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    Hypofractionated Intensity-Modulated Radiotherapy for Carcinoma of the Prostate: Analysis of Toxicity.

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    Authors
    Coote, Joanna H
    Wylie, James P
    Cowan, Richard A
    Logue, John P
    Swindell, Ric
    Livsey, Jacqueline E
    Affiliation
    Department of Clinical Oncology, Christie Hospital, Manchester, United Kingdom.
    Issue Date
    2009-01-06
    
    Metadata
    Show full item record
    Abstract
    PURPOSE: Dose escalation for prostate cancer improves biological control but with a significant increase in late toxicity. Recent estimates of low alpha/beta ratio for prostate cancer suggest that hypofractionation may result in biological advantage. Intensity-modulated radiotherapy (IMRT) should enable dose escalation to the prostate while reducing toxicity to local organs. We report late toxicity data of a hypofractionated IMRT regime. METHODS AND MATERIALS: Eligible men had T2-3N0M0 adenocarcinoma prostate, and either Gleason score >/= 7 or prostate-specific antigen 20-50 ng/L. Patients received 57-60 Gy to prostate in 19-20 fractions using five-field IMRT. All received hormonal therapy for 3 months before radiotherapy to a maximum of 6 months. Toxicity was assessed 2 years postradiotherapy using the RTOG criteria, LENT/SOMA, and UCLA prostate index assessment tools. RESULTS: Acute toxicity was favorable with no RTOG Grade 3 or 4 toxicity. At 2 years, there was 4% Grade 2 bowel and 4.25% Grade 2 bladder toxicity. There was no Grade 3 or 4 bowel toxicity; one patient developed Grade 3 bladder toxicity. UCLA data showed a slight improvement in urinary function at 2 years compared with pretreatment. LENT/SOMA assessments demonstrated general worsening of bowel function at 2 years. Patients receiving 60 Gy were more likely to develop problems with bowel function than those receiving 57 Gy. CONCLUSIONS: These data demonstrate that hypofractionated radiotherapy using IMRT for prostate cancer is well tolerated with minimal late toxicity at 2 years posttreatment. Ongoing studies are looking at the efficacy of hypofractionated regimes with respect to biological control.
    Citation
    Hypofractionated Intensity-Modulated Radiotherapy for Carcinoma of the Prostate: Analysis of Toxicity. 2009: Int. J. Radiat. Oncol. Biol. Phys. 74(4)1121- 1127
    Journal
    International Journal of Radiation Oncology, Biology, Physics
    URI
    http://hdl.handle.net/10541/53093
    DOI
    10.1016/j.ijrobp.2008.09.032
    PubMed ID
    19131179
    Type
    Article
    Language
    en
    ISSN
    1879-355X
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.ijrobp.2008.09.032
    Scopus Count
    Collections
    All Christie Publications
    Clinical Oncology

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