Update of the HIPRO study: Late toxicity and outcome at seven years.

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 81-81
Author(s):  
D. Thomson ◽  
S. Merrick ◽  
R. Swindell ◽  
J. Coote ◽  
P. A. Elliott ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Disease Control ◽  
Dose Escalation ◽  
Treatment Time ◽  
Intensity Modulated Radiotherapy ◽  
Late Toxicity ◽  
Urinary Symptoms ◽  
Overall Treatment Time ◽  
Intensity Modulated ◽  
Pre Treatment

81 Background: Dose-escalated radiotherapy for localised prostate cancer improves disease control but at the expense of increased overall treatment time and late toxicity. Given the low alpha-beta ratio for prostate cancer, treatment with hypofractionation should be biologically advantageous. Intensity-modulated radiotherapy (IMRT) allows dose escalation with hypofractionation, while achieving acceptable levels of toxicity. We report our 7 year late toxicity data in patients treated with two such regimens within the Hypofractionated Dose Escalation utilising Intensity-modulated Radiotherapy in Carcinoma of the Prostate (HIPRO) study. Methods: Sixty men, median age 75 years (50-87), with localised adenocarcinoma of prostate (T1-3NOMO) and either Gleason score ≥7 or PSA 20-50ng/L received 57Gy in 19 fractions (n=30) or 60Gy in 20 fractions (n=30) using 5-field inverse-planned IMRT. All patients received neoadjuvant hormone therapy, continuing for up to 6 months after treatment. Late toxicity was assessed at 7 years follow-up using RTOG criteria and LENT/SOMA questionnaire. Results: Forty-four (73%) patients were alive at 7 years. Nine patients (21%) reported RTOG grade 1 bowel or bladder toxicity; there was no grade 2 toxicity or above and no difference between the fractionation schedules. LENT/SOMA questionnaires were returned by 31/44 patients. Mean and median scores were less than one for bowel and urinary symptoms. When compared with pre-treatment, the proportion of patients with significant (maximum LENT/SOMA ≥2) urinary symptoms remained similar (75% vs. 76%), problems with sexual function had decreased (84% vs. 98%) but bowel symptoms increased (62% vs. 25%). At 5 years, overall survival was 83% and 74% and cause-specific survival was 83% and 84% in the 57Gy and 60Gy groups respectively. Conclusions: Dose-escalated hypofractionated IMRT for prostate cancer appears well tolerated with acceptable levels of late toxicity. Studies to assess long term disease control with these regimens are on-going. No significant financial relationships to disclose.

scholarly journals Moderate Hypofractionated Protracted Radiation Therapy and Dose Escalation for Prostate Cancer: Do Dose and Overall Treatment Time Matter?

2016 ◽  
Vol 94 (2) ◽  
pp. 272-279 ◽  
Author(s):  
Melpomeni Kountouri ◽  
Thomas Zilli ◽  
Michel Rouzaud ◽  
Angèle Dubouloz ◽  
Dolors Linero ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Dose Escalation ◽  
Treatment Time ◽  
Overall Treatment Time

Phase I/II study on stereotactic hypofractionated once-weekly radiation therapy (SHORT) for localized prostate cancer.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 130-130 ◽  
Author(s):  
Indranil Mallick ◽  
Moses Arunsingh ◽  
Sriram Prasath ◽  
B Arun ◽  
Paromita Roy ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Clinical Trial ◽  
High Risk ◽  
Phase I ◽  
Treatment Time ◽  
Late Toxicity ◽  
Biochemical Control ◽  
Overall Treatment Time ◽  
Risk Patients ◽  
Prescription Dose

130 Background: The low α/β ratio of prostate cancer (PrCa) is well established. However, stereotactic hypofractionated radiotherapy (SRT) has been investigated primarily in highly selected patient populations with low-intermediate risk disease. We performed a clinical trial of SRT delivered in once-weekly fractions on an unselected cohort of patients with non-metastatic PrCa. Methods: In this Phase I/II study 30 patients with non-metastatic PrCa (multiparametric MRI cT1-4N0, M0, Gleason 6-10, PSA < = 60 ng/ml) were treated with SRT to a prescription dose of 35Gy in 5 fractions delivered once a week (overall treatment time 29 days). Elective nodal RT at 25Gy/5Fr was delivered in patients high-risk by NCCN criteria, and androgen deprivation therapy given to intermediate and high-risk patients. SRT was planned using volumetric intensity modulated arc therapy (VMAT) or Helical Tomotherapy (HT) with pre-defined dose-criteria. The primary endpoint was acute toxicity NCI CTC v4, and secondary endpoints were biochemical control and late toxicity. Results: Thirty patients completed treatment per-protocol. Stage T3, Gleason 8-10, and PSA > 10 was seen in 18 (60%), 7 (23%) and 24 (80%) respectively. Overall 20 (66.7%) were high-risk. Median of Mean PTV dose was 36Gy, and normal tissue constraints could be met in all patients (Table). Acute urinary toxicities (Gr 0: 1; Gr 1: 27; Gr 2: 1; Gr 3-4: 0) and acute rectal toxicities (Gr 0: 20; Gr 1: 10; Gr 2: 0; Gr 3-4: 0) were very modest. The mean IPSS scores at baseline, end of treatment and 3 months after treatment were 8.8, 14.7, and 9.9. With a median follow up of 23.7 months, the 2 year biochemical control was 96%. Late grade 2 rectal bleeding developed in 1 patient. Conclusions: Carefully planned stereotactic VMAT/HT based once-weekly SRT to a predominantly high-risk non-metastatic PrCa cohort was very well tolerated and found to be safe for clinical use. Preliminary biochemical control and late toxicity profiles are encouraging. Clinical trial information: CTRI/2016/02/006671. [Table: see text]

scholarly journals Impact on Late Toxicity of using Transabdominal Ultrasound for Prostate Cancer Patients Treated with Intensity Modulated Radiotherapy

2005 ◽  
Vol 4 (1) ◽  
pp. 115-120 ◽  
Author(s):  
Ashesh B. Jani ◽  
John Gratzle ◽  
Emil Muresan ◽  
Mary K. Martel
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
External Beam Radiotherapy ◽  
Intensity Modulated Radiotherapy ◽  
Late Toxicity ◽  
Institutional Setting ◽  
Regression Analyses ◽  
Intensity Modulated ◽  
Gu Toxicity ◽  
Gi Toxicity

An analysis of the effects of using the B-mode ultrasound Acquisition and Targeting (BAT) system for positioning of prostate cancer patients receiving external beam radiotherapy (EBRT) on late gastrointestinal (GI) and genitourinary (GU) toxicity is provided. The records of 49 consecutive patients treated using the BAT were reviewed; additionally, a comparison (No-BAT) group treated in a similar manner was identified, consisting of 49 patients treated immediately prior to this BAT group. There were no other fundamental differences between the two groups. The daily BAT movements were charted and late toxicity was scored for all patients using established toxicity scales. The results demonstrated similar GU toxicity rates between the two groups, but slightly lower rates of GI toxicity in the BAT group vs. the No-BAT group. However, regression analyses revealed that no factors, including BAT use, were significantly correlated with late GI or GU toxicity. Further efforts, perhaps better undertaken in a multi-institutional setting, are needed to determine whether BAT use can significantly reduce late GI toxicity.

scholarly journals Outcome and patient-reported toxicity in localised prostate cancer treated with dose-escalated hypofractionated intensity-modulated radiotherapy

2013 ◽  
Vol 12 (4) ◽  
pp. 326-333
Author(s):  
David Thomson ◽  
Sophie Merrick ◽  
Ric Swindell ◽  
James Wylie ◽  
Richard Cowan ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
High Risk ◽  
Intensity Modulated Radiotherapy ◽  
Late Toxicity ◽  
Phase Iii ◽  
Patient Questionnaire ◽  
Intensity Modulated ◽  
High Risk Disease ◽  
Cause Specific Survival

AbstractObjectiveTo report outcomes and late toxicity for a hypofractionated dose-escalated radiotherapy schedule in patients treated using intensity-modulated radiotherapy (IMRT) for localised prostate cancer.Materials and methodsEighty-eight men with localised prostate cancer were treated with 57 Gy in 19 daily fractions over 4 weeks. A total of 70 out of 88 had high-risk disease. Overall survival, cause-specific survival and biochemical progression-free survival (bPFS, Phoenix definition) were reported. Toxicity was measured retrospectively using Radiation Therapy Oncology Group (RTOG) criteria and assessed prospectively with a validated Late Effects in Normal Tissues Subjective, Objective, Management and Analytic (LENT/SOMA) patient questionnaire.ResultsAt 5 years, overall survival was 84%, cause-specific survival 88% and bPFS 65%. In patients with high-risk disease, 5-year bPFS was 62%. There was no RTOG toxicity above grade III. LENT/SOMA questionnaires were returned by 74% patients. Median scores for bowel and urinary function were <1. Maximum bowel and urinary toxicity scores ≥2 were reported by 64% and 59% of patients, respectively. The median score for sexual function was 1·5, but nearly all (96%) patients recorded a toxicity score ≥2 for at least one question.ConclusionsDose-escalated hypofractionated radiotherapy delivered using IMRT has promising outcomes and acceptable late toxicity. This fractionation schedule is being compared with conventional treatment within an on-going multicentre phase III clinical trial.

Sign in / Sign up

Export Citation Format

Share Document