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Comparative Study
. 2014:2014:541847.
doi: 10.1155/2014/541847. Epub 2014 Mar 18.

Image guided hypofractionated radiotherapy by helical tomotherapy for prostate carcinoma: toxicity and impact on Nadir PSA

Salvina Barra  1 , Stefano Vagge  1 , Michela Marcenaro  1 , Gladys Blandino  2 , Giorgia Timon  2 , Giulia Vidano  2 , Dario Agnese  2 , Marco Gusinu  3 , Francesca Cavagnetto  3 , Renzo Corvò  4
Affiliations
Comparative Study

Image guided hypofractionated radiotherapy by helical tomotherapy for prostate carcinoma: toxicity and impact on Nadir PSA

Salvina Barra et al. Biomed Res Int. 2014.

Abstract

Aim: To evaluate the toxicity of a hypofractionated schedule for primary radiotherapy (RT) of prostate cancer as well as the value of the nadir PSA (nPSA) and time to nadir PSA (tnPSA) as surrogate efficacy of treatment.

Material and methods: Eighty patients underwent hypofractionated schedule by Helical Tomotherapy (HT). A dose of 70.2 Gy was administered in 27 daily fractions of 2.6 Gy. Acute and late toxicities were graded on the RTOG/EORTC scales. The nPSA and the tnPSA for patients treated with exclusive RT were compared to an equal cohort of 20 patients treated with conventional fractionation and standard conformal radiotherapy.

Results: Most of patients (83%) did not develop acute gastrointestinal (GI) toxicity and 50% did not present genitourinary (GU) toxicity. After a median follow-up of 36 months only grade 1 of GU and GI was reported in 6 and 3 patients as late toxicity. Average tnPSA was 30 months. The median value of nPSA after exclusive RT with HT was 0.28 ng/mL and was significantly lower than the median nPSA (0.67 ng/mL) of the conventionally treated cohort (P = 0.02).

Conclusions: Hypofractionated RT schedule with HT for prostate cancer treatment reports very low toxicity and reaches a low level of nPSA that might correlate with good outcomes.

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Figures

Figure 1
Figure 1
Biochemical disease-free survival (bDFS) in exclusive RT and ADT + RT.
Figure 2
Figure 2
Incidence of biochemical disease failure (bDF) for exclusive RT and ADT + RT.
Figure 3
Figure 3
Genitourinary toxicity.
Figure 4
Figure 4
Gastrointestinal toxicity.
Figure 5
Figure 5
Trend of the PSA to achieve nadir.
Figure 6
Figure 6
Boxplot of the median nadir PSA between patients treated with exclusive radiotherapy with a conventional fractionation and hypofractionation. The difference between the two groups of median PSA nadir is significative.
See this image and copyright information in PMC

References

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