Canales Juan P, Barnafi Esteban, Salazar Cristian, Reyes Paula, Merino Tomas, Calderón David, Cortés Analía
Department of Hemato-oncology, Radiotherapy, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile.
Medicine School, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile.
Rep Pract Oncol Radiother. 2024 Jun 6;29(2):187-196. doi: 10.5603/rpor.99677. eCollection 2024.
Hypofractionated radiotherapy in the treatment of prostate cancer has been widely studied. However, in the postoperative setting it has been less explored. The objective of this prospective study is to evaluate the safety and efficacy of hypofractionated radiotherapy in postoperative prostate cancer.
A prospective study was designed to include patients with prostate cancer with an indication of postoperative radiotherapy as adjuvant or salvage. A hypofractionated radiotherapy scheme of 51 Gy in 17 fractions was performed with the possibility of treating the pelvis at a dose of 36 Gy in 12 fractions sequentially. Safety was evaluated based on acute and late toxicity [according to the Radiation Therapy Oncology Group (RTOG) scale and Common Terminology Criteria Adverse Events (CTCAE) v4.03], International Prognostic Scoring System (IPSS) over time, and quality of life.
From August 2020 to June 2022, 31 patients completed treatment and were included in this report. 35.5% of patients received elective treatment of the pelvic nodal areas. Most patients reported minimal or low acute toxicity, with an acute gastrointestinal (GI) and genitourinary (GU) grade 3 or greater toxicity of 3.2% and 0%, respectively. The evolution in time of the IPSS remained without significant differences (p = 0.42). With the exception of a significant improvement in the domains of hormonal and sexual symptoms of the Expanded Prostate Cancer Index Composite (EPIC) questionnaire, the rest of the domains [EPIC, European Organization for Research and Treatment of Cancer (EORTC) Core quality of life questionnaire (C-30) and Prostate Cancer module (PR-25)] were maintained without significant differences over time. With a follow-up of 15.4 months, late GI and GU grade 2 toxicity was reported greater than 0% and 9.6%, respectively.
Hypofractionated radiotherapy in postoperative prostate cancer appears to be safe with low reports of relevant acute or late toxicity. Further follow-up is required to confirm these results.
The protocol was approved by the accredited Medical Ethical Committee of Pontificia Universidad Católica de Chile. All participants accepted and wrote informed consent.
前列腺癌的大分割放疗已得到广泛研究。然而，在术后情况下的研究较少。这项前瞻性研究的目的是评估大分割放疗在前列腺癌术后的安全性和有效性。
设计一项前瞻性研究，纳入有术后放疗指征作为辅助或挽救治疗的前列腺癌患者。采用17次分割给予51 Gy的大分割放疗方案，同时有可能依次给予盆腔12次分割36 Gy的剂量。根据急性和晚期毒性[依据放射治疗肿瘤学组（RTOG）标准和不良事件通用术语标准（CTCAE）v4.03]、随时间变化的国际预后评分系统（IPSS）以及生活质量评估安全性。
2020年8月至2022年6月，31例患者完成治疗并纳入本报告。35.5%的患者接受了盆腔淋巴结区域的选择性治疗。大多数患者报告的急性毒性最小或较低，急性胃肠道（GI）和泌尿生殖系统（GU）3级或更高毒性分别为3.2%和0%。IPSS随时间的变化无显著差异（p = 0.42）。除了扩展前列腺癌指数综合问卷（EPIC）的激素和性症状领域有显著改善外，其余领域[EPIC、欧洲癌症研究与治疗组织（EORTC）核心生活质量问卷（C - 30）和前列腺癌模块（PR - 25）]随时间保持无显著差异。随访15.4个月时，晚期GI和GU 2级毒性报告分别大于0%和9.6%。
前列腺癌术后大分割放疗似乎是安全的，相关急性或晚期毒性报告较少。需要进一步随访以证实这些结果。
该方案已获得智利天主教大学认可的医学伦理委员会批准。所有参与者均接受并签署了知情同意书。
