Radiation Therapy for Prostate Cancer Using HYpofractionation Directed by UltraSound (RAPHYDUS): A Brazilian Public Health Care System Study.

Autor:	Faustino FLC; Radiotherapy Department, DF Star Hospital, Brasilia, Brazil., Altei WF; Radiation Oncology Department, Barretos Cancer Hospital, Sao Paulo, Brazil; Molecular Oncology Research Center, Barretos Cancer Hospital, Sao Paulo, Brazil. Electronic address: wanaltei@gmail.com., Canton HP; Radiotherapy Department, DF Star Hospital, Brasilia, Brazil., Morato L; Radiation Oncology Department, Barretos Cancer Hospital, Sao Paulo, Brazil., Jorge de Paula LLR; Molecular Oncology Research Center, Barretos Cancer Hospital, Sao Paulo, Brazil., Salvador GB; Radiation Oncology Department, Barretos Cancer Hospital, Sao Paulo, Brazil., Fonseca DSL; Radiation Oncology Department, Barretos Cancer Hospital, Sao Paulo, Brazil., Gonçalves TK; Radiation Oncology Department, Barretos Cancer Hospital, Sao Paulo, Brazil., Kupelian PA; Radiation Oncology Department, Ronald Reagan UCLA Medical Center, UCLA, Los Angeles, California., Zaparolli JC; Radiation Oncology Department, Barretos Cancer Hospital, Sao Paulo, Brazil., Ercolin L; Radiation Oncology Department, Barretos Cancer Hospital, Sao Paulo, Brazil., Marconi DG; Radiation Oncology Department, Barretos Cancer Hospital, Sao Paulo, Brazil; Rehabilitation Center, Barretos Cancer Hospital, Sao Paulo, Brazil.
Jazyk:	angličtina
Zdroj:	Practical radiation oncology [Pract Radiat Oncol] 2022 Jul-Aug; Vol. 12 (4), pp. e286-e295. Date of Electronic Publication: 2022 Apr 22.
DOI:	10.1016/j.prro.2022.04.001
Abstrakt:	Purpose: This study evaluated the toxicity associated with a short course dose-escalated hypofractionated radiation therapy (HFRT) using image guided RT with or without androgen suppression therapy in patients with prostate cancer. Methods and Materials: This single-center prospective observational study included 132 patients with prostate cancer from 2016 to 2020. Patients received HFRT using image guided RT (84%) with 3-dimensional (91%) or intensity modulated RT (9%). Total prescribed doses were 66 Gy (63%), 63 Gy (12%), and 60 Gy (24%) in 22, 21, or 20 daily fractions depending on organ-at-risk dose constraints. Acute toxicity was scored using Radiation Therapy Oncology Group criteria and the international prostate symptom index. The expanded prostate cancer index composite questionnaire was used to collect quality of life data (ranging from 0-100). Results: The study population consisted of 111 patients who completed RT during a period of 3 years. The risk groups were as follows: low risk (12%), intermediate (32%), and high (56%). None of the patients had suspicious lymph nodes. Ninety percent received androgen suppression therapy. Maximum acute genitourinary and gastrointestinal toxicity peaked at grade 3 in 4 of 111 evaluated patients (4%) and at grade 2 in 7 of 111 evaluated patients (8%), respectively. The average international prostate symptom score increased from 4.8 at pretreatment to 14.0 during week 4 and normalized (5.7) 3 months after treatment completion. Conclusions: The current HFRT dose-escalation trial has demonstrated the feasibility of administering 66 Gy in 22 fractions with low acute gastrointestinal and genitourinary toxicities. Further follow-up will report late toxicities and outcomes. (Copyright © 2022 American Society for Radiation Oncology. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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