Hypofractionated stereotactic boost in intermediate risk prostate carcinoma: Preliminary results of a multicenter phase II trial (CKNO-PRO)

Autor: Thomas Lacornerie, David Pasquier, Philippe Nickers, Eric Lartigau, Pascal Pommier, Philippe Maingon, Geoffrey Martinage, Emmanuelle Tresch, Didier Peiffert
Rok vydání: 2017
Předmět:
Male
0301 basic medicine
medicine.medical_treatment
Cancer Treatment
lcsh:Medicine
Drug research and development
Toxicology
Pathology and Laboratory Medicine
Metastasis
Prostate cancer
Clinical trials
0302 clinical medicine
Medicine and Health Sciences
lcsh:Science
Booster Doses
Aged
80 and over
Vaccines
Multidisciplinary
Prostate Cancer
Prostate Diseases
Middle Aged
Infectious Diseases
Oncology
030220 oncology & carcinogenesis
Toxicity
Anatomy
Phase II clinical investigation
Research Article
Clinical Oncology
medicine.medical_specialty
Infectious Disease Control
Urology
Urinary system
Radiation Therapy
Carcinomas
03 medical and health sciences
Exocrine Glands
Carcinoma
medicine
Humans
Aged
Pharmacology
business.industry
Genitourinary system
lcsh:R
Prostatic Neoplasms
Biology and Life Sciences
Cancers and Neoplasms
Prostate carcinoma
medicine.disease
Research and analysis methods
Radiation therapy
Genitourinary Tract Tumors
030104 developmental biology
lcsh:Q
Prostate Gland
Radiotherapy
Intensity-Modulated
Clinical Medicine
business
Zdroj: PLoS ONE
PLoS ONE, Vol 12, Iss 11, p e0187794 (2017)
ISSN: 1932-6203
Popis: Purpose Dose escalation may improve curability in intermediate-risk prostate carcinoma. A multicenter national program was developed to assess toxicity and tumor response with hypofractionated stereotactic boost after conventional radiotherapy in intermediate-risk prostate cancer. Methods and material Between August 2010 and April 2013, 76 patients with intermediated-risk prostate carcinoma were included in the study. A first course delivered 46 Gy by IMRT (68.4% of patients) or 3D conformal radiotherapy (31.6% of patients). The second course delivered a boost of 18 Gy (3x6Gy) within 10 days. Gastrointestinal (GI) and genitourinary (GU) toxicities were evaluated as defined by NCI-CTCAE (v4.0). Secondary outcome measures were local control, overall and metastasis-free survival, PSA kinetics, and patient functional status (urinary and sexual) according to the IIEF5 and IPSS questionnaires. Results The overall treatment time was 45 days (median, range 40–55). Median follow-up was 26.4 months (range, 13.6–29.9 months). Seventy-seven per cent (n = 58) of patients presented a Gleason score of 7. At 24 months, biological-free survival was 98.7% (95% CI, 92.8–99.9%) and median PSA 0.46 ng/mL (range, 0.06–6.20 ng/mL). Grade ≥2 acute GI and GU toxicities were 13.2% and 23.7%, respectively. Grade ≥2 late GI and GU toxicities were observed in 6.6% and 2.6% of patients, respectively. No grade 4 toxicity was observed. Conclusions Hypofractionated stereotactic boost is effective and safely delivered for intermediate-risk prostate carcinoma after conventional radiation. Mild-term relapse-free survival and tolerance results are promising, and further follow-up is warranted to confirm the results at long term. Trial registration ClinicalTrials.gov NCT01596816.
Databáze: OpenAIRE
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