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

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International Journal of Clinical Oncology Aims and scope Submit manuscript

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.

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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

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Acknowledgments

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

Author information

Authors and Affiliations

  1. Department of Radiation Oncology, Tokyo Women’s Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan

    Yaichiro Hashimoto, Yuka Ishii, Sawa Kono, Sachiko Izumi & Kumiko Karasawa

  2. Division of Radiation Oncology and Particle Therapy, National Cancer Center Hospital East, Chiba, Japan

    Atsushi Motegi & Tetsuo Akimoto

  3. Radiation Therapy Center, Hitachinaka General Hospital, Ibaraki, Japan

    Norio Mitsuhashi

  4. Department of Urology, Tokyo Women’s Medical University, Tokyo, Japan

    Junpei Iizuka & Kazunari Tanabe

Authors
  1. Yaichiro Hashimoto
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  2. Atsushi Motegi
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  3. Tetsuo Akimoto
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  4. Norio Mitsuhashi
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  5. Junpei Iizuka
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  6. Kazunari Tanabe
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  7. Yuka Ishii
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  8. Sawa Kono
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  9. Sachiko Izumi
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  10. Kumiko Karasawa
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Contributions

All authors have read and approved the final manuscript.

Corresponding author

Correspondence to Yaichiro Hashimoto.

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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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Hashimoto, Y., Motegi, A., Akimoto, T. et al. The 5-year outcomes of moderately hypofractionated radiotherapy (66 Gy in 22 fractions, 3 fractions per week) for localized prostate cancer: a retrospective study. Int J Clin Oncol 23, 165–172 (2018). https://doi.org/10.1007/s10147-017-1175-1

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  • DOI: https://doi.org/10.1007/s10147-017-1175-1

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