Prospective phase Ⅱ trial of hypofractionated intensity-modulated radiotherapy for localized prostate cancer
LIU Yue-ping, LI Ye-xiong, WANG Wei-hu, FANG Hui, JIN Jing, WANG Shu-lian, SONG Yong-wen, REN Hua, LIU Xin-fan, YU Zi-hao, DAI Jian-rong
Department of Radiation Oncology, Cancer Hospital (Institute), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021,China Corresponding author:LI Ye-xiong, Email:yexiong3@yahoo.com.cn
Abstract：Objective To prospectively evaluate the efficacy and toxicity of hypofractionated intensity-modulated radiotherapy (IMRT) for prostate cancer. Methods Fifty-two consecutive patients with localized prostate cancer were enrolled in this study between Feb. 2009 and Mar. 2011. All patients received hypofractionated IMRT (2.7 Gy/fx,25 fractions, total 67.5 Gy) to the prostate and seminal vesicles. 32 high risk patients also received prophylactic irradiation to the pelvic lymph nodes concurrently (2 Gy/fx,25 fractions). Imaging-guided radiotherapy was employed in 35 patients. Androgen deprivation therapy was adopted in 48 of 52 patients. Results After a median follow-up of 13 months, the mean prostate specific antigen (PSA) was reduced from (40.3±36.6) ng/ml before treatment to (0.5±1.7) ng/ml at the last follow-up. By the time of last follow-up, 2 patients (4%) failed. One had PSA failure and the other had both PSA failure and pelvic lymph node relapse. 25% of the patients experienced grade 2 acute gastrointestinal (GI) toxicity and 4% experienced grade 3 GI toxicity. Acute grade 2 and grade 3 genitourinary (GU) toxicity occurred in 15% and 2%, respectively. The incidence of late grade 2 and grade 3 GI toxicity was 17% and 0%, respectively. Late grade 2 and 3 GU toxicity was 8% and 2%. The potencywas unable to evaluate because most of the patients received androgen deprivation therapy. Conclusions The short-term PSA-free survival after 2.7 Gy/fx,25 fractions′ hypofractionated IMRT for localized prostate cancer is favorable, and the acute and late GI and GU toxicity are acceptable. A longer time follow-up is warranted to ascertain the long term efficacy and safety of this regimen.
LIU Yue-ping,LI Ye-xiong,WANG Wei-hu et al. Prospective phase Ⅱ trial of hypofractionated intensity-modulated radiotherapy for localized prostate cancer[J]. Chinese Journal of Radiation Oncology, 2012, 21(3): 237-240.
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