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Hypofractionated Radiation Therapy in Prostate Cancer: Rationale, History, and Outcomes

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Book cover Robotic Radiosurgery. Treating Prostate Cancer and Related Genitourinary Applications

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Abstract

About 10 years ago, the first studies supporting the hypothesis that the response of prostate cancer to radiation was similar to that of slow-proliferating normal tissues were published. However, hypofractionation has been a common practice throughout radiotherapy history, mainly in western countries. The results of both experimental and clinical studies suggest that the α/β ratio for prostate cancer cells is lower than the α/β ratio for late-responding cells of the rectum and the bladder. This particularity allows the therapeutic window to be increased through the use of hypofractionated schemes. It has also been possible to establish, based on late toxicity results, that hypofractionated regimens are safe, and even without the use of IMRT or IGRT technology, the slight increases in acute toxicity found in some studies has been well tolerated. Nevertheless, to date, hypofractionation has not proved to be superior to conventionally fractionated therapy in terms of tumor control. Hypofractionation studies have so far been limited by their relatively short follow-up, a modest increase in dose per fraction (usually 2.5–3 Gy), and the difficulty to establish comparisons among different radiation techniques, hypofractionation schemes, and toxicity scales.

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Authors and Affiliations

  1. Department of Radiation Medicine, Georgetown University Hospital, Georgetown University School of Medicine, Washington, DC, USA

    Víctor Macias Hernandez M.D., Ph.D.

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  1. Víctor Macias Hernandez M.D., Ph.D.
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Correspondence to Víctor Macias Hernandez M.D., Ph.D. .

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Editors and Affiliations

  1. Dept. Urology, Center for Urologic Oncology &, University Hospitals Case Medical Center, Euclid Avenue 11100, Cleveland, 44106, Ohio, USA

    Lee E. Ponsky

  2. Radiosurgery Medical Group, Inc., San Diego Cyberknife Center, Ruffin Rd. 5395, San Diego, 92123, California, USA

    Donald B. Fuller

  3. Medical Director, Radiation Oncology, Swedish Cancer Institute at Northwest Ho, 1560 North 115th Street G16, Seattle, 98133, Washington, USA

    Robert M. Meier

  4. Director, Physics, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, 19111-2497, Pennsylvania, USA

    Charlie Ma

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Hernandez, V.M. (2012). Hypofractionated Radiation Therapy in Prostate Cancer: Rationale, History, and Outcomes. In: Ponsky, L., Fuller, D., Meier, R., Ma, C. (eds) Robotic Radiosurgery. Treating Prostate Cancer and Related Genitourinary Applications. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-11495-3_9

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  • DOI: https://doi.org/10.1007/978-3-642-11495-3_9

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