title: SHARP hypofractionated stereotactic radiotherapy is well tolerated in prostate cancer : Toxicity and quality of life assessment.
abstract: BACKGROUND
  Quality of life (QoL) is one of the most significant issues in prostate cancer treatment decisions. This study aimed to investigate the toxicity of hypofractionated stereotactic radiotherapy (SBRT) and QoL after treatment in localized prostate cancer patients.
  
  
  METHODS
  A prospective single-center clinical study was performed in low- and intermediate-risk prostate cancer patients. Patients received 33.5 Gy in 5 fractions (SHARP regimen). Acute and late toxicity was assessed according to RTOG/EORTC score. Patients filled out EORTC QLQ-C30 and prostate cancer-specific QLQ-PR25 questionnaires.
  
  
  RESULTS
  The analysis included 68 prostate cancer patients (55-83 years, median 73) with clinical stage T1c-T2cN0M0, median combined Gleason score of 6 (3-8), and median prostate-specific antigen (PSA) level of 10 ng/mL (4-20 ng/mL). Neoadjuvant androgen deprivation therapy was given to 52 patients (76.5 %), and stopped in 31 patients (45.5 %) after 6 months; in 21 patients (31 %) after 2-3 years. Average and median follow-up was 24 months (18-45). Median nadir PSA level was 0.03 ng/mL for all patients and 0.6 ng/mL for patients without hormone treatment. No patients had PSA failure. There were no acute grade IV toxicities. One patient (1.5 %) developed grade III and 24 patients (35.3 %) grade II acute bladder toxicity. No one developed grade III and 7 patients (10.3 %) grade II acute rectal toxicity. No grade III or IV late gastrointestinal or genitourinary toxicities were reported. Grade II late urinary symptoms were observed in 8 patients (11.8 %) and gastrointestinal symptoms in 3 patients (4.4 %). Global health status/QoL was good and improved during the observational period.
  
  
  CONCLUSIONS
  SBRT for prostate cancer patients is a well-tolerated treatment in terms of toxicity and QoL, has no negative impact on functioning and everyday life, with the important benefit of a short treatment period. However, long-term follow-up data are needed.
authors.affiliation: Department of Oncology, University of Warmia and Mazury in Olsztyn, Olsztyn, Poland. m_rucinska@poczta.onet.pl.|Department of Radiation Oncology, Independent Public Health Care Facility of the Ministry of the Interior with Warmia and Mazury Oncology Centre in Olsztyn, Wojska Polskiego 37, 10-228, Olsztyn, Poland. m_rucinska@poczta.onet.pl.
authors.forename: Monika
authors.initials: M
authors.lastname: Rucinska
authors.affiliation: Polish Association of Cognitive and Behavioural Therapy, Minds of Hope, Warsaw, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Kieszkowska-Grudny
authors.affiliation: Department of Oncology and Radiotherapy, Medical University of Silesia, Katowice, Poland.
authors.forename: Sergiusz
authors.initials: S
authors.lastname: Nawrocki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D058958:Organs at Risk / Q000528:radiation effects; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000523:psychology* / Q000532:radiotherapy*; D011788:Quality of Life / Q000523:psychology*; D000069473:Radiation Dose Hypofractionation; D011832:Radiation Injuries / Q000175:diagnosis / Q000209:etiology / Q000523:psychology*; D016634:Radiosurgery / Q000009:adverse effects* / Q000379:methods; D016896:Treatment Outcome
keywords: Bladder; Hypofractionated stereotactic radiotherapy; Organs of risk; Quality of Life; Rectum