Palliative pelvic radiotherapy for symptomatic incurable prostate cancer – A prospective multicenter study

Cameron, Marte Grønlie; Kersten, Christian; Vistad, Ingvild; Helvoirt, R. Van; Weyde, Kjetil; Undseth, Christine; Mjaaland, Ingvil; Skovlund, Eva; Fosså, Sophie D.; Guren, Marianne G.

doi:10.1016/j.radonc.2015.05.021

Cited by 24 publications

(13 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Response rates were good for pain and rectal dysfunction as well although symptomatic improvement was slower and time courses more variable than for hematochezia. This is consistent with findings in other pelvic cancers, such as prostate [9], bladder [17] and gynecological cancers [18], and may reflect the fact that palliation of pain and rectal dysfunction requires a degree of tumor shrinkage. PPRT in this study was well tolerated, with primarily transient low-grade toxicities reported.…”

Section: Discussionsupporting

confidence: 89%

“…This clinically significant finding, indicating that PPRT impacts positively on a constellation of simultaneous pelvic symptoms, gives added value to PPRT compared to other modalities which typically target only one or a few isolated symptoms. As with other pelvic tumors, results demonstrate that the positive effects of PPRT outweigh the negative [9].…”

Section: Discussionmentioning

confidence: 52%

“…Hematuria and pain were particularly well palliated, with 11/12 and 7/9 responders, respectively [9]. A randomized study of PPRT of bladder cancer comparing 35 Gy in 10 fractions to 21 Gy in 3 fractions, found no differences in efficacy or toxicity between the two arms (overall 68% of patients achieving symptomatic improvement) three months after treatment [24].…”

Section: Discussionmentioning

confidence: 99%

“…After feasibility testing [8], we performed two parallel nationwide prospective multicenter phase II single arm studies (PallRad1) of PPRT in the range of 30-39 Gy for prostate and RCs [9]. The range of doses was chosen because it covered the most commonly used fractionation schedules in Norway when the study was planned.…”

mentioning

confidence: 99%

See 3 more Smart Citations

Palliative pelvic radiotherapy for symptomatic rectal cancer – a prospective multicenter study

et al. 2016

Self Cite

View full text Add to dashboard Cite

Background and purpose: Palliative pelvic radiotherapy (PPRT) is used to treat locally advanced rectal cancer (RC) although symptomatic effects and toxicities are poorly documented. Aims were to evaluate symptom severity, quality of life (QOL) and toxicity after PPRT. Material and methods: Fifty-one patients with symptomatic primary or recurrent RC prescribed PPRT with fractions of 3 Gy to 30-39 Gy were included. Primary outcome was severity of target symptoms (TS) 12 weeks after PPRT. Pelvic symptom burden, toxicity, and QOL were assessed. Response was defined as patient-reported TS improvement or resolution. Results: Pain (n ¼ 24), rectal dysfunction (n ¼ 16), and hematochezia (n ¼ 9) were the most common TSs. Overall response rate among evaluable patients 12 weeks after PPRT was 28/33 (85%). Eighteen patients did not complete the study follow-up, 16 due to deteriorating health. TS responses were 10/13 (77%) for pain, 9/10 (90%) for rectal dysfunction, and 8/8 for hematochezia. Non-target pelvic symptom severity decreased and median QOL scores remained stable. There was no grade 4 toxicity. Median survival was nine months. Conclusions: In the majority of patients with symptomatic primary or recurrent RC, PPRT with 30-39 Gy contributes to pelvic symptom relief, with little toxicity. Patients prescribed PPRT of RC have limited life expectancy. Future studies should investigate simplification of PPRT.

show abstract

Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Palliative pelvic radiotherapy for symptomatic rectal cancer – a prospective multicenter study

et al. 2016

Self Cite

View full text Add to dashboard Cite

show abstract

“…In a study on palliative pelvic RT (30-39 Gy in 10-13 fractions) for symptomatic incurable prostate cancer, the overall symptomatic response rate was 62% again lower compared to our results (28). This difference may be due to the different symptomatic profile of patients with prostate cancer who present with lower urinary tract symptoms as the most frequent tumor-related complication.…”

Section: Discussioncontrasting

confidence: 84%

Palliative Short-course Radiotherapy in Advanced Pelvic Cancer: A Phase II Study (SHARON Project)

Farina

Macchia²,

Siepe

et al. 2019

Anticancer Res

View full text Add to dashboard Cite

Aim: To define safety and efficacy of a palliative, short-course accelerated radiation therapy for symptomatic locally advanced primary pelvic cancer. Materials and Methods: A phase II trial was planned based on the minimax Simon's twostage design. A total of 18 Gy in 4.5 Gy/fraction administered twice a day was delivered (SHARON). Pain and quality of life were recorded according to the Visual Analogue self-assessment and the cancer linear analog scales (CLAS), respectively. Results: Twenty-five patients were enrolled in the study. The most frequent baseline symptoms were pain (48%), bleeding (40%), bleeding/pain (8%), and intestinal sub-occlusion (4%). The overall palliative response rate was 96.0%, with a median palliative duration of 6 months. An improvement of quality-oflife indices (well-being, fatigue, and ability to perform daily activities) was noted in 64.0%, 36.0%, and 48.0% of patients, respectively. Conclusion: The SHARON regimen was well tolerated and effective in the palliative treatment of patients with locally advanced pelvic cancer. Based on these results, a multicentric prospective phase III trial is ongoing to compare this regimen with traditional 2-week radiotherapy treatment. Symptoms such as pain, bleeding, intestinal/urinary occlusion, nausea, and vomiting can deeply affect the quality of life (QoL) of patients with locally advanced pelvic cancers (1-5). Moreover, for symptomatic patients with metastatic disease or severe comorbidities, radical treatments are generally contraindicated. Palliative radiotherapy (RT) can be an effective option to control symptoms and consequently improve patient QoL (6). Short-course RT regimens have several advantages in the palliative setting: i) Reduced discomfort for patients, ii) reduced delay of systemic treatment when indicated, iii) reduced delay until hospice admission, and iv) reduced costs for the health system. These advantages are particularly interesting in lesser resourced settings with long waiting lists for RT (7). Our group previously reported the results of hypofractionated-accelerated RT (delivered in four fractions on 2 consecutive days) in different palliative settings: complicated bone metastases, brain metastases, head and neck cancer, thoracic tumors, and elderly patients (8-13). The treatment was well tolerated and effective in terms of symptom relief. A potential risk while using a hypo-fractionated regimen is the development of long-term radiation-related side-effects 4237 This article is freely accessible online.

show abstract

Radiotherapy for Advanced Prostate Cancer

Roy

Spratt

2022

Urologic Oncology

View full text Add to dashboard Cite

Palliative pelvic radiotherapy for symptomatic incurable prostate cancer – A prospective multicenter study

Abstract: In the majority of patients with CRPC and a symptomatic pelvic tumor, PPRT with 30-39 Gy contributes to relief of hematuria, pain and other pelvic symptoms, with acceptable toxicity. Future studies should investigate whether PPRT regimens can be simplified.

Cited by 24 publications

References 19 publications

Palliative pelvic radiotherapy for symptomatic rectal cancer – a prospective multicenter study

Palliative pelvic radiotherapy for symptomatic rectal cancer – a prospective multicenter study

Palliative Short-course Radiotherapy in Advanced Pelvic Cancer: A Phase II Study (SHARON Project)

Radiotherapy for Advanced Prostate Cancer

Contact Info

Product

Resources

About