Radiotherapy / Q000009:adverse effects; D011880:Radiotherapy Planning, Computer-Assisted; D012007:Rectum / Q000528:radiation effects; D012307:Risk Factors; D001743:Urinary Bladder / Q000528:radiation effects
keywords: Normal tissue complication probability; RapidArc; Tumor control probability; VMAT; alternated time schedule; hypofractionationation; volumetric arc therapy