We previously reported outcomes after hypofractionated postprostatectomy radiotherapy (HYPORT) with a median follow-up of 32 months. This was a primary citation supporting the fractionation selection for NRG-GU003 which showed noninferiority of HYPORT vs conventional radiotherapy.
161 consecutive patients with biochemically recurrent prostate cancer after prostatectomy underwent HYPORT from 2003-2013 at a single academic institution using image-guided intensity-modulated radiotherapy (IG-IMRT), with the majority (154/161) receiving 65 Gy in 26 fractions. A modified LENT/RTOG scoring system was used to grade late genitourinary toxicities.
Median follow-up was 13.5 years. Forty-four patients (27.3%) experienced 58 late grade 3-5 toxicities (LTOX3) a median of 106 months after HYPORT. 55 of 58 LTOX3 were genitourinary related. Higher grade toxicities included 6 cystectomies and 3 deaths. At 2 years, only two patients had experienced a LTOX3. At 15 years, overall survival was 70%, freedom from biochemical recurrence was 52%, and the risk of LTOX3 was 34%.
Long follow-up is needed to fully capture severe toxicities following dose-escalated HYPORT. This should be considered prior to broad adoption of similar regimens for this patient population with long survival potential.
International journal of radiation oncology, biology, physics. 2025 Apr 11 [Epub ahead of print]
Kaili Ranta, Andrzej P Wojcieszynski, Shuang G Zhao, Yingzhou Liu, David F Jarrard, Menggang Yu, Karol Huenerberg, Ryan Hutten, Greg Cooley, Timothy J Kruser, Mark A Ritter, John Floberg
Department of Human Oncology, University of Wisconsin Hospital and Clinics, Madison, WI. Electronic address: ., Kaiser Permanente, Denver, CO., Department of Human Oncology, University of Wisconsin Hospital and Clinics, Madison, WI., Analysis Group Inc., Los Angeles, CA., Department of Urology, University of Wisconsin Hospital and Clinics, Madison, WI., Department of Biostatistics, University of Michigan, Ann Arbor, MI.