Early toxicity of hypofractionated radiotherapy for prostate cancer

Autor: Lukas Bobek, Hana Tichá, Libor Komínek, Jana Zitterbartová, Pavel Krupa, Anna Odlozilikova, Aleš Kudláček, Pavel Šlampa, Radana Dymackova, Tomas Kazda
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Male
medicine.medical_specialty
medicine.medical_treatment
Urinary Bladder
Urology
Rectum
lcsh:Medicine
General Biochemistry
Genetics and Molecular Biology
030218 nuclear medicine & medical imaging
03 medical and health sciences
Prostate cancer
0302 clinical medicine
Prostate
Risk Factors
normal tissue complication probability
medicine
rapidarc
Humans
alternated time schedule
Radiation Injuries
Aged
Urinary bladder
Radiotherapy
hypofractionationation
Genitourinary system
business.industry
Radiotherapy Planning
Computer-Assisted
lcsh:R
Prostatic Neoplasms
Femur Head
medicine.disease
tumor control probability
Radiation therapy
medicine.anatomical_structure
Dose Hypofractionation
030220 oncology & carcinogenesis
Toxicity
volumetric arc therapy
Feasibility Studies
Radiation Dose Hypofractionation
vmat
business
Nuclear medicine
Zdroj: Biomedical Papers, Vol 160, Iss 3, Pp 435-441 (2016)
ISSN: 1804-7521
1213-8118
Popis: Background: Hypofractionated accelerated radiotherapy (HART) is now a feasible option for prostate cancer treatment apropos toxicity, biochemical control and shortening of treatment. The aim of this study was to investigate hypofractionated schedules in the treatment of patients with localized prostate cancer. Patients and Methods: Between 2011-2014, 158 patients were treated using the RapidArc technique with IGRT. The target volume for low risk patients was the prostate alone with a prescribed dose of 20x3.0 Gy (EQD2=77 Gy). Targets volumes for intermediate and high risk patients were prostate and two thirds of the seminal vesicles with a prescribed dose 21-22x3.0/2.1 Gy (EQD2=81/45.4-84.9/47.5). Based on radiobiological modelling of early toxicity, we used four fractions per week in the low risk group and four fractions in odd weeks and three fractions in even weeks in intermediate and high risk groups. The RTOG/EORTC toxicity scale was used. Results: Early genitourinary (GU) toxicity was observed for grades 0, 1, 2, 3 and 4 in 73 (46%), 60 (38%), 22 (14%), 0 and 3 (2%), respectively; early gastrointestinal (GI) toxicity was recorded for grades 0, 1, 2 and 3 in 119 (75%), 37 (23%), and 2 (1%) patients, respectively. Conclusion: A combination of moderate hypofractionation, number of fractions per week adapted to target volume and precise dose delivery technique with image guidance appears safe with low early toxicity. Longer follow up is needed to assess late toxicity and tumor control probability.
Databáze: OpenAIRE
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