AIMS: Most men with low-risk localised prostate cancer prefer treatments with high control rates and minimal disruption to their lives. Hypofractionating external radiation treatments can theoretically maintain high bioequivalent tumour doses, decrease treatment visits and decrease acute and late toxicities. The aim of this study was to assess the toxicity and feasibility of a hypofractionated accelerated regimen for these patients. MATERIALS AND METHODS: The present study was a phase I/II study in which patients with T1-2b, Gleason < or = 6 and prostate-specific antigen (PSA) < or = 10 ng/ml prostate cancer received 35Gy in five fractions, once a week over 29 days. Treatment was delivered with intensity-modulated radiotherapy on standard linear accelerators, with daily image guidance using gold seed fiducials, and a 4mm clinical target volume to planning target volume margin. RESULTS: As of January 2008, the target accrual of 30 patients had been reached and all had completed treatment and at least 6 months of follow-up. Dose-volume histogram objectives were achievable in all patients. Treatment was very well tolerated with no grade 3 or 4 genitourinary toxicity, gastrointestinal toxicity nor fatigue observed (95% confidence interval 0-12%). As a group, compared with baseline, the following additional grade 2 toxicities were observed: 13% genitourinary, 7% gastrointestinal and 10% fatigue. At 6 months all scores had returned to or improved over baseline. The median PSA before treatment was 6.0 ng/ml. At 6 months, the median PSA was 1.8 ng/ml and 75% had a PSA < or = 3.0 ng/ml. CONCLUSIONS: This novel technique using standard linear accelerators seems feasible and is well tolerated. Further follow-up will be carried out to document late toxicity and efficacy.
AIMS: Most men with low-risk localised prostate cancer prefer treatments with high control rates and minimal disruption to their lives. Hypofractionating external radiation treatments can theoretically maintain high bioequivalent tumour doses, decrease treatment visits and decrease acute and late toxicities. The aim of this study was to assess the toxicity and feasibility of a hypofractionated accelerated regimen for these patients. MATERIALS AND METHODS: The present study was a phase I/II study in which patients with T1-2b, Gleason < or = 6 and prostate-specific antigen (PSA) < or = 10 ng/ml prostate cancer received 35Gy in five fractions, once a week over 29 days. Treatment was delivered with intensity-modulated radiotherapy on standard linear accelerators, with daily image guidance using gold seed fiducials, and a 4mm clinical target volume to planning target volume margin. RESULTS: As of January 2008, the target accrual of 30 patients had been reached and all had completed treatment and at least 6 months of follow-up. Dose-volume histogram objectives were achievable in all patients. Treatment was very well tolerated with no grade 3 or 4 genitourinary toxicity, gastrointestinal toxicity nor fatigue observed (95% confidence interval 0-12%). As a group, compared with baseline, the following additional grade 2 toxicities were observed: 13% genitourinary, 7% gastrointestinal and 10% fatigue. At 6 months all scores had returned to or improved over baseline. The median PSA before treatment was 6.0 ng/ml. At 6 months, the median PSA was 1.8 ng/ml and 75% had a PSA < or = 3.0 ng/ml. CONCLUSIONS: This novel technique using standard linear accelerators seems feasible and is well tolerated. Further follow-up will be carried out to document late toxicity and efficacy.
Authors: Nicholas G Zaorsky; Amy S Harrison; Edouard J Trabulsi; Leonard G Gomella; Timothy N Showalter; Mark D Hurwitz; Adam P Dicker; Robert B Den Journal: Nat Rev Urol Date: 2013-09-10 Impact factor: 14.432
Authors: Himanshu R Lukka; Stephanie L Pugh; Deborah W Bruner; Jean-Paul Bahary; Colleen A F Lawton; Jason A Efstathiou; Rajat J Kudchadker; Lee E Ponsky; Samantha A Seaward; Ian S Dayes; Darindra D Gopaul; Jeff M Michalski; Guila Delouya; Irving D Kaplan; Eric M Horwitz; Mack Roach; Wayne H Pinover; David C Beyer; John O Amanie; Howard M Sandler; Lisa A Kachnic Journal: Int J Radiat Oncol Biol Phys Date: 2018-06-18 Impact factor: 7.038
Authors: William C Jackson; Jessica Silva; Holly E Hartman; Robert T Dess; Amar U Kishan; Whitney H Beeler; Laila A Gharzai; Elizabeth M Jaworski; Rohit Mehra; Jason W D Hearn; Todd M Morgan; Simpa S Salami; Matthew R Cooperberg; Brandon A Mahal; Payal D Soni; Samuel Kaffenberger; Paul L Nguyen; Neil Desai; Felix Y Feng; Zachary S Zumsteg; Daniel E Spratt Journal: Int J Radiat Oncol Biol Phys Date: 2019-04-06 Impact factor: 7.038
Authors: Colin I Tang; Perakaa Sethukavalan; Patrick Cheung; Gerard Morton; Geordi Pang; D Andrew Loblaw Journal: Can Urol Assoc J Date: 2013 Mar-Apr Impact factor: 1.862
Authors: Cathy Menkarios; Éric Vigneault; Nicolas Brochet; David H A Nguyen; Jean-Paul Bahary; Marjory Jolicoeur; Marie-Claude Beauchemin; Hugo Villeneuve; Thu Van Nguyen; Bernard Fortin; Carole Lambert Journal: Radiat Oncol Date: 2011-09-09 Impact factor: 3.481