??Acute toxicity profile in prostate cancer with conventional and hypofractionated treatment
Purpose: To compare the acute toxicities in radical treatment of prostate cancer between conventional schedule (C-ARM) with 78 Gy/39 fractions and hypofractionation conformal treatment (H-ARM) with 69 Gy/23 fractions.Methods and material: This prospective double arm study consisted of 217 patients with prostate cancer, 112 in H-ARM and 105 in C-ARM arm. C-ARM received conventional six- field conformal radiotherapy with 78 Gy in 39 fractions while H-ARM received hypofractionation with 69 Gy in 23 fractions.Weekly assessment of acute reactions was done during treatment and with one, and 3 months using RTOG scale. Univariated analysis was performed to evaluate differences between the incidences of acute reaction in the treatment arms.
Variables with p value less than 0.1 were included in the multivariated logistic regression.
Results: There was no difference between H-ARM versus C-ARM for severity and incidence in genitourinary (GU) and gastrointestinal (GI) acute toxicity. During the treatment comparing H-ARM with C-ARM no differences was observed for GI toxicity (grade 0--3; H-ARM = 45.5%, 34%, 18.7% and 1.8% versus C-ARM = 47.6%, 35.2%, 17.2% and 0).
For acute GU toxicity no difference was detected between H-ARM (grade 0--3; 22.3%, 54.5%, 18.7% and 4.5%) and C-ARM (grade 0--3; 25.8%, 53.3%, 17.1% and 3.8%).At the 3- months follow-up, persistent Grade >=2 acute GU and GI toxicity were 2.5% and 1.8% in H-ARM versus 5.7 % and 3% in C-ARM (p >0.05). In univariated and multivariated analyses, there was not any dosimetric predictor for GI and GU toxicity.
Conclusions: Our data demonstrate that hypofractionated radiotherapy achieving high biological effective dose using conformal radiotherapy is feasible for prostate cancer, being well tolerated with minimal severe acute toxicity.
Author: Gustavo Arruda VianiLucas Bernardes da SilvaBruna Bueno da SilvaYuri Bonicelli CrempeVinicius Spazzapan MartinsRicardo Jose FerrariMariana Colbachini PóloBruno Thiago RossiElton SuguikawaGiseli Correa ZullianiEduardo Jose Stefano
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Published on: 2013-04-21
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