Stereotactic hypofractionated accurate radiotherapy of the prostate (SHARP), 33.5 Gy in five fractions for localized disease: First clinical trial results

Madsen, Berit; Hsi, R.A.; Pham, Huong; Fowler, Jack F.; Esagui, L.; Corman, John M.

doi:10.1016/j.ijrobp.2006.10.050

Cited by 355 publications

(236 citation statements)

References 13 publications

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“…3,[20][21][22][23][24][25]27,28 Similarly, no AEs of grade 3 or higher were found in our study. Overall EPIC bowel scores were high during follow-up.…”

Section: Discussionsupporting

confidence: 72%

“…18 Clinical results for hypofractionated photon prostate cancer treatments have also been favorable. 3,[19][20][21][22][23][24][25][26][27][28][29][30][31] Many different fractionations, from 6.75 Gy in 5 treatments to 10 Gy in 5 treatments, have been used. Our design was based on data published with high-dose-rate brachytherapy for prostate cancer and the published normal tissue ˛/ř atio.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, other publications with longer followup have not seen an AE grade 3 or higher. 25,27,28 So, there is no reason to think that AEs would be seen with longer follow-up. Furthermore, most grade-3 events in the University of Texas Southwestern study 19 and the Georgetown University study 21 were seen within 12 months.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

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

Vargas

Hartsell²,

Dunn

et al. 2016

Reports of Practical Oncology & Radiotherapy

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“…3,[20][21][22][23][24][25]27,28 Similarly, no AEs of grade 3 or higher were found in our study. Overall EPIC bowel scores were high during follow-up.…”

Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

Vargas

Hartsell²,

Dunn

et al. 2016

Reports of Practical Oncology & Radiotherapy

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“…The bladder and rectum were contoured according to Radiation Therapy Oncology Group (RTOG) guidelines [13]. All patients were treated with 6-15 mV photon beams.…”

Section: Menmentioning

confidence: 99%

“…However, at the present the main concern is the uncertainty about normal tissue toxicity of such HF protocols. Although clinical reports [7][8][9][10][11][12][13][14][15] have found acceptable levels of morbidity and reasonable PSA control rates using doses of 2.5-3 Gy, clinical data are sparse and, although promising, require further validation. If the hypothesis that the prostate cancer α / β ratio is lower than normal tissue is correct, then the optimal fractional dose is likely to be even higher than the doses tested thus far, but if incorrect, the result may be increased normal tissue toxicity.…”

Section: Introductionmentioning

confidence: 99%

Late morbidity and oncological outcome after radical hypofractionated radiotherapy in men with prostate cancer

et al. 2010

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OBJECTIVE To test the hypothesis that three-dimensional hypofractionated radiotherapy (3D-HFRT) is well tolerated and not worse than 3-D conventional RT (3D-CRT) for oncological outcome. PATIENTS AND METHODS In all, 162 men with hystologically confirmed prostate adenocarcinoma were included in the analysis. In all, 82 men were treated with 3D-HFRT (15 fractions of 3.62 Gy delivered 3 times/week; a total dose of 54.3 Gy). This group was retrospectively compared with 80 men who met the same inclusion criteria and who were treated with 3D-CRT (39 fractions of 2 Gy delivered daily; a total dose of 78 Gy). A short course of hormone therapy was administered concomitantly with the RT. RESULTS Only one (1.7%) patient in the 3D-CRT group and two (4.0%) in the 3D-HFRT group had Grade 3 genitourinary toxicity. There was late gastrointestinal morbidity of >= grade 3 in only 5.1% of men treated with 3D-HFRT and in 4.0% of men treated with 3D-CRT. In both groups there was no Grade 4 toxicity. At the median (range) follow-up of 45 (39.4-51) months for the 3D-HFRT group and 57.5 (54.9-59.1) months for 3D-CRT group the progression rate was 18/82 (21.9%) and 20/80 (25.0%), respectively, with no significant worsening in the risk of biochemical failure (BCF; log-rank test, P = 0.222). CONCLUSIONS In the present study, men with clinically localized prostate cancer had similar levels of morbidity irrespective of whether they received HFRT or CRT without any worsening in the early risk of BCF. Thus, the present data provide some clinical evidence to justify trends already emerging toward HF regimens for treating clinically localised prostate cancer

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Long-term Outcomes of Stereotactic Body Radiotherapy for Low-Risk and Intermediate-Risk Prostate Cancer

et al. 2019

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Importance Stereotactic body radiotherapy harnesses improvements in technology to allow the completion of a course of external beam radiotherapy treatment for prostate cancer in the span of 4 to 5 treatment sessions. Although mounting short-term data support this approach, long-term outcomes have been sparsely reported. Objective To assess long-term outcomes after stereotactic body radiotherapy for low-risk and intermediate-risk prostate cancer. Design, Setting, and Participants This cohort study analyzed individual patient data from 2142 men enrolled in 10 single-institution phase 2 trials and 2 multi-institutional phase 2 trials of stereotactic body radiotherapy for low-risk and intermediate-risk prostate cancer between January 1, 2000, and December 31, 2012. Statistical analysis was performed based on follow-up from January 1, 2013, to May 1, 2018. Main Outcomes and Measures The cumulative incidence of biochemical recurrence was estimated using a competing risk framework. Physician-scored genitourinary and gastrointestinal toxic event outcomes were defined per each individual study, generally by Radiation Therapy Oncology Group or Common Terminology Criteria for Adverse Events scoring systems. After central review, cumulative incidences of late grade 3 or higher toxic events were estimated using a Kaplan-Meier method. Results A total of 2142 men (mean [SD] age, 67.9 [9.5] years) were eligible for analysis, of whom 1185 (55.3%) had low-risk disease, 692 (32.3%) had favorable intermediate-risk disease, and 265 (12.4%) had unfavorable intermediate-risk disease. The median follow-up period was 6.9 years (interquartile range, 4.9-8.1 years). Seven-year cumulative rates of biochemical recurrence were 4.5% (95% CI, 3.2%-5.8%) for low-risk disease, 8.6% (95% CI, 6.2%-11.0%) for favorable intermediate-risk disease, 14.9% (95% CI, 9.5%-20.2%) for unfavorable intermediate-risk disease, and 10.2% (95% CI, 8.0%-12.5%) for all intermediate-risk disease. The crude incidence of acute grade 3 or higher genitourinary toxic events was 0.60% (n = 13) and of gastrointestinal toxic events was 0.09% (n = 2), and the 7-year cumulative incidence of late grade 3 or higher genitourinary toxic events was 2.4% (95% CI, 1.8%-3.2%) and of late grade 3 or higher gastrointestinal toxic events was 0.4% (95% CI, 0.2%-0.8%). Conclusions and Relevance In this study, stereotactic body radiotherapy for low-risk and intermediate-risk disease was associated with low rates of severe toxic events and high rates of biochemical control. These data suggest that stereotactic body radiotherapy is an appropriate definitive treatment modality for low-risk and intermediate-risk prostate cancer.

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Stereotactic hypofractionated accurate radiotherapy of the prostate (SHARP), 33.5 Gy in five fractions for localized disease: First clinical trial results

Cited by 355 publications

References 13 publications

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

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

Late morbidity and oncological outcome after radical hypofractionated radiotherapy in men with prostate cancer

Long-term Outcomes of Stereotactic Body Radiotherapy for Low-Risk and Intermediate-Risk Prostate Cancer

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