Long-term outcomes of moderately hypofractionated radiotherapy (67.5 Gy in 25 fractions) for prostate cancer confined to the pelvis: a single center retrospective analysis.
Radiat Oncol
; 15(1): 231, 2020 Oct 02.
Article
em En
| MEDLINE
| ID: mdl-33008404
ABSTRACT
BACKGROUND:
There is an increasing application of moderately hypofractionated radiotherapy for prostate cancer. We presented our outcomes and treatment-related toxicities with moderately hypofractionated (67.5 Gy in 25 fractions) radiotherapy for a group of advanced prostate cancer patients from China.METHODS:
From November 2006 to December 2018, 246 consecutive patients with prostate cancer confined to the pelvis were treated with moderately hypofractionated radiotherapy (67.5 Gy in 25 fractions). 97.6% of the patients received a different duration of androgen deprivation therapy. Failure-free survival (FFS), prostate cancer-specific survival (PCSS), overall survival (OS), and cumulative grade ≥ 2 late toxicity were evaluated using the Kaplan-Meier actuarial method. Prognostic factors for FFS, PCSS, and OS were analyzed.RESULTS:
The median follow-up time was 74 months (range 6-150 months). For all patients, the 5- and 10-year FFS rates were 80.0% (95% CI 74.7-85.7%) and 63.5% (95% CI 55.4-72.8%). The failure rates for the intermediate, high-risk, locally advanced, and N1 groups were 6.1%, 13.0%, 18.4%, and 35.7%, respectively (P = 0.003). Overall, 5- and 10-year PCSS rates were 95.7% (95% CI 93.0-98.5%) and 88.2% (95% CI 82.8-93.8%). Prostate cancer-specific mortality rates for the high-risk, locally advanced, and N1 groups were 4.0%, 8.2%, and 23.8%, respectively (P < 0.001). Overall, 5- and 10-year actuarial OS rates were 92.4% (95% CI 88.8-96.1%) and 72.7% (95% CI 64.8-81.5%). High level prostate-specific antigen and positive N stage were significantly associated with worse FFS (P < 0.05). Advanced T stage and positive N stage emerged as worse predictors of PCSS (P < 0.05). Advanced age, T stage, and positive N stage were the only factors that were significantly associated with worse OS (P < 0.05). The 5-year cumulative incidence rate of grade ≥ 2 late GU and GI toxicity was 17.8% (95% CI 12.5-22.7%) and 23.4% (95% CI 17.7-28.7%), respectively.CONCLUSIONS:
Moderately hypofractionated radiotherapy (67.5 Gy in 25 fractions) for this predominantly high-risk, locally advanced, or N1 in Chinese patients demonstrates encouraging long-term outcomes and acceptable toxicity. This fractionation schedule deserves further evaluation in similar populations.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Pélvicas
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Neoplasias da Próstata
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Hipofracionamento da Dose de Radiação
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Aged80
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Radiat Oncol
Assunto da revista:
NEOPLASIAS
/
RADIOTERAPIA
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
China
País de publicação:
ENGLAND
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ESCOCIA
/
GB
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GREAT BRITAIN
/
INGLATERRA
/
REINO UNIDO
/
SCOTLAND
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UK
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UNITED KINGDOM