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Nanos C, Souftas V, Zisimopoulos A, et al. Comparative radiobiological analysis and preliminary results of Ultra hypofractionated accelerated radiotherapy for low-risk prostate cancer patients. J BUON. 2021;26(3):956-963
Nanos, C., Souftas, V., Zisimopoulos, A., Abatzoglou, I., & Koukourakis, M. I. (2021). Comparative radiobiological analysis and preliminary results of Ultra hypofractionated accelerated radiotherapy for low-risk prostate cancer patients. Journal of B.U.ON. : official journal of the Balkan Union of Oncology, 26(3), 956-963.
Nanos, Christos, et al. "Comparative radiobiological analysis and preliminary results of Ultra hypofractionated accelerated radiotherapy for low-risk prostate cancer patients." Journal of B.U.ON. : official journal of the Balkan Union of Oncology vol. 26,3 (2021): 956-963.
Nanos C, Souftas V, Zisimopoulos A, Abatzoglou I, Koukourakis MI. Comparative radiobiological analysis and preliminary results of Ultra hypofractionated accelerated radiotherapy for low-risk prostate cancer patients. J BUON. 2021 May-Jun;26(3):956-963. PMID: 34268959.
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J BUON. 2021 May-Jun;26(3):956-963.

Comparative radiobiological analysis and preliminary results of Ultra hypofractionated accelerated radiotherapy for low-risk prostate cancer patients.

Journal of B.U.ON. : official journal of the Balkan Union of Oncology

Christos Nanos, Vasilios Souftas, Athanasios Zisimopoulos, Ioannis Abatzoglou, Michael I Koukourakis

Affiliations

  1. Department of Radiotherapy / Oncology, Democritus University of Thrace, University Hospital of Alexandroupolis, Alexandroupolis, Greece.

PMID: 34268959

Abstract

PURPOSE: Moderately accelerated hypofractionation (HypoAR) has been recently established as a standard radiotherapy scheme for low-risk prostate cancer. The application of ultra-hypofractionated regimens (ultra-HypoAR), with fraction size above 5 Gy, is also widely tested.

METHODS: We applied Image Guided Radiation Therapy (IGRT) ultra-HypoAR delivered with Volumetric Modulated Arc Therapy (VMAT) technique in low-risk prostate cancer patients (5.75 Gy/fraction, 40.25 Gy total dose, two fractions per week). A comparative radiobiological analysis of Dose-Volume Ηistograms (DVH) obtained for target volumes and organs at risk was performed, investigating the advantages and disadvantages of ultra-HypoAR and conventional radiotherapy regimens (CRT). Early clinical results on efficacy and toxicity are also reported.

RESULTS: We calculated the Normalized Total Dose (NTD) and NTD with time correction (NTD_T)-based biological Dose- Volume Histograms (bDVH) for bladder and rectum tissue late effects (α/β=4 Gy) and early effects (α/β=10 Gy). Ultra-HypoAR produced a significantly lower biological dose burden than CRT, for both early and late responding tissue components of the bladder and rectum, whether calculated for time-correction or not (p<0.0001). Our clinical experience showed that the ultra-HypoAR regimen produced minimal early and late radiation sequelae. The median PSA levels dropped from 9.1 to 0.75 and 0.45 ng/ml at 6 and 12 months, respectively, after the end of therapy.

CONCLUSIONS: In conclusion, radiobiological analysis of DVHs and preliminary clinical experience predict a better efficacy and low early and late toxicity profile for the tested seven-fraction VMAT ultra-HypoAR regimen with IGRT.

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