Hypofractionated intensity-modulated radiotherapy in patients with localized prostate cancer: a preliminary study.
OBJECTIVE
The aim of this work was to assess the efficacy and tolerability of hypofractionated intensity-modulated radiotherapy (IMRT) in patients with localized prostate cancer.


METHODS
Thirty-nine patients who received radical hypofractionated IMRT were retrospectively reviewed. Based on a pelvic lymph node involvement risk of 15% as the cutoff value, we decided whether to deliver treatment prostate and seminal vesicle only radiotherapy (PORT) or whole pelvis radiotherapy (WPRT). Sixteen patients (41%) received PORT with prostate receiving 45 Gy in 4.5 Gy per fraction in 2 weeks and the other 23 patients (59%) received WPRT with the prostate receiving 72 Gy in 2.4 Gy per fraction in 6 weeks. The median equivalent dose in 2 Gy fractions to the prostate was 79.9 Gy based on the assumption that the α/β ratio is 1.5 Gy.


RESULTS
The median follow-up time was 38 months (range, 4 to 101 months). The 3-year biochemical failure-free survival rate was 88.2%. The 3-year clinical failure-free and overall survival rates were 94.5% and 96.3%, respectively. The rates of grade 2 acute genitourinary (GU) and gastrointestinal (GI) toxicities were 20.5% and 12.8%, respectively. None of the patients experienced grade ≥3 acute GU and GI toxicities. The grade 2-3 late GU and GI toxicities were found in 8.1% and 5.4% of patients, respectively. No fatal late toxicity was observed.


CONCLUSIONS
Favorable biochemical control with low rates of toxicity was observed after hypofractionated IMRT, suggesting that our radiotherapy schedule can be an effective treatment option in the treatment of localized prostate cancer.
Department of Radiation Oncology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea.
Hye Jin
HJ
Kang
Department of Radiation Oncology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea.
Chul-Seung
CS
Kay
Department of Radiation Oncology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea.
Seok Hyun
SH
Son
Department of Radiation Oncology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea.
Myungsoo
M
Kim
Department of Radiation Oncology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea.
In Young
IY
Jo
Department of Radiation Oncology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea.
So Jung
SJ
Lee
Department of Urology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea.
Dong Hwan
DH
Lee
Department of Urology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea.
Hong Jin
HJ
Suh
Department of Urology, Incheon St. Mary's Hospital, The Catholic University of Korea College of Medicine, Incheon, Korea.
Yong Sun
YS
Choi
Disease-free survival; Intensity-modulated radiotherapy; Prostate cancer; Toxicity