Moderately Hypofractionated Radiotherapy with Simultaneous Integrated Boost in Prostate Cancer: A Comparative Study with Conventionally Fractionated Radiation
Background. To report 5-year clinical outcomes and toxicity in organ-confined prostate cancer (PCa) for low- and intermediate-risk patients treated with a moderately hypofractionated schedule of radiotherapy (RT) delivered with simultaneous integrated boost (SIB) compared to a conventionally fractio...
Main Authors: | , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Hindawi Limited
2020-01-01
|
Series: | Journal of Oncology |
Online Access: | http://dx.doi.org/10.1155/2020/3170396 |
id |
doaj-74b56f1f83f34120ac5edb69df6bfa1d |
---|---|
record_format |
Article |
spelling |
doaj-74b56f1f83f34120ac5edb69df6bfa1d2020-12-14T09:46:37ZengHindawi LimitedJournal of Oncology1687-84501687-84692020-01-01202010.1155/2020/31703963170396Moderately Hypofractionated Radiotherapy with Simultaneous Integrated Boost in Prostate Cancer: A Comparative Study with Conventionally Fractionated RadiationDomenico Cante0Cristina Piva1Edoardo T. F. Petrucci2Piera Sciacero3Silvia Ferrario4Massimo Pasquino5Valeria Casanova Borca6Maria R. La Porta7Pierfrancesco Franco8Department of Radiation Oncology, ASL TO4, Ivrea Community Hospital, Ivrea, ItalyDepartment of Radiation Oncology, ASL TO4, Ivrea Community Hospital, Ivrea, ItalyDepartment of Medical Physics, ASL TO4, Ivrea Community Hospital, Ivrea, ItalyDepartment of Radiation Oncology, ASL TO4, Ivrea Community Hospital, Ivrea, ItalyDepartment of Radiation Oncology, ASL TO4, Ivrea Community Hospital, Ivrea, ItalyDepartment of Medical Physics, ASL TO4, Ivrea Community Hospital, Ivrea, ItalyDepartment of Medical Physics, ASL TO4, Ivrea Community Hospital, Ivrea, ItalyDepartment of Radiation Oncology, ASL TO4, Ivrea Community Hospital, Ivrea, ItalyDepartment of Oncology, Radiation Oncology, School of Medicine, University of Turin, Turin, ItalyBackground. To report 5-year clinical outcomes and toxicity in organ-confined prostate cancer (PCa) for low- and intermediate-risk patients treated with a moderately hypofractionated schedule of radiotherapy (RT) delivered with simultaneous integrated boost (SIB) compared to a conventionally fractionated RT regimen. Methods. Data of 384 patients with PCa treated between August 2006 and June 2017 were retrospectively reviewed. The treatment schedule consisted of hypofractionated RT (HYPO FR) with SIB up to 70 Gy to the prostate gland and 63 Gy to seminal vesicles delivered in 28 fractions or in conventionally fractionated RT (CONV FR) up to a total dose of 80 Gy in 40 fractions. Patient allocation to treatment was based on the time period considered. For intermediate-risk patients, androgen deprivation was given for a median duration of 6 months. The 5-year biochemical relapse-free survival (bRFS), cancer-specific survival (CSS), and overall survival (OS) were assessed. Furthermore, we evaluated gastrointestinal (GI) and genitourinary (GU) toxicities. Uni- and multivariate Cox regression analyses were used to test the impact of clinical variables on both outcome and toxicity. Results. A total of 198 patients was treated with hypofractionated RT and 186 with the conventional schedule. At a median follow-up of 5 years, no significant differences were observed in terms of GI toxicity and outcome between the two groups. Early GU toxicity was significantly increased in HYPO FR, while late GU toxicity was significantly higher in CONV FR. In HYPO FR, a biochemical relapse occurred in 12 patients (6.1%), and 9 patients (4.5%) reported a clinical relapse (4 local, 2 locoregional, and 3 systemic recurrence). In CONV FR, 15 patients (8.1%) experienced a biochemical relapse and 11 patients (5.9%) showed a clinical relapse (5 local, 4 locoregional, and 3 systemic recurrences). Early grades 1-2 GU and GI toxicities were observed in 60 (30.3%) and 37 (18.7%) patients, respectively, in the hypofractionated group and in 33 (17.7%) and 27 (14.5%) patients, respectively, in the conventionally fractionated RT group. Late GU and GI toxicities occurred in 1 (0.51%) and 8 (4.1%) patients, respectively, in HYPO FR. In CONV FR, 5 (2.7%) and 6 (3.2%) patients experienced late GU and GI toxicities, respectively. The 5-year OS, bRFS, and CSS were 98.9%, 94.1%, and 99.5%, respectively, in HYPO FR, and 94.5%, 92.1%, and 99.0%, respectively, in CONV FR. Conclusions. Results obtained in this study showed that moderately hypofractionated RT employing SIB can be an effective approach providing valuable clinical outcomes with an acceptable toxicity profile.http://dx.doi.org/10.1155/2020/3170396 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Domenico Cante Cristina Piva Edoardo T. F. Petrucci Piera Sciacero Silvia Ferrario Massimo Pasquino Valeria Casanova Borca Maria R. La Porta Pierfrancesco Franco |
spellingShingle |
Domenico Cante Cristina Piva Edoardo T. F. Petrucci Piera Sciacero Silvia Ferrario Massimo Pasquino Valeria Casanova Borca Maria R. La Porta Pierfrancesco Franco Moderately Hypofractionated Radiotherapy with Simultaneous Integrated Boost in Prostate Cancer: A Comparative Study with Conventionally Fractionated Radiation Journal of Oncology |
author_facet |
Domenico Cante Cristina Piva Edoardo T. F. Petrucci Piera Sciacero Silvia Ferrario Massimo Pasquino Valeria Casanova Borca Maria R. La Porta Pierfrancesco Franco |
author_sort |
Domenico Cante |
title |
Moderately Hypofractionated Radiotherapy with Simultaneous Integrated Boost in Prostate Cancer: A Comparative Study with Conventionally Fractionated Radiation |
title_short |
Moderately Hypofractionated Radiotherapy with Simultaneous Integrated Boost in Prostate Cancer: A Comparative Study with Conventionally Fractionated Radiation |
title_full |
Moderately Hypofractionated Radiotherapy with Simultaneous Integrated Boost in Prostate Cancer: A Comparative Study with Conventionally Fractionated Radiation |
title_fullStr |
Moderately Hypofractionated Radiotherapy with Simultaneous Integrated Boost in Prostate Cancer: A Comparative Study with Conventionally Fractionated Radiation |
title_full_unstemmed |
Moderately Hypofractionated Radiotherapy with Simultaneous Integrated Boost in Prostate Cancer: A Comparative Study with Conventionally Fractionated Radiation |
title_sort |
moderately hypofractionated radiotherapy with simultaneous integrated boost in prostate cancer: a comparative study with conventionally fractionated radiation |
publisher |
Hindawi Limited |
series |
Journal of Oncology |
issn |
1687-8450 1687-8469 |
publishDate |
2020-01-01 |
description |
Background. To report 5-year clinical outcomes and toxicity in organ-confined prostate cancer (PCa) for low- and intermediate-risk patients treated with a moderately hypofractionated schedule of radiotherapy (RT) delivered with simultaneous integrated boost (SIB) compared to a conventionally fractionated RT regimen. Methods. Data of 384 patients with PCa treated between August 2006 and June 2017 were retrospectively reviewed. The treatment schedule consisted of hypofractionated RT (HYPO FR) with SIB up to 70 Gy to the prostate gland and 63 Gy to seminal vesicles delivered in 28 fractions or in conventionally fractionated RT (CONV FR) up to a total dose of 80 Gy in 40 fractions. Patient allocation to treatment was based on the time period considered. For intermediate-risk patients, androgen deprivation was given for a median duration of 6 months. The 5-year biochemical relapse-free survival (bRFS), cancer-specific survival (CSS), and overall survival (OS) were assessed. Furthermore, we evaluated gastrointestinal (GI) and genitourinary (GU) toxicities. Uni- and multivariate Cox regression analyses were used to test the impact of clinical variables on both outcome and toxicity. Results. A total of 198 patients was treated with hypofractionated RT and 186 with the conventional schedule. At a median follow-up of 5 years, no significant differences were observed in terms of GI toxicity and outcome between the two groups. Early GU toxicity was significantly increased in HYPO FR, while late GU toxicity was significantly higher in CONV FR. In HYPO FR, a biochemical relapse occurred in 12 patients (6.1%), and 9 patients (4.5%) reported a clinical relapse (4 local, 2 locoregional, and 3 systemic recurrence). In CONV FR, 15 patients (8.1%) experienced a biochemical relapse and 11 patients (5.9%) showed a clinical relapse (5 local, 4 locoregional, and 3 systemic recurrences). Early grades 1-2 GU and GI toxicities were observed in 60 (30.3%) and 37 (18.7%) patients, respectively, in the hypofractionated group and in 33 (17.7%) and 27 (14.5%) patients, respectively, in the conventionally fractionated RT group. Late GU and GI toxicities occurred in 1 (0.51%) and 8 (4.1%) patients, respectively, in HYPO FR. In CONV FR, 5 (2.7%) and 6 (3.2%) patients experienced late GU and GI toxicities, respectively. The 5-year OS, bRFS, and CSS were 98.9%, 94.1%, and 99.5%, respectively, in HYPO FR, and 94.5%, 92.1%, and 99.0%, respectively, in CONV FR. Conclusions. Results obtained in this study showed that moderately hypofractionated RT employing SIB can be an effective approach providing valuable clinical outcomes with an acceptable toxicity profile. |
url |
http://dx.doi.org/10.1155/2020/3170396 |
work_keys_str_mv |
AT domenicocante moderatelyhypofractionatedradiotherapywithsimultaneousintegratedboostinprostatecanceracomparativestudywithconventionallyfractionatedradiation AT cristinapiva moderatelyhypofractionatedradiotherapywithsimultaneousintegratedboostinprostatecanceracomparativestudywithconventionallyfractionatedradiation AT edoardotfpetrucci moderatelyhypofractionatedradiotherapywithsimultaneousintegratedboostinprostatecanceracomparativestudywithconventionallyfractionatedradiation AT pierasciacero moderatelyhypofractionatedradiotherapywithsimultaneousintegratedboostinprostatecanceracomparativestudywithconventionallyfractionatedradiation AT silviaferrario moderatelyhypofractionatedradiotherapywithsimultaneousintegratedboostinprostatecanceracomparativestudywithconventionallyfractionatedradiation AT massimopasquino moderatelyhypofractionatedradiotherapywithsimultaneousintegratedboostinprostatecanceracomparativestudywithconventionallyfractionatedradiation AT valeriacasanovaborca moderatelyhypofractionatedradiotherapywithsimultaneousintegratedboostinprostatecanceracomparativestudywithconventionallyfractionatedradiation AT mariarlaporta moderatelyhypofractionatedradiotherapywithsimultaneousintegratedboostinprostatecanceracomparativestudywithconventionallyfractionatedradiation AT pierfrancescofranco moderatelyhypofractionatedradiotherapywithsimultaneousintegratedboostinprostatecanceracomparativestudywithconventionallyfractionatedradiation |
_version_ |
1714998267777908736 |