Two versus five stereotactic ablative radiotherapy treatments for localized prostate cancer: A quality of life analysis of two prospective clinical trials
| Autor: | Aldrich Ong, Amit Chowdhury, Yasir Alayed, William Chu, Renee Korol, Hans Chung, Kristina Commisso, Ananth Ravi, Harvey Quon, Dilip Panjwani, Alexandre Mamedov, Geordi Pang, Danny Vesprini, Boyd McCurdy, Liying Zhang, Patrick Cheung, Melanie Davidson, Angela Commisso, Joelle Helou, Andrea Deabreu, Andrew Loblaw |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Urology Phases of clinical research Radiosurgery SABR volatility model 030218 nuclear medicine & medical imaging law.invention 03 medical and health sciences Prostate cancer 0302 clinical medicine Randomized controlled trial Quality of life law Prostate Humans Medicine Radiology Nuclear Medicine and imaging Prospective Studies Aged business.industry Prostatic Neoplasms Hematology Middle Aged medicine.disease Clinical trial medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Cohort Quality of Life business |
| Zdroj: | Radiotherapy and Oncology. 140:105-109 |
| ISSN: | 0167-8140 |
| DOI: | 10.1016/j.radonc.2019.06.018 |
| Popis: | Purpose Stereotactic ablative radiotherapy (SABR) is appealing for prostate cancer (PCa) due to low α/β, and increasing the dose per fraction could improve the therapeutic index and lead to a better quality of life (QOL). Here we report the outcomes of a QOL comparison between two phase II clinical trials: two vs. five fraction prostate SABR. Methods Patients had low or intermediate risk PCa. The doses prescribed were 26 Gy/2 and 40 Gy/5. Expanded prostate cancer index composite was collected. Urinary, bowel and sexual domains were analyzed. Minimal clinically important change (MCIC) was defined as >0.5 standard deviation. Results 30 and 152 patients were treated with 2-fraction and 5-fraction SABR. Median follow-up was 55 and 62 months. Five-year biochemical failure rate was 3.3% and 4.6%. The 2-fraction cohort had a significantly better mean QOL over time in the bowel domain ( p = 0.0004), without a significant difference in the urinary or sexual domains. The 2-fraction cohort had a significantly lower rate of bowel MCIC (17.8% vs 42.3%, p = 0.01), but there was no difference in urinary (24.1% vs 35.7%) or sexual (15.3% vs 29.2%) MCIC. For MCIC x2 (moderate QOL change), the 2-fraction trial had significantly lower MCIC rates in both the bowel (7.1% vs 24%, p = 0.04) and sexual (0 vs 17.6%, p = 0.01) domains. Conclusions 2-Fraction SABR is feasible to deliver and well tolerated, with significant signals of improved bowel and sexual QOL. A randomized trial of two vs. five fractions for prostate SABR is needed to confirm the promising findings of this study. |
| Databáze: | OpenAIRE |
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