Impact of image guidance on toxicity and tumour outcome in moderately hypofractionated external-beam radiotherapy for prostate cancer

AbstractTo report toxicity and efficacy outcome of moderately hypofractionated image-guided external-beam radiotherapy in a large series of patients treated for prostate cancer (PCa). Between 10/2006 and 12/2015, 572 T1-T3N0M0 PCa patients received 70.2  Gy in 26 fractions at 2.7 Gy/fraction: 344 patients (60%) with three-dimensional conformal radiotherapy (3D-CRT) and 228 (40%) with intensity-modulated radiotherapy (IMRT). Radiation Therapy Oncology Group/European Organization for Research and Treatment of Cancer criteria and Houston definition (nadir + 2) were used for toxicity and biochemical failure evaluation, respectively. Median age was 74 years (interquartile range 69–77). Compared with 3D-CRT, in IMRT group more high-risk patients (29% vs 18%;P = 0.002) and more high-volume target (75% vs 60%;P <  0.001) were included. Acute gastro-intestinal (GI) toxicityG >  1 were registered in 8% and in 11% IMRT and 3D-CRT patients, respectively, whereas late GIG >  1 were observed in 2% and 16% IMRT and 3D-CRT patients, respectively. Acute genito-urinary (GU) toxicityG >  1 were registered in 26% and 40% IMRT and 3D-CRT patients, respectively, whereas late GUG >  1 occurred in 5% IMRT and 15% 3D-CRT patients. Multivariate proportional hazard Cox models confirmed significantly greater risk of late toxicity with 3D-CRT compared to IMRT for GU >  1 (P = 0.004) and for GI >  1 (P <  0.001). With a median 4-year...
Source: Medical Oncology - Category: Cancer & Oncology Source Type: research