Moderately HRT vs. CRT for localized prostate cancer using image-guided VMAT with SIB: evaluation of acute and late toxicities.
Purpose: This retrospective study aims at investigating the effects of moderately hypofractionated radiation therapy (HRT) on acute and late toxicities as well as on early biochemical control and therapeutic efficiency compared to conventional radiation therapy (CRT) in prostate cancer.Patients and...
| Publicado en: | Strahlentherapie und Onkologie Vol. 196; no. 7; pp. 598 - 608 |
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| Autores principales: | , , , , |
| Formato: | Journal Article |
| Publicado: |
Springer Nature
Jul2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=143855714&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 143855714 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01797158 NZE jtl: Strahlentherapie und Onkologie issn: 01797158 maglogo: N pubinfo: dt: Jul2020 vid: 196 iid: 7 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 143855714 143855714 144161666 NLM32040691 10.1007/s00066-020-01589-w NLM32040691 143855714 ppf: 598 ppct: 10 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Moderately HRT vs. CRT for localized prostate cancer using image-guided VMAT with SIB: evaluation of acute and late toxicities. aug: au: Vassis, Stratos Nöldeke, Beatrice Christiansen, Hans von Klot, Christoph A. Merten, Roland affil: Department of Radiation Oncology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hanover, Germany sug: subj: Adenocarcinoma Radiotherapy Prostatic Neoplasms Radiotherapy Radiotherapy, Conformal Methods Radiation Injuries Etiology Aged, 80 and Over Adenocarcinoma Blood Cystitis Pathology Gastrointestinal Diseases Prevention and Control Middle Age Male Adenocarcinoma Pathology Time Factors Prospective Studies Body Regions Radiation Effects Cystitis Etiology Urination Disorders Etiology Genitalia, Male Radiation Effects Genitalia, Male Pathology Bladder Radiation Effects Radiotherapy, Conformal Adverse Effects Radiation Injuries Prevention and Control Retrospective Design Rectum Radiation Effects Aged Rectal Diseases Etiology Prostatic Neoplasms Pathology Rectal Diseases Prevention and Control Prostate-Specific Antigen Blood Probability Prostatic Neoplasms Blood Therapeutics Methods Body Weights and Measures Gastrointestinal Diseases Etiology Urination Disorders Pathology Arthritis Impact Measurement Scales Aged, 80 & over Middle Aged: 45-64 years Aged: 65+ years Male ab: Purpose: This retrospective study aims at investigating the effects of moderately hypofractionated radiation therapy (HRT) on acute and late toxicities as well as on early biochemical control and therapeutic efficiency compared to conventional radiation therapy (CRT) in prostate cancer.Patients and Methods: We analyzed 55 HRT patients irradiated with the total dose of 60 Gy in 20 fractions delivered over 4 weeks. These patients were compared to a control group of 55 patients who received CRT with a total of <78 Gy in 37-39 fractions delivered over circa 8 weeks. External beam radiation therapy (EBRT) was conducted using daily image-guided (cone beam CT) volumetric modulated arc therapy (VMAT) and a simultaneously integrated boost (SIB) for both groups to protect the rectum. Acute toxicities were evaluated according to Common Terminology Criteria for Adverse Events (CTCAE) v5, whereas chronic toxicities were assessed in accordance with LENT-SOMA. Patient traits were compared by implementing t‑tests and Wilcoxon-Whitney tests for continuous variables, whereas discrete characteristics were evaluated by applying two-tailed Fisher's exact tests. In addition, we calculated average treatment effects (ATE). Thereby, propensity score matching (PSM) based on nearest-neighbor matching considering age, comorbidities, and risk stratification as covariates was applied. The statistical analysis was conducted using Stata 14.2 (StataCorp LLC, TX, USA).Results: As confirmed by the descriptive tests, the ATE revealed that the intensity and occurrence of urinary frequency (p = 0.034) and proctitis (p = 0.027) significantly decreased for the HRT group, whereas all other acute toxicities did not differ significantly between the HRT and CRT groups. For late toxicities, neither statistical tests nor ATE estimation showed significant differences. Also, no significant difference was found regarding the decrease in prostate specific antigen (PSA) after a median follow-up of 13 months (range 2-28 months), which indicates biochemical freedom from progression.Conclusion: HRT offers several medical and economic advantages and should therefore be considered as a useful alternative to CRT. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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