H Bindu Musunuru1, Harvey Quon2, Melanie Davidson3, Patrick Cheung1, Liying Zhang4, Laura D'Alimonte1, Andrea Deabreu5, Alexandre Mamedov5, Andrew Loblaw6. 1. Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Canada; Department of Radiation Oncology, University of Toronto, Canada. 2. Department of Radiation Oncology, CancerCare Manitoba, Canada. 3. Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Canada; Department of Medical Physics, Odette Cancer Centre, Canada. 4. MacroStat, Inc, Toronto, Canada. 5. Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Canada. 6. Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Canada; Department of Radiation Oncology, University of Toronto, Canada; Institute of Health Policy, Measurement and Evaluation, University of Toronto, Canada. Electronic address: andrew.loblaw@sunnybrook.ca.
Abstract
PURPOSE: To compare biochemical outcome and toxicities of two prospective 5-fraction stereotactic ablative radiotherapy (SABR) studies in prostate cancer. MATERIALS AND METHODS: 84 patients in pHART3 received 35 Gy, 30 patients in pHART6 received 40 Gy in 5-fractions to the prostate alone, once weekly. 4mm and 5mm PTV margins were used, respectively. Biochemical outcome, acute, late and cumulative genitourinary (GU)/gastrointestinal (GI) toxicities were compared. RESULTS: Median follow-up was 74 and 36 months, respectively. Median prostate specific antigen nadir was 0.4 ng/ml and 0.3 ng/ml. 2-, 4- and 6-year biochemical relapse-free survival (bRFS-2+nadir) was 100%, 98.7% and 95.9% in pHART3; 100%, 100% and not reached in pHART6 (p=0.91). There was one acute grade 3 GU (retention) and late grade 4 GI (fistula) toxicity in pHART3, none in pHART6. One patient in each study had persisting grade 2+ toxicity at the last follow-up. pHART6 patients had a greater grade 2+ cumulative GU (5% versus 24.2%) and GI (7.6% versus 26.2%) toxicities. CONCLUSIONS: Patients receiving dose-escalated SABR had slightly lower PSA nadir and similar bRFS, longer follow-up is needed to better estimate biochemical outcomes. There was a greater risk of grade 2 toxicity in pHART6 but not grade 3+ toxicities. Persisting toxicity at the last follow-up is similar.
PURPOSE: To compare biochemical outcome and toxicities of two prospective 5-fraction stereotactic ablative radiotherapy (SABR) studies in prostate cancer. MATERIALS AND METHODS: 84 patients in pHART3 received 35 Gy, 30 patients in pHART6 received 40 Gy in 5-fractions to the prostate alone, once weekly. 4mm and 5mm PTV margins were used, respectively. Biochemical outcome, acute, late and cumulative genitourinary (GU)/gastrointestinal (GI) toxicities were compared. RESULTS: Median follow-up was 74 and 36 months, respectively. Median prostate specific antigen nadir was 0.4 ng/ml and 0.3 ng/ml. 2-, 4- and 6-year biochemical relapse-free survival (bRFS-2+nadir) was 100%, 98.7% and 95.9% in pHART3; 100%, 100% and not reached in pHART6 (p=0.91). There was one acute grade 3 GU (retention) and late grade 4 GI (fistula) toxicity in pHART3, none in pHART6. One patient in each study had persisting grade 2+ toxicity at the last follow-up. pHART6patients had a greater grade 2+ cumulative GU (5% versus 24.2%) and GI (7.6% versus 26.2%) toxicities. CONCLUSIONS:Patients receiving dose-escalated SABR had slightly lower PSA nadir and similar bRFS, longer follow-up is needed to better estimate biochemical outcomes. There was a greater risk of grade 2 toxicity in pHART6 but not grade 3+ toxicities. Persisting toxicity at the last follow-up is similar.
Authors: Scott C Morgan; Karen Hoffman; D Andrew Loblaw; Mark K Buyyounouski; Caroline Patton; Daniel Barocas; Soren Bentzen; Michael Chang; Jason Efstathiou; Patrick Greany; Per Halvorsen; Bridget F Koontz; Colleen Lawton; C Marc Leyrer; Daniel Lin; Michael Ray; Howard Sandler Journal: J Clin Oncol Date: 2018-10-11 Impact factor: 44.544
Authors: Rebecca G Levin-Epstein; Naomi Y Jiang; Xiaoyan Wang; Shrinivasa K Upadhyaya; Sean P Collins; Simeng Suy; Nima Aghdam; Constantine Mantz; Alan J Katz; Leszek Miszczyk; Aleksandra Napieralska; Agnieszka Namysl-Kaletka; Nicholas Prionas; Hilary Bagshaw; Mark K Buyyounouski; Minsong Cao; Nzhde Agazaryan; Audrey Dang; Ye Yuan; Patrick A Kupelian; Nicholas G Zaorsky; Daniel E Spratt; Osama Mohamad; Felix Y Feng; Brandon A Mahal; Paul C Boutros; Arun U Kishan; Jesus Juarez; David Shabsovich; Tommy Jiang; Sartajdeep Kahlon; Ankur Patel; Jay Patel; Nicholas G Nickols; Michael L Steinberg; Donald B Fuller; Amar U Kishan Journal: Radiother Oncol Date: 2020-10-07 Impact factor: 6.280
Authors: Sarah O S Osman; Prakash Jeevanandam; Nithya Kanakavelu; Denise M Irvine; Ciara A Lyons; Suneil Jain; Alan R Hounsell; Conor K McGarry Journal: Radiat Oncol Date: 2016-11-24 Impact factor: 3.481
Authors: Kyle Wang; Panayiotis Mavroidis; Trevor J Royce; Aaron D Falchook; Sean P Collins; Stephen Sapareto; Nathan C Sheets; Donald B Fuller; Issam El Naqa; Ellen Yorke; Jimm Grimm; Andrew Jackson; Ronald C Chen Journal: Int J Radiat Oncol Biol Phys Date: 2020-12-22 Impact factor: 7.038
Authors: Ritchell van Dams; Naomi Y Jiang; Donald B Fuller; Andrew Loblaw; Tommy Jiang; Alan J Katz; Sean P Collins; Nima Aghdam; Simeng Suy; Kevin L Stephans; Ye Yuan; Nicholas G Nickols; Vedang Murthy; Tejshri P Telkhade; Patrick A Kupelian; Michael L Steinberg; Tahmineh Romero; Amar U Kishan Journal: Int J Radiat Oncol Biol Phys Date: 2021-01-23 Impact factor: 7.038
Authors: Ben G L Vanneste; Y van Wijk; L C Lutgens; E J Van Limbergen; E N van Lin; K van de Beek; P Lambin; A L Hoffmann Journal: Strahlenther Onkol Date: 2017-10-16 Impact factor: 3.621
Authors: Luca F Valle; Dan Ruan; Audrey Dang; Rebecca G Levin-Epstein; Ankur P Patel; Joanne B Weidhaas; Nicholas G Nickols; Percy P Lee; Daniel A Low; X Sharon Qi; Christopher R King; Michael L Steinberg; Patrick A Kupelian; Minsong Cao; Amar U Kishan Journal: Front Oncol Date: 2020-05-20 Impact factor: 6.244
Authors: Harvey C Quon; Hima Bindu Musunuru; Patrick Cheung; Geordi Pang; Alexandre Mamedov; Laura D'Alimonte; Andrea Deabreu; Liying Zhang; Andrew Loblaw Journal: Front Oncol Date: 2016-08-29 Impact factor: 6.244