International Journal of Clinical Oncology

, Volume 23, Issue 1, pp 165–172 | Cite as

The 5-year outcomes of moderately hypofractionated radiotherapy (66 Gy in 22 fractions, 3 fractions per week) for localized prostate cancer: a retrospective study

  • Yaichiro Hashimoto
  • Atsushi Motegi
  • Tetsuo Akimoto
  • Norio Mitsuhashi
  • Junpei Iizuka
  • Kazunari Tanabe
  • Yuka Ishii
  • Sawa Kono
  • Sachiko Izumi
  • Kumiko Karasawa
Original Article
  • 126 Downloads

Abstract

Background

Hypofractionated radiotherapy using fewer and larger fractional doses may be more beneficial than conventional external-beam radiotherapy for localized prostate cancer. We evaluated the 5-year outcomes of moderately hypofractionated radiotherapy for localized prostate cancer.

Methods

We retrospectively evaluated 195 patients with localized prostate cancer (T1–3N0M0) who underwent intensity-modulated radiotherapy (IMRT) (66 Gy delivered in fractions of 3 Gy every other weekday) between May 2005 and December 2011. Patients received androgen deprivation therapy depending on the perceived intermediate or high risk of their disease. A prostate-specific antigen nadir +2.0 ng/ml indicated biochemical failure. We assessed toxicity using the Radiation Therapy Oncology Group and the European Organization for Research and Treatment of Cancer (RTOG/EORTC) criteria, and patient-reported outcomes using the Expanded Prostate Cancer Index Composite (EPIC).

Results

The risk classifications (proportion) were low risk (13.8%), intermediate risk (35.9%), and high risk (50.3%). The median follow-up was 69 months. Thirteen (6.66%) patients experienced biochemical failure within a median of 40 months (interquartile range, 25–72 months). The 5-year overall survival rate and no biological evidence of disease rate were 97.7% and 92.4%, respectively. Based on the RTOG/EORTC criteria, no patient experienced acute or late toxicity of grade 3 or higher. The EPIC scores revealed significant differences in the average value of all domains (p < 0.01). At 1 month postradiotherapy completion, the general urinary and bowel domain scores had decreased, but these scores returned to baseline level by 3 months post radiotherapy.

Conclusions

The moderately hypofractionated radiotherapy protocol yielded short-term satisfactory clinical outcomes with acceptable toxicity.

Keywords

Hypofractionation Intensity-modulated radiotherapy Patient-reported outcome Prostate cancer Prostate-specific antigen Quality of life 

Abbreviations

ADT

Androgen deprivation therapy

ANOVA

Analysis of variance

BED

Biologically effective dose

bNED

No biochemical evidence of disease

CHHiP

Conventional or hypofractionated high-dose intensity-modulated radiotherapy for prostate cancer

CTCAE

Common terminology criteria for adverse events

EORTC

European Organization for Research and Treatment of Cancer

EPIC

Expanded Prostate Cancer Index Composite

HYPRO

HYpofractionated irradiation for PROstate cancer

OS

Overall survival

OTT

Overall treatment time

PROFIT

PROstate fractionated irradiation trial

PRO

Patient-reported outcome

PSA

Prostate-specific antigen

QOL

Quality of life

RTOG

Radiation Therapy Oncology Group

Notes

Acknowledgments

Editage (www.editage.jp) provided English language editing for this manuscript.

Author contribution

All authors have read and approved the final manuscript.

Compliance with ethical standards

Ethics approval and consent to participate

The protocol of this study was approved by the institutional review board of Tokyo Women’s Medical University in Tokyo, Japan (protocol number 637). All participants provided informed consent.

Conflict of interest

No author has any conflict of interest.

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Copyright information

© Japan Society of Clinical Oncology 2017

Authors and Affiliations

  • Yaichiro Hashimoto
    • 1
  • Atsushi Motegi
    • 2
  • Tetsuo Akimoto
    • 2
  • Norio Mitsuhashi
    • 3
  • Junpei Iizuka
    • 4
  • Kazunari Tanabe
    • 4
  • Yuka Ishii
    • 1
  • Sawa Kono
    • 1
  • Sachiko Izumi
    • 1
  • Kumiko Karasawa
    • 1
  1. 1.Department of Radiation OncologyTokyo Women’s Medical UniversityTokyoJapan
  2. 2.Division of Radiation Oncology and Particle TherapyNational Cancer Center Hospital EastChibaJapan
  3. 3.Radiation Therapy CenterHitachinaka General HospitalIbarakiJapan
  4. 4.Department of UrologyTokyo Women’s Medical UniversityTokyoJapan

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