Prostate stereotactic body radiotherapy (SBRT) regimens differ in time, dose, and fractionation. We completed a multicentre, randomized phase II study to investigate the impact of overall treatment time on quality of life (QOL).
Men with low and intermediate-risk prostate cancer were randomly assigned to 40 Gy in 5 fractions delivered once per week (QW) vs. every other day (EOD). QOL was assessed using the Expanded Prostate Cancer Index Composite. The primary endpoint was the proportion with a minimum clinically important change (MCIC) in bowel QOL during the acute (≤12 week) period, and analysis was by intention-to-treat. ClinicalTrials.gov NCT01423474.
152 men from 3 centres were randomized with median follow-up of 47 months. Patients treated QW had superior acute bowel QOL with 47/69 (68%) reporting a MCIC compared to 63/70 (90%) treated EOD (p = 0.002). Fewer patients treated QW reported moderate-severe problems with bowel QOL during the acute period compared with EOD (14/70 [20%] vs. 40/70 [57%], p < 0.001). Acute urinary QOL was also better in the QW arm, with 52/67 (78%) vs 65/69 (94%) experiencing a MCIC (p = 0.006). There were no significant differences in late urinary or bowel QOL at 2 years or last follow-up.
Prostate SBRT delivered QW improved acute bowel and urinary QOL compared to EOD. Patients should be counselled regarding the potential for reduced short-term toxicity and improved QOL with QW prostate SBRT.
Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. 2018 Mar 15 [Epub ahead of print]
Harvey C Quon, Aldrich Ong, Patrick Cheung, William Chu, Hans T Chung, Danny Vesprini, Amit Chowdhury, Dilip Panjwani, Geordi Pang, Renee Korol, Melanie Davidson, Ananth Ravi, Boyd McCurdy, Liying Zhang, Alexandre Mamedov, Andrea Deabreu, Andrew Loblaw
Tom Baker Cancer Centre, Calgary, Canada. Electronic address: ., CancerCare Manitoba, Winnipeg, Canada., Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada., BC Cancer Agency, Abbotsford, Canada.