Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Strahlentherapie und Onkologie
Published in: Strahlentherapie und Onkologie 7/2016

Open Access 01-07-2016 | Original Article

SHARP hypofractionated stereotactic radiotherapy is well tolerated in prostate cancer

Toxicity and quality of life assessment

Authors: Monika Rucinska, Anna Kieszkowska-Grudny, Sergiusz Nawrocki

Published in: Strahlentherapie und Onkologie | Issue 7/2016

Login to get access

Abstract

Background

Quality of life (QoL) is one of the most significant issues in prostate cancer treatment decisions. This study aimed to investigate the toxicity of hypofractionated stereotactic radiotherapy (SBRT) and QoL after treatment in localized prostate cancer patients.

Materials and methods

A prospective single-center clinical study was performed in low- and intermediate-risk prostate cancer patients. Patients received 33.5 Gy in 5 fractions (SHARP regimen). Acute and late toxicity was assessed according to RTOG/EORTC score. Patients filled out EORTC QLQ-C30 and prostate cancer-specific QLQ-PR25 questionnaires.

Results

The analysis included 68 prostate cancer patients (55–83 years, median 73) with clinical stage T1c-T2cN0M0, median combined Gleason score of 6 (3–8), and median prostate-specific antigen (PSA) level of 10 ng/mL (4–20 ng/mL). Neoadjuvant androgen deprivation therapy was given to 52 patients (76.5 %), and stopped in 31 patients (45.5 %) after 6 months; in 21 patients (31 %) after 2–3 years. Average and median follow-up was 24 months (18–45). Median nadir PSA level was 0.03 ng/mL for all patients and 0.6 ng/mL for patients without hormone treatment. No patients had PSA failure. There were no acute grade IV toxicities. One patient (1.5 %) developed grade III and 24 patients (35.3 %) grade II acute bladder toxicity. No one developed grade III and 7 patients (10.3 %) grade II acute rectal toxicity. No grade III or IV late gastrointestinal or genitourinary toxicities were reported. Grade II late urinary symptoms were observed in 8 patients (11.8 %) and gastrointestinal symptoms in 3 patients (4.4 %). Global health status/QoL was good and improved during the observational period.

Conclusion

SBRT for prostate cancer patients is a well-tolerated treatment in terms of toxicity and QoL, has no negative impact on functioning and everyday life, with the important benefit of a short treatment period. However, long-term follow-up data are needed.
Literature
1.
2.
Kim YJ, Cho KH, Pyo HR et al (2015) Radical prostatectomy versus external beam radiotherapy for localized prostate cancer: Comparison of treatment outcomes. Strahlenther Onkol 191:321–329CrossRefPubMed
3.
Dolezel M, Odrazka K, Zouhar M et al (2015) Comparing morbidity and cancer control after 3D-conformal (70/74 Gy) and intensity modulated radiotherapy (78/82 Gy) for prostate cancer. Strahlenther Onkol 191:338–346CrossRefPubMed
4.
Zelefsky MJ, Chan H, Hunt M et al (2006) Long-term outcome of high dose intensity modulated radiation therapy for patients with clinically localized prostate cancer. J Urol 176:1415–1419CrossRefPubMed
5.
Pickett B, Vigneault E, Kurhanewicz J (1999) Static field intensity modulation to treat a dominant intra-prostatic lesion to 90 Gy compared to seven field 3‑dimensional radiotherapy. Int J Radiat Oncol Biol Phys 44:921–929CrossRefPubMed
6.
Bauman G, Rumble RB, Chen J et al (2012) Members of the IMRT Indications Expert panel (2012) Intensity-modulated radiotherapy in the treatment of prostate cancer. Clin Oncol 24:461–473CrossRef
7.
Singh J, Greer PB, White MA et al (2013) Treatment-related morbidity in prostate cancer: a comparison of 3‑dimensional conformal radiation therapy with and without image guidance using implanted fiducial markers. Int J Radiat Oncol Biol Phys 85:1018–1023CrossRefPubMed
8.
Zelefsky MJ, Kollmeier M, Cox B et al (2012) Improved clinical outcomes with high-dose image guided radiotherapy compared with non-IGRT for the treatment of clinically localized prostate cancer. Int J Radiat Oncol Biol Phys 84:125–129CrossRefPubMed
9.
Fowler JF, Ritter MA, Chappell RJ et al (2003) What hypofractionated protocols should be tested for prostate cancer? Int J Radiat Oncol Biol Phys 56:1093–1104CrossRefPubMed
10.
Yeoh EE, Holloway RH, Fraser RJ et al (2006) Hypofractionated vs.conventionally fractionated radiation therapy for prostate carcinoma: Updated results of a phase III randomized trial. Int J Radiat Oncol Biol Phys 66:1072–1083CrossRefPubMed
11.
Kupelian PA, Willoughby TR, Reddy CA et al (2007) Hypofractionated intensity-modulated radiotherapy (70 Gy at 2.5 Gy per fraction) for localized prostate cancer: Cleveland Clinic experience. Int J Radiat Oncol Biol Phys 68:1424–1430CrossRefPubMed
12.
Collins CD, Lloyd-Davies RW, Swan AV (1991) Radical external beam radiotherapy for localized carcinoma of the prostate using a hypofractionation technique. Clin Oncol 3:127–132CrossRef
13.
Lloyd-Davies RW, Collins CD, Swan AV (1990) Carcinoma of prostate treated by radical external beam radiotherapy using hypofractionation. Twenty-two years’ experience (1962–1984). Urology 36:107–111CrossRefPubMed
14.
Panje CM, Dal Pra A, Zilli T et al (2015) Consensus and differences in primary radiotherapy for localized and locally advanced prostate cancer in Switzerland: A survey on patterns of practice. Strahlenther Onkol 191:778–786CrossRefPubMed
15.
16.
17.
18.
Hüttenrauch P, Witt M, Wolff D et al (2014) Target volume coverage and dose to organs at risk in prostate cancer patients. Dose calculation on daily cone-beam CT data sets. Strahlenther Onkol 190:310–316CrossRefPubMed
19.
Madsen BL, Hsi RA, Pham HT et al (2007) Stereotactic hypofractionated accurate radiotherapy of the prostate (SHARP), 33.5 Gy in five fractions for localized disease: first clinical trial results. Int J Radiat Oncol Biol Phys 67:1099–1105CrossRefPubMed
20.
Fowler JF, Chappell R, Ritter M (2001) Is alfa/beta for prostate tumors really low? Int J Radiat Oncol Biol Phys 50:1021–1031CrossRefPubMed
21.
Duchesne GM, Peters LJ (1999) What is the α/β ratio for prostate cancer? Rationale for hypofractionated high-dose rate brachytherapy. Int J Radiat Oncol Biol Phys 44:747–748CrossRefPubMed
22.
Michalski JM, Gay H, Jackson A et al (2010) Radiation dose-volume effects in radiation-induced rectal injury. Int J Radiat Oncol Biol Phys 76(3):123–129CrossRef
23.
Thames H, Kuban D, Levy L et al (2003) Comparison of alternative biochemical failure definitions based on clinical outcome in 4839 prostate cancer patients treated by external beam radiotherapy between 1986 and 1995. Int J Radiat Oncol Biol Phys 57:929–943CrossRefPubMed
24.
Roach M 3rd, Hanks G, Thames H Jr et al (2006) Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer: recommendations of the RTOG-ASTRO Phoenix Consensus Conference. Int J Radiat Oncol Biol Phys 65:965–974CrossRefPubMed
25.
26.
King CR, Collins S, Fuller D et al (2013) Health-related quality of life after stereotactic body radiation therapy for localized prostate cancer: results from a multi-institutional consortium of prospective trials. Int J Radiat Oncol Biol Phys 87:939–945CrossRefPubMed
27.
Macias V, Biete A (2009) Hypofractionated radiotherapy for localised prostate cancer. Review of clinical trials. Clin Transl Oncol 11:437–445CrossRefPubMed
28.
Soete G, Arcangeli S, De Meerleer G et al (2006) Phase II study of a four-week hypofractionated external beam radiotherapy regimen for prostate cancer: report on acute toxicity. Radioth Oncol 80:78–81CrossRef
29.
King CR, Brooks JD, Gil H et al (2012) Long-term outcomes from a prospective trial of stereotactic body radiotherapy for low-risk prostate cancer. Int J Radiat Oncol Biol Phys 82:877–882CrossRefPubMed
30.
Yarbro CH, Ferrans CE (1998) Quality of life of patients with prostate cancer treated with surgery or radiation therapy. Oncol Nurs Forum 25:685–693PubMed
31.
Cox J, Grignon D, Kaplan R et al (1997) Consensus statement: guidelines for PSA following radiation therapy. Int J Radiat Oncol Biol Phys 37:1035–1041CrossRef
32.
Abramowitz MC, Li T, Buyounouski MK et al (2008) The Phoenix definition of biochemical failure predicts for overall survival in patients with prostate cancer. Cancer 112:55–60CrossRefPubMed
33.
Zaorsky NG, Studenski MT, Dicker AP et al (2013) Stereotactic body radiation therapy for prostate cancer: Is the technology ready to be the standard of care? Cancer Treat Rev 39:212–218CrossRefPubMed
34.
35.
Madsen BL, Hsi RA, Pham HT et al (2003) Intrafractional stability of the prostate using a stereotactic radiotherapy technique. Int J Radiat Oncol Biol Phys 57:1285–1291CrossRefPubMed
36.
King CR, Freeman D, Kaplan I et al (2013) Stereotactic body radiotherapy for localized prostate cancer: pooled analysis from a multi-institutional consortium of prospective phase II trials. Radiother Oncol 109:217–221CrossRefPubMed
37.
Sher DJ, Parikh RB, Mays-Jackson S et al (2014) Cost-effectiveness analysis of SBRT versus IMRT for low-risk prostate cancer. Am J Clin Oncol 37:215–221CrossRefPubMed
Metadata
Title
SHARP hypofractionated stereotactic radiotherapy is well tolerated in prostate cancer
Toxicity and quality of life assessment
Authors
Monika Rucinska
Anna Kieszkowska-Grudny
Sergiusz Nawrocki
Publication date
01-07-2016
Publisher
Springer Berlin Heidelberg
Published in
Strahlentherapie und Onkologie / Issue 7/2016
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-016-0971-2

Other articles of this Issue 7/2016

Strahlentherapie und Onkologie 7/2016 Go to the issue

Literatur kommentiert

Capacitabine und Oxaliplatin (XelOx) im Vergleich zu Fluorouracil/Folinsäure als adjuvante Therapie bei Kolonkarzinomen im Stadium III: Ergebnisse der kontrollierten randomisierten Phase III-Studie NO16968

Original Article

High dose-rate endoluminal brachytherapy for primary and recurrent esophageal cancer

Literatur kommentiert

Bei diffus großzelligen B‑Zell-Lymphomen des Magens nach Komplett-Remission nach Chemotherapie konsolidierende Strahlentherapie empfohlen

Original Article

Risk of biochemical recurrence and timing of radiotherapy in pT3a N0 prostate cancer with positive surgical margin

Original Article

68Ga-PSMA ligand PET/CT-based radiotherapy in locally recurrent and recurrent oligometastatic prostate cancer

Literatur kommentiert

Protonentherapie bei Kindern mit Medulloblastom bei akzeptablen Nebenwirkungen ähnlich erfolgreich wie Photonentherapie