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Moderate hypofractionation and simultaneous integrated boost by helical tomotherapy in prostate cancer: monoinstitutional report of acute tolerability assessment with different toxicity scales

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Abstract

Introduction

Based on radiobiology evidence, hypofractionated radiotherapy has the potential of improving treatment outcome in prostate cancer patients. In this study, we evaluated the safety, in terms of acutetoxicity, of using moderate hypofractionated radiotherapy delivered with Helical Tomotherapy (HT) to treat prostate cancer patients.

Materials and methods

Between December 2012 and April 2014, 42 consecutive patients were treated with hypofractionated radiotherapy using HT. All patients received 70 Gy in 28 fractions to PTV1, which included the prostate. In the intermediate risk group, 61.6 Gy were delivered to PTV2, which included the seminal vesicles. In high risk patients, the pelvic nodes were added (PTV3) and received 50.4 Gy. Acute toxicity was recorded prospectively with RTOG and Common Terminology Criteria for Adverse Events 3.0, retrospectively with CTCAE 4.0. Expanded Prostate Cancer Index Composite (EPIC) was measured at baseline and 3 months after end of treatment, to investigate health related quality of life with regards to bladder and gastrointestinal function.

Results

Acute toxicity was acceptable, independently from the system used to score side effects. Moderate genitourinary toxicity was more frequent than gastrointestinal toxicity. No correlation between acute side effects and patients’ characteristics or physical dose parameters was registered. EPIC evaluation showed a negligible difference in urinary and bowel function post-treatment, that did not reach statistical significance.

Conclusions

Our experience confirms the safety of moderate hypofractionation delivered with HT in prostate cancer patients with low, intermediate and high risk.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

This article does not contain any studies with human participants or animals performed by any of the authors.

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Authors and Affiliations

  1. Radiation Oncology, ARNAS-Civico Hospital, Palermo, Italy

    Giuseppe Ferrera, Gianluca Mortellaro & Maria Pia Pappalardo

  2. University of Palermo, Palermo, Italy

    Mariella Mannino

  3. Radiation Oncology School, University of Palermo, Palermo, Italy

    Giovanni Caminiti, Antonio Spera, Vanessa Figlia, Rosario Mazzola, Antonio Lo Casto & Roberto Lagalla

  4. Medical Physics, ARNAS-Civico Hospital, Palermo, Italy

    Giuseppina Iacoviello

  5. Statistic Sciences Faculty, University of Palermo, Palermo, Italy

    Gioacchino Di Paola

  6. RadiationOncology, Sacro Cuore Don Calabria Hospital, Negrar, Verona, Italy

    Filippo Alongi

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  1. Giuseppe Ferrera
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Correspondence to Giovanni Caminiti.

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Ferrera, G., Mortellaro, G., Mannino, M. et al. Moderate hypofractionation and simultaneous integrated boost by helical tomotherapy in prostate cancer: monoinstitutional report of acute tolerability assessment with different toxicity scales. Radiol med 120, 1170–1176 (2015). https://doi.org/10.1007/s11547-015-0555-8

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  • DOI: https://doi.org/10.1007/s11547-015-0555-8

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