Stereotactic hypofractionated accurate radiotherapy of the prostate (SHARP), 33.5 Gy in five fractions for localized disease: first clinical trial results
| Autor: | John M. Corman, Jack F. Fowler, L. Esagui, Huong T. Pham, R. Alex Hsi, B.L. Madsen |
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| Rok vydání: | 2006 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty medicine.medical_treatment Urology Urogenital System Stereotaxic Techniques Prostate cancer Prostate medicine Humans Radiology Nuclear Medicine and imaging Prospective Studies Aged Aged 80 and over Radiation business.industry Dose fractionation Rectum Prostatic Neoplasms Prostheses and Implants Middle Aged Prostate-Specific Antigen medicine.disease Acute toxicity Surgery Radiation therapy Gastrointestinal Tract medicine.anatomical_structure Oncology Localized disease Stereotaxic technique Toxicity Feasibility Studies Dose Fractionation Radiation Radiotherapy Conformal business Gastrointestinal Hemorrhage Algorithms |
| Zdroj: | International journal of radiation oncology, biology, physics. 67(4) |
| ISSN: | 0360-3016 |
| Popis: | Purpose: To evaluate the feasibility and toxicity of stereotactic hypofractionated accurate radiotherapy (SHARP) for localized prostate cancer. Methods and Materials: A Phase I/II trial of SHARP performed for localized prostate cancer using 33.5 Gy in 5 fractions, calculated to be biologically equivalent to 78 Gy in 2 Gy fractions (α/β ratio of 1.5 Gy). Noncoplanar conformal fields and daily stereotactic localization of implanted fiducials were used for treatment. Genitourinary (GU) and gastrointestinal (GI) toxicity were evaluated by American Urologic Association (AUA) score and Common Toxicity Criteria (CTC). Prostate-specific antigen (PSA) values and self-reported sexual function were recorded at specified follow-up intervals. Results: The study includes 40 patients. The median follow-up is 41 months (range, 21–60 months). Acute toxicity Grade 1–2 was 48.5% (GU) and 39% (GI); 1 acute Grade 3 GU toxicity. Late Grade 1–2 toxicity was 45% (GU) and 37% (GI). No late Grade 3 or higher toxicity was reported. Twenty-six patients reported potency before therapy; 6 (23%) have developed impotence. Median time to PSA nadir was 18 months with the majority of nadirs less than 1.0 ng/mL. The actuarial 48-month biochemical freedom from relapse is 70% for the American Society for Therapeutic Radiology and Oncology definition and 90% by the alternative nadir + 2 ng/mL failure definition. Conclusions: SHARP for localized prostate cancer is feasible with minimal acute or late toxicity. Dose escalation should be possible. |
| Databáze: | OpenAIRE |
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