Image-guided hypofractionated proton beam therapy for low-risk prostate cancer: Analysis of quality of life and toxicity, PCG GU 002

Vargas, Carlos; Hartsell, William F.; Dunn, Megan; Keole, Sameer R.; Doh, L.; Chang, John; Larson, Gary

doi:10.1016/j.rpor.2016.01.002

Cited by 22 publications

(21 citation statements)

References 37 publications

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“…They did not find any apparent clinical difference in outcomes with moderate hypofractionated proton beam therapy compared with standard fractionation with a median follow‐up time of 18 months. The same group published an analysis of the quality of life and toxicity of the extreme hypofractionated treatment, and they found excellent QOL scores, persistently low American Urological Association Symptom Index (AUA) and no AE grade ≥3 . Considering long‐term results for extreme hypofractionation from CyberKnife, better dosimetric parameters of PBS and published results of interim analyses of PCG GU 002, extreme hypofractionated radiotherapy appears to be promising.…”

Section: Discussionmentioning

confidence: 99%

“…The same group published an analysis of the quality of life and toxicity of the extreme hypofractionated treatment, and they found excellent QOL scores, persistently low American Urological Association Symptom Index (AUA) and no AE grade ≥3. 11 Considering long-term results for extreme hypofractionation from CyberKnife, 5,6 better dosimetric parameters of PBS and published results of interim analyses of PCG GU 002, extreme hypofractionated radiotherapy appears to be promising. Our results support this fact.…”

Section: Hypofractionationmentioning

confidence: 99%

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Extreme hypofractionated proton radiotherapy for prostate cancer using pencil beam scanning: Dosimetry, acute toxicity and preliminary results

et al. 2019

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Introduction Extreme hypofractionated radiotherapy for prostate cancer is a common modality in photon therapy. Pencil beam scanning (PBS) in similar fractionation allows better dose distribution and makes proton therapy more available for such patients. The purpose of this study is the feasibility of extreme proton hypofractionated radiotherapy and publication of early clinical results. Methods Two hundred patients with early‐stage prostate cancer were treated with IMPT (intensity‐modulated proton therapy), extreme hypofractionated schedule (36.25 GyE in five fractions) between February 2013 and December 2015. Mean age of the patients was 64.3 years, and the mean value of prostate‐specific antigen (PSA) before treatment was 6.83 μg/L (0.6–17.3 μg/L). Ninety‐three patients (46.5%) were in the low‐risk group. One hundred and seven patients (53.5%) were in the intermediate‐risk group. Twenty‐nine patients (14.5%) had neoadjuvant hormonal therapy, and no patients had adjuvant hormonal therapy. Acute toxicity, late toxicity and short‐term results were evaluated. Results All patients finished radiotherapy without interruptions. The median follow‐up time was 36 months. The mean treatment time was 9.5 days (median 9 days). Acute toxicity according to Common Terminology Criteria for Adverse Events (CTCAE) v 4.0 was (gastrointestinal toxicity) GI (grade) G1‐17%, G2‐3.5%; (genitourinary toxicity) GU G1‐40%, G2‐19%; and no G3 toxicity was observed. Late toxicity was GI G1‐19%, G2‐5.5%; GU G1‐17%, G2‐4%; and no G3 toxicity was observed. PSA relapse was observed in one patient (1.08%) in the low‐risk group (pelvic lymph node involvement was detected) and in seven patients (6.5%) in the intermediate‐risk group (three lymph node metastases, two lymph node and bone metastases, two PSA relapses). No patient died of prostate cancer, and three patients died from other reasons. No local recurrence of cancer in the prostate was observed. Conclusions Proton beam radiotherapy for prostate cancer is feasible with a low rate of acute toxicity and promising late toxicity and effectivity.

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Section: Discussionmentioning

confidence: 99%

Section: Hypofractionationmentioning

confidence: 99%

Extreme hypofractionated proton radiotherapy for prostate cancer using pencil beam scanning: Dosimetry, acute toxicity and preliminary results

et al. 2019

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“…The inclusion of AOL beam configuration aimed to test the possibility of reducing the dose burden on the femoral heads in case of extreme hypofractionation. Although there have been clinical studies that used BL‐only proton beams in five fractions, they did not specifically report on adverse events lower than grade 3 for femoral heads during their 2‐year follow‐up . This means that the lower grade toxicities that are more prevalent in bilateral proton therapy, for example, hip pain, were excluded.…”

Section: Discussionmentioning

confidence: 99%

“…Although radiotherapy of prostate is currently practiced using standard fractionation regimens (eg, 44 fx at 1.8 Gy/fx over ~9 weeks), hypofractionation is gaining more clinical attention and momentum. Several clinical trials have found hypofractionated radiotherapy to be well‐tolerated by prostate cancer patients with no apparent differences in outcome and toxicities . Moderate hypofractionation protocols (eg, 60 Gy in 20 fx) were demonstrated as non‐inferior to conventional fractionations and were recommended to become the new standard of care for radiotherapy of localized prostate cancer …”

Section: Introductionmentioning

confidence: 99%

“…Several clinical trials have found hypofractionated radiotherapy to be well-tolerated by prostate cancer patients with no apparent differences in outcome and toxicities. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Moderate hypofractionation protocols (eg, 60 Gy in 20 fx) were demonstrated as non-inferior to conventional fractionations and were recommended to become the new standard of care for radiotherapy of localized prostate cancer. 5 Despite radiobiological advantages of hypofractionation, technical concerns of such treatments, for example, robustness to variations and motion must be fully addressed.…”

Section: Introductionmentioning

confidence: 99%

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