Treatment of low-risk prostate cancer with radical hypofractionated accelerated radiotherapy with cytoprotection (HypoARC): An interim analysis of toxicity and efficacy - Abstract

Department of Radiotherapy Oncology, Democritus University of Thrace, PO BOX 12, Alexandroupolis 68100, Greece.

 

Radiobiological analysis of clinical data suggests that prostate cancer has a low α/β ratio, implying that large radiotherapy fractions may better control the disease. Acceleration of radiotherapy may be also of importance in a subset of tumors. In this study we assessed the feasibility and efficacy of a highly accelerated and hypofractionated scheme of radiotherapy (HypoARC), for the treatment of localized low risk prostate cancer.

Fifty-five patients with prostate cancer (T1-2 stage, Gleason score < 7 and prostate specific antigen (PSA) < 10 ng/ml) were treated with localized conformal 4-field radiotherapy to the prostate and seminal vesicles: 51 Gy were delivered (3.4 Gy/fraction, within 19 days). The biological dose to the prostate ranged from 67.9-91.7 Gy. Amifostine (0-1000 mg depending upon tolerance) was delivered daily for cytoprotection. The median follow-up of patients is 30 (6-69) months.

Early toxicity was overall low, proctitis being the most frequent side-effect (23.6% grade II). High dose amifostine significantly protected against proctitis (p=0.005). Grade 2 frequency and dysurea occurred in 1.8% and 3.7% of cases, respectively. There was no late toxicity ≥grade 2. Amifostine significantly protected against chronic frequency (p=0.02). Within a median follow-up of 30 months, one patient (1.8%) experienced a biochemical relapse.

HypoARC is feasible and safe for patients with low-risk prostate cancer and, considering also the high efficacy noted, a strong rationale is provided for the further evaluation of HypoARC in randomized trials.

Written by:
Koukourakis MI, Kyrgias G, Papadopoulou A, Panteliadou M, Giatromanolaki A, Sivridis E, Mavropoulou S, Kalogeris K, Nassos P, Milioudis N, Touloupidis S.   Are you the author?

Reference: Anticancer Res. 2011 May;31(5):1745-51.

PubMed Abstract
PMID: 21617234

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