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Ricco A, Mukhopadhyay N, Deng X, et al. Moderately Hypofractionated Intensity Modulated Radiation Therapy With Simultaneous Integrated Boost for Prostate Cancer: Five-Year Toxicity Results From a Prospective Phase I/II Trial. Front Oncol. 2020;10:1686doi: 10.3389/fonc.2020.01686.
Ricco, A., Mukhopadhyay, N., Deng, X., Holdford, D., Skinner, V., Saraiya, S., Moghanaki, D., Anscher, M. S., & Chang, M. G. (2020). Moderately Hypofractionated Intensity Modulated Radiation Therapy With Simultaneous Integrated Boost for Prostate Cancer: Five-Year Toxicity Results From a Prospective Phase I/II Trial. Frontiers in oncology, 101686. https://doi.org/10.3389/fonc.2020.01686
Ricco, Anthony, et al. "Moderately Hypofractionated Intensity Modulated Radiation Therapy With Simultaneous Integrated Boost for Prostate Cancer: Five-Year Toxicity Results From a Prospective Phase I/II Trial." Frontiers in oncology vol. 10 (2020): 1686. doi: https://doi.org/10.3389/fonc.2020.01686
Ricco A, Mukhopadhyay N, Deng X, Holdford D, Skinner V, Saraiya S, Moghanaki D, Anscher MS, Chang MG. Moderately Hypofractionated Intensity Modulated Radiation Therapy With Simultaneous Integrated Boost for Prostate Cancer: Five-Year Toxicity Results From a Prospective Phase I/II Trial. Front Oncol. 2020 Aug 21;10:1686. doi: 10.3389/fonc.2020.01686. eCollection 2020. PMID: 32974208; PMCID: PMC7471868.
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Front Oncol. 2020 Aug 21;10:1686. doi: 10.3389/fonc.2020.01686. eCollection 2020.

Moderately Hypofractionated Intensity Modulated Radiation Therapy With Simultaneous Integrated Boost for Prostate Cancer: Five-Year Toxicity Results From a Prospective Phase I/II Trial.

Frontiers in oncology

Anthony Ricco, Nitai Mukhopadhyay, Xiaoyan Deng, Diane Holdford, Vicki Skinner, Siddharth Saraiya, Drew Moghanaki, Mitchell S Anscher, Michael G Chang

Affiliations

  1. Massey Cancer Center, Department of Radiation Oncology, Virginia Commonwealth University Health System, Richmond, VA, United States.
  2. Department of Biostatistics, Virginia Commonwealth University, Richmond, VA, United States.
  3. Virginia Commonwealth University Health System, Virginia Commonwealth University, Richmond, VA, United States.
  4. Hunter Holmes McGuire Veterans Administration Medical Center, Richmond, VA, United States.

PMID: 32974208 PMCID: PMC7471868 DOI: 10.3389/fonc.2020.01686

Abstract

BACKGROUND: In this phase I/II trial, 5-year physician-assessed toxicity and patient reported quality of life data is reported for patients undergoing moderately hypofractionated intensity modulated radiation therapy (IMRT) for prostate cancer using a simultaneous integrated boost (SIB) and pelvic lymph node (LN) coverage.

MATERIALS AND METHODS: Patients with T1-T2 localized prostate cancer were prospectively enrolled, receiving risk group based coverage of prostate ± seminal vesicles (SVs) ± pelvic lymph nodes (LNs). Low risk (LR) received 69.6 Gy/29 fractions to the prostate, while intermediate risk (IR) and high risk (HR) patients received 72 Gy/30fx to the prostate and 54Gy/30fx to the SVs. If predicted risk of LN involvement >15%, 50.4 Gy/30fx was delivered to pelvic LNs. Androgen deprivation therapy was given to IR and HR patients.

RESULTS: There were 55 patients enrolled and 49 patients evaluable at a median follow up of 60 months. Included were 11 (20%) LR, 23 (41.8%) IR, and 21 (38.2%) HR patients. Pelvic LN treatment was given in 25 patients (51%). Prevalence rates of late grade 2 GI toxicity at 1, 3, and 5 years was 5.8, 3.9, and 5.8%, respectively, with no permanent grade 3 events. Prevalence rates of late grade 2 GU toxicity at 1, 3, and 5 years rates were 15.4, 7.7, and 13.5%, respectively, with three grade 3 events (5.8%). The biochemical relapse free survival at 5 years was 88.3%. There were no local, regional, or distant failures, with all patients still alive at last follow up.

CONCLUSION: Moderate hypofractionation of localized prostate cancer utilizing a SIB technique and LN coverage produces tolerable acute/late toxicity. Given equivalent efficacy between moderate hypofractionation schedules, the optimal regimen will be determined by long-term toxicity reported from both the physician and patient perspective.

CLINICAL TRIAL REGISTRATION: www.ClinicalTrials.gov, identifier NCT01117935, Date of Registration: 5/6/2010.

Copyright © 2020 Ricco, Mukhopadhyay, Deng, Holdford, Skinner, Saraiya, Moghanaki, Anscher and Chang.

Keywords: clinical trial; gastrointestinal toxicity; genitourinary toxicity; moderate hypofractionation; patient reported outcome measures; pelvic lymph nodes; prostate radiation therapy; simultaneous integrated boost

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