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.
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.