Skip to main content
Top
Published in: Journal of Cancer Research and Clinical Oncology 10/2014

01-10-2014 | Original Article – Clinical Oncology

Stereotactic body radiotherapy with flattening filter-free beams for prostate cancer: assessment of patient-reported quality of life

Authors: Marta Scorsetti, Filippo Alongi, Elena Clerici, Tiziana Comito, Antonella Fogliata, Cristina Iftode, Pietro Mancosu, Piera Navarria, Giacomo Reggiori, Stefano Tomatis, Elisa Villa, Luca Cozzi

Published in: Journal of Cancer Research and Clinical Oncology | Issue 10/2014

Login to get access

Abstract

Purpose

Stereotactic body radiotherapy (SBRT) is an emerging treatment approach reported as safe and effective strategy for low- and intermediate-risk prostate cancer patients. End point of the current study is to appraise the patient-reported quality of life according to the expanded prostate cancer index composite (EPIC) questionnaire.

Methods

In the framework of a prospective mono-institutional phase II trial, EPIC questionnaire was dispensed (up to 1 year after treatment) to a cohort of 46 patients of 72 treated with 5 fractions of 7 Gy each to the prostate. SBRT was delivered with RapidArc VMAT with 10 MV flattening filter-free photon beams.

Results

Median follow-up of patients was 14.5 months (range: 6–23). Acute rectal toxicity was mild (only 23/72 cases with G1–2 and no G3–4) as well as urinary (50/72 G1–2 and no G3–4). At the moment, four cases of G1 late rectal toxicity and 22 cases of G1 urinary (1 of G2) were reported. Urinary, rectal, sexual, and hormonal scores resulted stable over time: 1 year scores resulted, respectively, in −0.3, +2.8, −1.7, and −2.8 % variations with respect to baseline. No significant differences were observed also when data were stratified according to functional and bother sub-scales.

Conclusions

Stereotactic body radiotherapy (SBRT) treatment of prostate with RapidArc and high-intensity photon beams resulted to be well tolerated by patients with mild toxicity profiles and good patient-reported quality of life perception for the first year after treatment. Longer follow-up in the trial cohort is in progress.
Literature
go back to reference Alongi F, Cozzi L, Arcangeli S, Iftode C, Comito T, Villa E et al (2013) Linac based SBRT for prostate cancer in 5 fractions with VMAT and flattening filter free beams: preliminary report of a phase II study. Radiat Oncol 8:171PubMedCrossRefPubMedCentral Alongi F, Cozzi L, Arcangeli S, Iftode C, Comito T, Villa E et al (2013) Linac based SBRT for prostate cancer in 5 fractions with VMAT and flattening filter free beams: preliminary report of a phase II study. Radiat Oncol 8:171PubMedCrossRefPubMedCentral
go back to reference Aznar MC, Petersen PM, Logadottir A, Lindberg H, Korreman SS, Kjaer-Kristoffersen F, Engelholm SA (2010) Rotational radiotherapy for prostate cancer in clinical practice. Radiother Oncol 97:480–484PubMedCrossRef Aznar MC, Petersen PM, Logadottir A, Lindberg H, Korreman SS, Kjaer-Kristoffersen F, Engelholm SA (2010) Rotational radiotherapy for prostate cancer in clinical practice. Radiother Oncol 97:480–484PubMedCrossRef
go back to reference Bhattasali O, Chen L, Woo J, Park J, Kim J, Moures R et al (2014) Patient reported outcomes following stereotactic body radiation therapy for clinically localized prostate cancer. Radiat Oncol 9:52PubMedCrossRefPubMedCentral Bhattasali O, Chen L, Woo J, Park J, Kim J, Moures R et al (2014) Patient reported outcomes following stereotactic body radiation therapy for clinically localized prostate cancer. Radiat Oncol 9:52PubMedCrossRefPubMedCentral
go back to reference Greco C (2013) Extreme hypofractionated image-guided radiotherapy for prostate cancer. Eur Med J 1:48–55CrossRef Greco C (2013) Extreme hypofractionated image-guided radiotherapy for prostate cancer. Eur Med J 1:48–55CrossRef
go back to reference Hoppe BS, Michalski JM, Mendenhall NP, Morris CG, Henderson RH, Nichols RC, Mendenhall WM, Williams CR, Regan MM, Chipman JJ, Crociani CM, Sandler HM, Sanda MG, Hamstra DA (2014) Comparative effectiveness study of patient-reported outcomes after proton therapy or intensity-modulated radiotherapy for prostate cancer. Cancer 120:1076–1082PubMedCrossRef Hoppe BS, Michalski JM, Mendenhall NP, Morris CG, Henderson RH, Nichols RC, Mendenhall WM, Williams CR, Regan MM, Chipman JJ, Crociani CM, Sandler HM, Sanda MG, Hamstra DA (2014) Comparative effectiveness study of patient-reported outcomes after proton therapy or intensity-modulated radiotherapy for prostate cancer. Cancer 120:1076–1082PubMedCrossRef
go back to reference Katz A, Santoro M, Diblasio F, Ashley R (2013) Stereotactic body radiotherapy for localized prostate cancer: disease control and quality of life at 6 years. Radiat Oncol 8:118PubMedCrossRefPubMedCentral Katz A, Santoro M, Diblasio F, Ashley R (2013) Stereotactic body radiotherapy for localized prostate cancer: disease control and quality of life at 6 years. Radiat Oncol 8:118PubMedCrossRefPubMedCentral
go back to reference King CR, Freeman D, Kaplan I, Fuller D, Bolzicco G, Collins S et al (2013a) Stereotactic body radiotherapy for localized prostate cancer. Pooled analysis from a multi-institutional consortium of prospective phase II trials. Radiother Oncol 109:217–221PubMedCrossRef King CR, Freeman D, Kaplan I, Fuller D, Bolzicco G, Collins S et al (2013a) Stereotactic body radiotherapy for localized prostate cancer. Pooled analysis from a multi-institutional consortium of prospective phase II trials. Radiother Oncol 109:217–221PubMedCrossRef
go back to reference King C, Collins S, Fuller D, Wang P, Kupelian P, Steinberg M, Katz A (2013b) Health related quality of life after stereotactic body radiation therapy for localised prostate cancer: results from a multi institutional consortium of prospective trials. Int J Radiat Oncol Biol Phys 87:939–945PubMedCrossRef King C, Collins S, Fuller D, Wang P, Kupelian P, Steinberg M, Katz A (2013b) Health related quality of life after stereotactic body radiation therapy for localised prostate cancer: results from a multi institutional consortium of prospective trials. Int J Radiat Oncol Biol Phys 87:939–945PubMedCrossRef
go back to reference Litwin M, Gore J, Kwan L, Brandei J, Lee S, Wither H et al (2007) Quality of life after surgery, external beam irradiation or brachytherapy for early stage prostate cancer. Cancer 109:2239–2247PubMedCrossRef Litwin M, Gore J, Kwan L, Brandei J, Lee S, Wither H et al (2007) Quality of life after surgery, external beam irradiation or brachytherapy for early stage prostate cancer. Cancer 109:2239–2247PubMedCrossRef
go back to reference Macdougall N, Dean C, Muirhead R (2014) Stereotactic body radiotherapy in prostate cancer: is rapidarc a better solution than cyberknife? Clin Oncol 26:4–9CrossRef Macdougall N, Dean C, Muirhead R (2014) Stereotactic body radiotherapy in prostate cancer: is rapidarc a better solution than cyberknife? Clin Oncol 26:4–9CrossRef
go back to reference Norkus D, Karklelyte A, Engels B, Versmessen H, Grikevicius R, De Ridder M et al (2013) A randomized hypofractionation dose escalation trial for high risk prostate cancer patients: interim analysis of acute toxicity and quality of life in 124 patients. Radiat Oncol 8:206PubMedCrossRefPubMedCentral Norkus D, Karklelyte A, Engels B, Versmessen H, Grikevicius R, De Ridder M et al (2013) A randomized hypofractionation dose escalation trial for high risk prostate cancer patients: interim analysis of acute toxicity and quality of life in 124 patients. Radiat Oncol 8:206PubMedCrossRefPubMedCentral
go back to reference Pesce GA, Clivio A, Cozzi L, Nicolini G, Richetti A, Salati E, Valli M, Vanetti E, Fogliata A (2010) Early clinical experience of radiotherapy of prostate cancer with volumetric modulated arc therapy. Radiat Oncol 5:54PubMedCrossRefPubMedCentral Pesce GA, Clivio A, Cozzi L, Nicolini G, Richetti A, Salati E, Valli M, Vanetti E, Fogliata A (2010) Early clinical experience of radiotherapy of prostate cancer with volumetric modulated arc therapy. Radiat Oncol 5:54PubMedCrossRefPubMedCentral
go back to reference Sanda M, Dunn R, Michalski J, Sandler H, Northouse L, Hembroff L et al (2008) Quality of life and satisfaction with outcome among prostate cancer survivors. N Engl J Med 358:1250–1261PubMedCrossRef Sanda M, Dunn R, Michalski J, Sandler H, Northouse L, Hembroff L et al (2008) Quality of life and satisfaction with outcome among prostate cancer survivors. N Engl J Med 358:1250–1261PubMedCrossRef
go back to reference Scorsetti M, Alongi F, Castiglioni S et al (2011) Feasibility and early clinical assessment of flattening filter free (FFF) based stereotactic body radiotherapy treatments. Radiat Oncol 6:113PubMedCrossRefPubMedCentral Scorsetti M, Alongi F, Castiglioni S et al (2011) Feasibility and early clinical assessment of flattening filter free (FFF) based stereotactic body radiotherapy treatments. Radiat Oncol 6:113PubMedCrossRefPubMedCentral
go back to reference Scorsetti M, Arcangeli S, Tozzi A, Comito T, Alongi F, Navarria P, Mancosu P, Reggiori G, Fogliata A, Torzilli G, Tomatis S, Cozzi L (2013) Is stereotactic body radiation therapy an attractive option for unresectable liver metastases? A preliminary report from a phase 2 trial. Int J Radiat Oncol Biol Phys 86:336–342PubMedCrossRef Scorsetti M, Arcangeli S, Tozzi A, Comito T, Alongi F, Navarria P, Mancosu P, Reggiori G, Fogliata A, Torzilli G, Tomatis S, Cozzi L (2013) Is stereotactic body radiation therapy an attractive option for unresectable liver metastases? A preliminary report from a phase 2 trial. Int J Radiat Oncol Biol Phys 86:336–342PubMedCrossRef
go back to reference Weber DC, Caparrotti F, Laouiti M, Malek K (2011) Simultaneous in-field boost for patients with 1 to 4 brain metastasis/es treated with volumetric modulated arc therapy: a prospective study on quality-of-life. Radiat Oncol 6:79PubMedCrossRefPubMedCentral Weber DC, Caparrotti F, Laouiti M, Malek K (2011) Simultaneous in-field boost for patients with 1 to 4 brain metastasis/es treated with volumetric modulated arc therapy: a prospective study on quality-of-life. Radiat Oncol 6:79PubMedCrossRefPubMedCentral
go back to reference Wei JT, Dunn RL, Litwin MS, Sandler HM, Sanda MG (2000) Development and validation of the expanded prostate cancer index composite (EPIC) for comprehensive assessment of health-related quality of life in men with prostate cancer. Urology 56:899–905PubMedCrossRef Wei JT, Dunn RL, Litwin MS, Sandler HM, Sanda MG (2000) Development and validation of the expanded prostate cancer index composite (EPIC) for comprehensive assessment of health-related quality of life in men with prostate cancer. Urology 56:899–905PubMedCrossRef
go back to reference Wiegner E, King C (2010) Sexual function after stereotactic body radiotherapy for prostate cancer: results of a prospective clinical trial. Int J Radiat Oncol Biol Phys 78:442–448PubMedCrossRef Wiegner E, King C (2010) Sexual function after stereotactic body radiotherapy for prostate cancer: results of a prospective clinical trial. Int J Radiat Oncol Biol Phys 78:442–448PubMedCrossRef
go back to reference Zwahlen DR, Lang S, Hrbacek J, Glanzmann C, Kloeck S, Najafi Y, Streller T, Studer G, Zaugg K, Luetolf UM (2012) The use of photon beams of a flattening filter-free linear accelerator for hypo-fractionated volumetric modulated arc therapy in localized prostate cancer. Int J Radiat Oncol Biol Phys 83:1655–1660PubMedCrossRef Zwahlen DR, Lang S, Hrbacek J, Glanzmann C, Kloeck S, Najafi Y, Streller T, Studer G, Zaugg K, Luetolf UM (2012) The use of photon beams of a flattening filter-free linear accelerator for hypo-fractionated volumetric modulated arc therapy in localized prostate cancer. Int J Radiat Oncol Biol Phys 83:1655–1660PubMedCrossRef
Metadata
Title
Stereotactic body radiotherapy with flattening filter-free beams for prostate cancer: assessment of patient-reported quality of life
Authors
Marta Scorsetti
Filippo Alongi
Elena Clerici
Tiziana Comito
Antonella Fogliata
Cristina Iftode
Pietro Mancosu
Piera Navarria
Giacomo Reggiori
Stefano Tomatis
Elisa Villa
Luca Cozzi
Publication date
01-10-2014
Publisher
Springer Berlin Heidelberg
Published in
Journal of Cancer Research and Clinical Oncology / Issue 10/2014
Print ISSN: 0171-5216
Electronic ISSN: 1432-1335
DOI
https://doi.org/10.1007/s00432-014-1732-1

Other articles of this Issue 10/2014

Journal of Cancer Research and Clinical Oncology 10/2014 Go to the issue

Original Article – Clinical Oncology

Prognostic impact of angiopoietin-2 in multiple myeloma