Treatment outcomes with hypofractionated high-dose radiation therapy for prostate cancer.
OBJECTIVE
To report the treatment results of a retrospective cohort of prostate cancer patients treated with Hypo-RT with a high equivalent biological effective dose (BED).


BACKGROUND
Hypofractionated radiotherapy (Hypo-RT) has gained popularity and interest in the treatment of prostate cancer. However, there are few experiences with adequate follow-up reporting treatment results using high equivalent dose with Hypo-RT.


METHODS
We assigned 149 men with low-, intermediate- and high-risk prostate cancer to receive Hypo-RT with a total dose of 69 Gy/23 fractions. Late gastrointestinal (GI) and genitourinary (GU) toxicity were prospectively evaluated according to modified RTOG criteria. Biochemical no evidence of disease (bNED) was defined as the nadir prostate-specific antigen level plus 2 ng/mL.


RESULTS
The median follow-up was 53 months. For the entire cohort, the 5-year bNED rate was 94.6%, and for low-, intermediate- and high-risk patients the 5-year bNED was 100%, 96.4%, and 86% (p = 0.007), respectively. The 5-year overall survival rate was 92%. Only 1 patient died from the disease at 48 months after treatment, giving a 5-year cancer-specific survival of 98%. The worst grade ≥2 rate GI and GU toxicity was 13.4% and 14%, respectively. No grade >3 toxicity was observed. The presence of grade ≥2 GI and GU toxicity at the last follow-up was only 1.3% and 3%, respectively.


CONCLUSIONS
Hypo-RT (69 Gy/23 fractions) with a high equivalent BED produces excellent rates of biochemical control for low, intermediate and high-risk prostate cancer. The long term GU and GI toxicity rates were considered low and acceptable.
Department of Radiation Oncology, Marilia Medical School, Marília, São Paulo, Brazil.
Gustavo Arruda
GA
Viani
Department of Radiation Oncology, Marilia Medical School, Marília, São Paulo, Brazil.
Bruno Tiago
BT
Rossi
Department of Radiation Oncology, Marilia Medical School, Marília, São Paulo, Brazil.
Elton
E
Suguikawa
Department of Radiation Oncology, Marilia Medical School, Marília, São Paulo, Brazil.
Gisele
G
Zuliani
Department of Radiation Oncology, Marilia Medical School, Marília, São Paulo, Brazil.
Eduardo Jose
EJ
Stefano
3D-CRT; Biochemical control; Late toxicity; Outcomes