Department of Radiation Oncology, University of Health Science Prof. Dr. CemilTascioglu City Hospital, Istanbul, Turkey.
Aging Male. 2021 Dec;24(1):50-57. doi: 10.1080/13685538.2021.1948992.
We aimed to investigate the efficacy and tolerability of ultra-hypofractionated radiotherapy (UHRT) in the treatment of low and intermediate-risk prostate cancer patients.
This retrospective study was conducted using data derived from 44 patients who underwent UHRT, and toxicity assessment and clinical response were investigated. Treatment consisted of 35-36.25 Gy in 5 fractions using stereotactic ablative radiotherapy (SABR) with the Linac-based delivery system.
The median duration of follow-up was 52 months (8-68 months) and the median age was 71.5 years (54-85 years). Twenty-seven patients were assigned as intermediate-risk, whereas 17 patients had low-risk. The 5-year overall survival rate was 87.8%, while the 5-year biochemical recurrence-free survival (bRFS) rate was 97.4%. Acute grade 3 genitourinary (GU) side effect was not observed in any patient, whereas acute gastrointestinal (GI) system grade 3 side effect was seen in 6.8% of the patients. Late grade 3 GU and GI side effects were seen in 4.6% and 6.8% of the patients, respectively. In patients with planning target volume (PTV) ≥85 ml, acute grade ≥2 GU side effects were more common (=.034).
Our data demonstrated that UHRT administered with volumetric arc therapy (VMAT) can be recommended for selected patients with low-intermediate risk prostate cancer. Further prospective, multicentric, controlled trials on larger series are warranted to reach more accurate conclusions.
本研究旨在评估超分割放疗（UHRT）治疗低危和中危前列腺癌患者的疗效和耐受性。
本回顾性研究纳入了 44 例接受 UHRT 治疗的患者，对其毒性评估和临床反应进行了研究。治疗采用基于直线加速器的立体定向消融放疗（SABR），处方剂量为 35-36.25Gy，共 5 次。
中位随访时间为 52 个月（8-68 个月），中位年龄为 71.5 岁（54-85 岁）。27 例患者为中危，17 例为低危。5 年总生存率为 87.8%，5 年生化无复发生存率（bRFS）为 97.4%。无患者出现急性 3 级泌尿生殖系统（GU）毒性，6.8%的患者出现急性胃肠道（GI）系统 3 级毒性。4.6%和 6.8%的患者分别出现迟发性 3 级 GU 和 GI 毒性。PTV≥85ml 的患者中，急性≥2 级 GU 毒性更为常见（=.034）。
我们的数据表明，容积旋转调强放疗（VMAT）联合 UHRT 可用于治疗某些低危和中危前列腺癌患者。需要进一步开展前瞻性、多中心、对照试验，以获得更准确的结论。
