Accelerating prostate stereotactic ablative body radiotherapy: Efficacy and toxicity of a randomized phase II study of 11 versus 29 days overall treatment time (PATRIOT)
| Autor: | Danny Vesprini, Ananth Ravi, Harvey Quon, Patrick Cheung, Dilip Panjwani, Andrea Deabreu, Aldrich Ong, Amit Chowdhury, Alexandre Mamedov, Melanie Davidson, Yasir Alayed, William Chu, Liying Zhang, Hans Chung, Geordi Pang, Andrew Loblaw, Renee Korol, Boyd McCurdy |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Male
Canada medicine.medical_specialty medicine.medical_treatment Urology Salvage therapy Phases of clinical research Radiosurgery SABR volatility model 030218 nuclear medicine & medical imaging 03 medical and health sciences Prostate cancer 0302 clinical medicine Quality of life Prostate medicine Humans Radiology Nuclear Medicine and imaging business.industry Prostatic Neoplasms Hematology medicine.disease Radiation therapy medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Toxicity Quality of Life Dose Fractionation Radiation business |
| Zdroj: | Radiotherapy and Oncology. 149:8-13 |
| ISSN: | 0167-8140 |
| Popis: | Background Prostate stereotactic ablative radiotherapy (SABR) regimens differ in time, dose, and fractionation. We report an update of a multicentre, Canadian randomized phase II study to investigate the impact of overall treatment time on quality of life (QOL), efficacy, and toxicity. Methods Men with intermediate risk prostate cancer were randomized to 40 Gy in 5 fractions delivered every other day (EOD) versus once per week (QW). Primary outcome was proportion of patients experiencing a minimally clinically important change (MCIC) in acute bowel QOL using EPIC. Secondary outcomes were toxicity, biochemical failure (BF), other QOL domains, and the rate of salvage therapy. Findings 152 men from 3 centers were randomized; the median follow-up was 62 months. Results are described for EOD versus QW. Acute bowel and urinary QOL was reported previously. Late changes in QOL were not significantly different between the two arms. There were 1 (1.3%) vs 3 (2.7%) late grade 3 + GI toxicities (p = 0.36) and 5 (6.7%) vs 2 (2.7%) late grade 3 GU toxicities (p = 0.44). Two and 5 patients had BF (5-year failure rate 3.0 vs 7.2%, p = 0.22); 0 and 4 patients received salvage therapy (p = 0.04). 5-Year OS and CSS was 95.8% and 98.6% with no difference between arms (p = 0.49, p = 0.15). 3 patients in the QW arm developed metastases. Interpretation Although we previously reported that weekly prostate SABR had better bowel and urinary QOL compared to EOD, the updated results show no difference in late toxicity, QOL, BF, or PSA kinetics. Patients should be counseled that QW SABR reduces short-term toxicity compared to QW SABR. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect