P068 Stereotactic body radiotherapy with four fractions for low- and intermediate-risk prostate cancer: Acute and late toxicity

Aluwini, S.; Beltramo, G.; Rooij, Peter van; Boormans, Joost L.; Kirkels, Wim J.; Kolkman-Deurloo, I.K.K.

doi:10.1016/s1569-9056(13)62393-3

Cited by 6 publications

(4 citation statements)

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“…An overview of trials comprising of at least 50 patients and results following extreme hypofractionation is provided in table 2 [33–35, 37, 39–51]. Additional evidence is provided by the Registry for Prostate Cancer Radiosurgery (RPCR) with an analysis of the largest cohort so far treated by extreme hypofractionated SBRT [43].…”

Section: Extreme Hypofractionationmentioning

confidence: 99%

Hypofractionated radiotherapy for localized prostate cancer

Höcht¹,

Aebersold

Albrecht

et al. 2016

Strahlenther Onkol

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AimThis article gives an overview on the current status of hypofractionated radiotherapy in the treatment of prostate cancer with a special focus on the applicability in routine use.MethodsBased on a recently published systematic review the German Society of Radiation Oncology (DEGRO) expert panel added additional information that has become available since then and assessed the validity of the information on outcome parameters especially with respect to long-term toxicity and long-term disease control.ResultsSeveral large-scale trials on moderate hypofractionation with single doses from 2.4–3.4 Gy have recently finished recruiting or have published first results suggestive of equivalent outcomes although there might be a trend for increased short-term and possibly even long-term toxicity. Large phase 3 trials on extreme hypofractionation with single doses above 4.0 Gy are lacking and only very few prospective trials have follow-up periods covering more than just 2–3 years.ConclusionUntil the results on long-term follow-up of several well-designed phase 3 trials become available, moderate hypofractionation should not be used in routine practice without special precautions and without adherence to the highest quality standards and evidence-based dose fractionation regimens. Extreme hypofractionation should be restricted to prospective clinical trials.

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Section: Extreme Hypofractionationmentioning

confidence: 99%

Hypofractionated radiotherapy for localized prostate cancer

Höcht¹,

Aebersold

Albrecht

et al. 2016

Strahlenther Onkol

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“…Regarding toxicity, we believe that our results were acceptable considering pioneering studies that reported relatively high incidences of Grade 2 and Grade 3 toxicities [ 22 – 29 ]. However, compared to current standard dose regimens such as 36 Gy in 5 fractions, our toxicity with 3 years of follow-up might have been slightly more severe, particularly for GI toxicities.…”

Section: Discussionmentioning

confidence: 55%

A phase II trial of stereotactic body radiotherapy in 4 fractions for patients with localized prostate cancer

et al. 2022

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Purpose/objective(s) To report results from our phase II study of stereotactic body radiotherapy (SBRT) delivering 36 Gy in 4 fractions for patients with localized prostate cancer. Materials/methods We enrolled 55 patients treated with SBRT delivering 36 Gy in 4 fractions between 2015 to 2018. All patients were categorized as low-risk (n = 4), intermediate-risk (n = 31) or high-risk (n = 20) according to National Comprehensive Cancer Network criteria. Median age was 73 years (range 54–86 years). Two-thirds of patients (n = 37) had received androgen-deprivation therapy for 3–46 months (median, 31 months). Median duration of follow-up was 36 months (range 1–54 months). We used Radiation Therapy Oncology Group and National Cancer Institute—Common Toxicity Criteria version 4 for toxicity assessments. Quality of life (QOL) outcomes were also evaluated using the Expanded Prostate Cancer Index Composite (EPIC). Results Protocol treatments were completed for all patients. Six patients experienced biochemical failures. Among these six patients, three patients experienced clinical failure. One patient showed bone metastasis before biochemical failure. One patient died of gastric cancer. The 3-year biochemical control rate was 89.8%. Acute grade 2 genitourinary (GU) and gastrointestinal (GI) toxicities were observed in 5 patients (9%) and 6 patients (11%), respectively. No grade 3 or higher acute toxicities were observed. Late grade 2 GU and GI toxicities were observed in 7 patients (13%) and 4 patients (7%), respectively. Late grade 3 GU and GI toxicities were observed in 1 patient (1.8%) each. EPIC scores decreased slightly during the acute phase and recovered within 3 months after treatment. Conclusion Our phase II study showed that SBRT delivering 36 Gy in 4 fractions was safe and effective with favorable QOL outcomes, although this regimen showed slightly more severe toxicities compared to current standards.

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“…The American Society for Radiation Oncology (ASTRO), American Society of Clinical Oncology (ASCO), and American Urological Association (AUA) guidelines recommend prescription doses between 35 Gy and 36.25 Gy in 5 fractions, and doses above 36.25 Gy are not suggested outside the setting of clinical trials due to the risk of late toxicities 2 . Table 6 shows the results of previous reports of relatively high incidences of ≥ Grade 2 toxicities 7 , 9 – 16 . Although it was not always high-dose prescriptions that led to high toxicity rates in previous studies, prescribed doses seem related to more severe toxicity, as our study suggested.…”

Section: Discussionmentioning

confidence: 99%

Multi-institutional retrospective analysis of ultrahypofractionated radiotherapy for Japanese prostate cancer patients

Ishiyama

Tsumura

Nagano³

et al. 2021

Sci Rep

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To report outcomes and risk factors of ultrahypofractionated (UHF) radiotherapy for Japanese prostate cancer patients. This multi-institutional retrospective analysis comprised 259 patients with localized prostate cancer from 6 hospitals. A total dose of 35–36 Gy in 4–5 fractions was prescribed for sequential or alternate-day administration. Biochemical failure was defined according to the Phoenix ASTRO consensus. Toxicities were assessed using National Cancer Institute Common Toxicity Criteria version 4. Tumor control and toxicity rates were analyzed by competing risk frames. Median follow-up duration was 32 months (range 22–97 months). 2- and 3-year biochemical control rates were 97.7% and 96.4%, respectively. Initial prostate-specific antigen (p < 0.01) and neoadjuvant androgen deprivation therapy (p < 0.05) were identified as risk factors for biochemical recurrence. 2- and 3-year cumulative ≥ Grade 2 late genitourinary (GU) toxicities were 5.8% and 7.4%, respectively. Corresponding rates of gastrointestinal (GI) toxicities were 3.9% and 4.5%, respectively. Grade 3 rates were lower than 1% for both GU and GI toxicities. No grade 4 or higher toxicities were encountered. Biologically effective dose was identified as a risk factor for ≥ Grade 2 late GU and GI toxicities (p < 0.05). UHF radiotherapy offered effective, safe treatment for Japanese prostate cancer with short-term follow-up. Our result suggest higher prescribed doses are related to higher toxicity rates.

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P068 Stereotactic body radiotherapy with four fractions for low- and intermediate-risk prostate cancer: Acute and late toxicity

Cited by 6 publications

References 0 publications

Hypofractionated radiotherapy for localized prostate cancer

Hypofractionated radiotherapy for localized prostate cancer

A phase II trial of stereotactic body radiotherapy in 4 fractions for patients with localized prostate cancer

Multi-institutional retrospective analysis of ultrahypofractionated radiotherapy for Japanese prostate cancer patients

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