Phase I/II study of a five-fraction hypofractionated accelerated radiotherapy treatment for low-risk localised prostate cancer: early results of pHART3.

AIMS: Most men with low-risk localised prostate cancer prefer treatments with high control rates and minimal disruption to their lives. Hypofractionating external radiation treatments can theoretically maintain high bioequivalent tumour doses, decrease treatment visits and decrease acute and late toxicities. The aim of this study was to assess the toxicity and feasibility of a hypofractionated accelerated regimen for these patients. MATERIALS AND METHODS: The present study was a phase I/II study in which patients with T1-2b, Gleason < or = 6 and prostate-specific antigen (PSA) < or = 10 ng/ml prostate cancer received 35Gy in five fractions, once a week over 29 days. Treatment was delivered with intensity-modulated radiotherapy on standard linear accelerators, with daily image guidance using gold seed fiducials, and a 4mm clinical target volume to planning target volume margin. RESULTS: As of January 2008, the target accrual of 30 patients had been reached and all had completed treatment and at least 6 months of follow-up. Dose-volume histogram objectives were achievable in all patients. Treatment was very well tolerated with no grade 3 or 4 genitourinary toxicity, gastrointestinal toxicity nor fatigue observed (95% confidence interval 0-12%). As a group, compared with baseline, the following additional grade 2 toxicities were observed: 13% genitourinary, 7% gastrointestinal and 10% fatigue. At 6 months all scores had returned to or improved over baseline. The median PSA before treatment was 6.0 ng/ml. At 6 months, the median PSA was 1.8 ng/ml and 75% had a PSA < or = 3.0 ng/ml. CONCLUSIONS: This novel technique using standard linear accelerators seems feasible and is well tolerated. Further follow-up will be carried out to document late toxicity and efficacy.

A systematic study of cement/PFA chemical stabilisation/solidification process for the treatment of heavy metal waste.

The aim of this study is to systematically quantify the physical and chemical properties of the cement based solidified/stabilised heavy metal waste with increasing replacement of cement by PFA. Bulk density and unconfined compressive strength are measured as the physical parameters. The equilibrium extraction tests, sequential chemical tests and dynamic leaching tests are reported as chemical characteristics. The results showed PFA-blended cement-based waste forms have higher porosity and lower strength than the pure cement-based waste forms at experimental curing time. The lower alkalinities of the PFA-blended cement-based waste forms, however, lead to higher leach rates of heavy metals when the waste is exposed to an acidic medium.