Hypofractionated versus conventionally fractionated radiation therapy for prostate carcinoma: Updated results of a phase III randomized trial

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dc.contributor.authorYeoh, E.
dc.contributor.authorHolloway, R.
dc.contributor.authorFraser, R.
dc.contributor.authorBotten, R.
dc.contributor.authorDi Matteo, A.
dc.contributor.authorButters, J.
dc.contributor.authorWeerasinghe, S.
dc.contributor.authorAbeysinghe, P.
dc.date.issued2006
dc.description.abstract<h4>Purpose</h4>The aim of this study was to compare the toxicity and efficacy of radiation therapy (RT) for localized carcinoma of the prostate, using a hypofractionated (55 Gy/20 fractions/4 weeks) vs. a conventionally fractionated (64 Gy/32 fractions/6.5 weeks) dose schedule.<h4>Methods and materials</h4>A total of 217 patients were randomized to either the hypofractionated (108 patients) or the conventional (109 patients) dose schedule, with planning with two-dimensional (2D) CT scan planning methodology in the majority of cases. All patients were followed for a median of 48 (6-108) months. Gastrointestinal (GI) and genitourinary (GU) toxicity was evaluated before RT and after its completion using modified late effects of normal tissue-subjective, objective, management, analytic (LENT-SOMA) scales and the European Organization for Research and Treatment of Cancer sexual function questionnaire. Efficacy of RT based on clinical, radiologic, and prostate-specific antigen data were also evaluated at baseline and after RT.<h4>Results</h4>Gastrointestinal and GU toxicity persisted 5 years after RT and did not differ between the two dose schedules other than in regard to urgency of defecation. However, 1-month GI toxicity was not only worse in patients with the hypofractionated RT schedule but also adversely affected daily activities. Nadir prostate-specific antigen values occurred at a median of 18.0 (3.0-54.0) months after RT. A total of 76 biochemical relapses, with or without clinical relapses, have occurred since; of these, 37 were in the hypofractionated and 39 in the conventional schedule. The 5-year biochemical +/- clinical relapse-free and overall survival was 55.9% and 85.3% respectively for all patients, and did not differ between the two schedules.<h4>Conclusions</h4>Radiation therapy for prostate carcinoma causes persistent GI toxicity that is largely independent of the two dose schedules. The hypofractionated schedule is equivalent in efficacy to the conventional schedule.
dc.identifier.citationInternational Journal of Radiation Oncology Biology Physics, 2006; 66(4):1072-1083
dc.identifier.doi10.1016/j.ijrobp.2006.06.005
dc.identifier.issn0360-3016
dc.identifier.issn1879-355X
dc.identifier.urihttp://hdl.handle.net/2440/23465
dc.language.isoen
dc.publisherElsevier Science Inc
dc.source.urihttps://doi.org/10.1016/j.ijrobp.2006.06.005
dc.subjectEXTERNAL-BEAM RADIOTHERAPY
dc.subjectPOSITION VARIABILITY
dc.subjectALPHA/BETA RATIO
dc.subjectCANCER
dc.subjectDYSFUNCTION
dc.subjectEXPERIENCE
dc.subjectSCHEDULES
dc.subjectPROCTITIS
dc.subjectSYMPTOMS
dc.subjectTOXICITY
dc.titleHypofractionated versus conventionally fractionated radiation therapy for prostate carcinoma: Updated results of a phase III randomized trial
dc.typeJournal article
pubs.publication-statusPublished

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