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01-01-2019 | RADIOTHERAPY

Late toxicity of image-guided hypofractionated radiotherapy for prostate: non-randomized comparison with conventional fractionation

Authors: Barbara Alicja Jereczek-Fossa, Alessia Surgo, Patrick Maisonneuve, Andrea Maucieri, Marianna Alessandra Gerardi, Dario Zerini, Giulia Marvaso, Delia Ciardo, Stefania Volpe, Damaris Patricia Rojas, Giulia Riva, Ombretta Alessandro, Samantha Dicuonzo, Giuseppe Fanetti, Paola Romanelli, Anna Starzyńska, Federica Cattani, Raffaella Cambria, Cristiana Fodor, Cristina Garibaldi, Chiara Romanò, Ottavio De Cobelli, Roberto Orecchia

Published in: La radiologia medica | Issue 1/2019

Abstract

Purpose

To evaluate the incidence and predictors for late toxicity and tumor outcome after hypofractionated radiotherapy using three different image-guided radiotherapy (IGRT) systems (hypo-IGRT) compared with conventional fractionation without image guidance (non-IGRT).

Methods and materials

We compared the late rectal and urinary toxicity and outcome in 179 prostate cancer patients treated with hypo-IGRT (70.2 Gy/26 fractions) and 174 non-IGRT patients (80 Gy/40 fractions). Multivariate analysis was performed to define predictors for late toxicity. 5- and 8-year recurrence-free survival (RFS) and overall survival (OS) were analyzed.

Results

Mean follow-up was 81 months for hypo-IGRT and 90 months for non-IGRT group. Mainly mild late toxicity was observed: Hypo-IGRT group experienced 65 rectal (30.9% G1/G2; 6.3% G3/G4) and 105 urinary events (56% G1/G2; 4% G3/G4). 5- and 8-year RFS rates were 87.5% and 86.8% (hypo-IGRT) versus 80.4% and 66.8% (non-IGRT). 5- and 8-year OS rates were 91.3% and 82.7% in hypo-IGRT and 92.2% and 84% in non-IGRT group. Multivariate analysis showed that hypo-IGRT is a predictor for late genitourinary toxicity, whereas hypo-IGRT, acute urinary toxicity and androgen deprivation therapy are predictors for late rectal toxicity. Advanced T stage and higher Gleason score (GS) were correlated with worse RFS.

Conclusions

A small increase in mild late toxicity, but not statistically significant increase in severe late toxicity in the hypo-IGRT group when compared with conventional non-IGRT group was observed. Our study confirmed that IGRT allows for safe moderate hypofractionation, offering a shorter overall treatment time, a good impact in terms of RFS and providing potentially more economic health care.

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Title: Late toxicity of image-guided hypofractionated radiotherapy for prostate: non-randomized comparison with conventional fractionation
Authors: Barbara Alicja Jereczek-Fossa
Alessia Surgo
Patrick Maisonneuve
Andrea Maucieri
Marianna Alessandra Gerardi
Dario Zerini
Giulia Marvaso
Delia Ciardo
Stefania Volpe
Damaris Patricia Rojas
Giulia Riva
Ombretta Alessandro
Samantha Dicuonzo
Giuseppe Fanetti
Paola Romanelli
Anna Starzyńska
Federica Cattani
Raffaella Cambria
Cristiana Fodor
Cristina Garibaldi
Chiara Romanò
Ottavio De Cobelli
Roberto Orecchia
Publication date: 01-01-2019
Publisher: Springer Milan
Published in: La radiologia medica / Issue 1/2019
Print ISSN: 0033-8362
Electronic ISSN: 1826-6983
DOI: https://doi.org/10.1007/s11547-018-0937-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Late toxicity of image-guided hypofractionated radiotherapy for prostate: non-randomized comparison with conventional fractionation

Abstract

Purpose

Methods and materials

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods and materials

Results

Conclusions

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