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Hypofractionated helical tomotherapy using 2.5–2.6 Gy daily fractions for localized prostate cancer

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Abstract

Background

The purpose of this study is to evaluate the tolerability of hypofractionated helical tomotherapy (HT) in the treatment of localized prostate cancer.

Materials and methods

We evaluated 48 patients with primary adenocarcinoma of the prostate (cT1-T3N0M0) who were treated with hypofractionated HT from August 2008 through July 2011. Hypofractionated regimens included: 68.04 Gy at 2.52 Gy/fraction, 70 Gy at 2.5 Gy/fraction, and 70.2 Gy at 2.6 Gy/fraction. Genitourinary (GU) and gastrointestinal (GI) toxicity was scored using the Radiation Therapy Oncology Group scoring system.

Results

Thirty-two patients were treated with 68.04 Gy, 5 patients with 70 Gy, and 11 with 70.2 Gy. The median age at diagnosis was 69 years (range 49–87) and the median follow-up 11 months (range 7–40). Grade 2 acute GI toxicity occurred in 9 patients (19 %). No grade 3 or higher acute GI toxicity was observed. Grade 2 and 3 acute GU toxicities occurred in 19 and 6 % of patients, respectively. The incidence of late grade 2 GI and GU toxicity was 4 and 2 %, respectively. No grade 3 or higher late toxicities were observed. Multivariate analysis showed that patients treated at 2.6 Gy/fraction or those who received a total radiation dose ≥70 Gy had higher rates of grade ≥2 acute GU toxicity (P = 0.004 and P = 0.048, respectively).

Conclusion

Hypofractionated HT in the treatment of localized prostate cancer is well tolerated with no grade 3 or higher early or late GI and GU toxicities. Further research is needed to assess definitive late toxicity and tumor control.

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Acknowledgments

The authors wish to thank Dr. Claudio Sole for his contribution to this study.

Conflict of interest

None.

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Authors and Affiliations

  1. Department of Radiation Oncology, Instituto Madrileño de Oncología/Grupo IMO, Clinica La Milagrosa, Calle Modesto Lafuente, 14, 28010, Madrid, Spain

    Jose Luis Lopez Guerra, Nicolas Isa, Raul Matute, Fernando Puebla, Cesar Beltran, Javier Jaen & Hugo Marsiglia

  2. Medical School, Diego Portales University, Santiago, Chile

    Moises Russo

  3. Radiomedicine Institute IRAM, Santiago, Chile

    Moises Russo

  4. Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA

    Michelle Miran Kim

  5. Radiation Physics, Instituto Madrileño de Oncología/Grupo IMO, Madrid, Spain

    Alberto Sanchez-Reyes

  6. Department of Radiation Oncology, Institut de cancérologie Gustave Roussy, Villejuif, Paris, France

    Celine Bourgier & Hugo Marsiglia

Authors
  1. Jose Luis Lopez Guerra
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  2. Nicolas Isa
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  3. Raul Matute
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  10. Celine Bourgier
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  11. Hugo Marsiglia
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Correspondence to Jose Luis Lopez Guerra.

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Lopez Guerra, J.L., Isa, N., Matute, R. et al. Hypofractionated helical tomotherapy using 2.5–2.6 Gy daily fractions for localized prostate cancer. Clin Transl Oncol 15, 271–277 (2013). https://doi.org/10.1007/s12094-012-0907-y

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  • DOI: https://doi.org/10.1007/s12094-012-0907-y

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