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Hypofractionated Post-Prostatectomy Radiotherapy in 16 Fractions: A Single-Institution Outcome

Background: The optimal hypofractionated schedule of post-prostatectomy radiotherapy remains to be established. We evaluated treatment outcomes and toxicity of moderately hypofractionated post-prostatectomy radiotherapy in 16 daily fractions delivered with intensity-modulated radiotherapy. The treat...

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Autores principales: Dubinsky, Pavol, Vojtek, Vladimir, Belanova, Katarina, Janickova, Natalia, Balazova, Noemi, Tomkova, Zuzana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10381816/
https://www.ncbi.nlm.nih.gov/pubmed/37511985
http://dx.doi.org/10.3390/life13071610
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author Dubinsky, Pavol
Vojtek, Vladimir
Belanova, Katarina
Janickova, Natalia
Balazova, Noemi
Tomkova, Zuzana
author_facet Dubinsky, Pavol
Vojtek, Vladimir
Belanova, Katarina
Janickova, Natalia
Balazova, Noemi
Tomkova, Zuzana
author_sort Dubinsky, Pavol
collection PubMed
description Background: The optimal hypofractionated schedule of post-prostatectomy radiotherapy remains to be established. We evaluated treatment outcomes and toxicity of moderately hypofractionated post-prostatectomy radiotherapy in 16 daily fractions delivered with intensity-modulated radiotherapy. The treatment schedule selection was motivated by limited technology resources and was radiobiologically dose-escalated. Methods: One hundred consecutive M0 patients with post-prostatectomy radiotherapy were evaluated. Radiotherapy indication was adjuvant (ART) in 19%, early-salvage (eSRT) in 46% and salvage (SRT) in 35%. The dose prescription for prostate bed planning target volume was 52.8 Gy in 16 fractions of 3.3 Gy. The Common Terminology Criteria v. 4 for Adverse Events scale was used for toxicity grading. Results: The median follow-up was 61 months. Five-year biochemical recurrence-free survival (bRFS) was 78.6%, distant metastases-free survival (DMFS) was 95.7% and overall survival was 98.8%. Treatment indication (ART or eSRT vs. SRT) was the only significant factor for bRFS (HR 0.15, 95% CI 0.05–0.47, p = 0.001) and DMFS (HR 0.16, 95% CI 0.03–0.90; p = 0.038). Acute gastrointestinal (GI) toxicity grade 2 was recorded in 24%, grade 3 in 2%, acute genitourinary (GU) toxicity grade 2 in 10% of patients, and no grade 3. A cumulative rate of late GI toxicity grade ≥ 2 was observed in 9% and late GU toxicity grade ≥ 2 in 16% of patients. Conclusions: The observed results confirmed efficacy and showed a higher than anticipated rate of early GI, late GI, and GU toxicity of post-prostatectomy radiobiologically dose-escalated hypofractionated radiotherapy in 16 daily fractions.
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spelling pubmed-103818162023-07-29 Hypofractionated Post-Prostatectomy Radiotherapy in 16 Fractions: A Single-Institution Outcome Dubinsky, Pavol Vojtek, Vladimir Belanova, Katarina Janickova, Natalia Balazova, Noemi Tomkova, Zuzana Life (Basel) Article Background: The optimal hypofractionated schedule of post-prostatectomy radiotherapy remains to be established. We evaluated treatment outcomes and toxicity of moderately hypofractionated post-prostatectomy radiotherapy in 16 daily fractions delivered with intensity-modulated radiotherapy. The treatment schedule selection was motivated by limited technology resources and was radiobiologically dose-escalated. Methods: One hundred consecutive M0 patients with post-prostatectomy radiotherapy were evaluated. Radiotherapy indication was adjuvant (ART) in 19%, early-salvage (eSRT) in 46% and salvage (SRT) in 35%. The dose prescription for prostate bed planning target volume was 52.8 Gy in 16 fractions of 3.3 Gy. The Common Terminology Criteria v. 4 for Adverse Events scale was used for toxicity grading. Results: The median follow-up was 61 months. Five-year biochemical recurrence-free survival (bRFS) was 78.6%, distant metastases-free survival (DMFS) was 95.7% and overall survival was 98.8%. Treatment indication (ART or eSRT vs. SRT) was the only significant factor for bRFS (HR 0.15, 95% CI 0.05–0.47, p = 0.001) and DMFS (HR 0.16, 95% CI 0.03–0.90; p = 0.038). Acute gastrointestinal (GI) toxicity grade 2 was recorded in 24%, grade 3 in 2%, acute genitourinary (GU) toxicity grade 2 in 10% of patients, and no grade 3. A cumulative rate of late GI toxicity grade ≥ 2 was observed in 9% and late GU toxicity grade ≥ 2 in 16% of patients. Conclusions: The observed results confirmed efficacy and showed a higher than anticipated rate of early GI, late GI, and GU toxicity of post-prostatectomy radiobiologically dose-escalated hypofractionated radiotherapy in 16 daily fractions. MDPI 2023-07-23 /pmc/articles/PMC10381816/ /pubmed/37511985 http://dx.doi.org/10.3390/life13071610 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Dubinsky, Pavol
Vojtek, Vladimir
Belanova, Katarina
Janickova, Natalia
Balazova, Noemi
Tomkova, Zuzana
Hypofractionated Post-Prostatectomy Radiotherapy in 16 Fractions: A Single-Institution Outcome
title Hypofractionated Post-Prostatectomy Radiotherapy in 16 Fractions: A Single-Institution Outcome
title_full Hypofractionated Post-Prostatectomy Radiotherapy in 16 Fractions: A Single-Institution Outcome
title_fullStr Hypofractionated Post-Prostatectomy Radiotherapy in 16 Fractions: A Single-Institution Outcome
title_full_unstemmed Hypofractionated Post-Prostatectomy Radiotherapy in 16 Fractions: A Single-Institution Outcome
title_short Hypofractionated Post-Prostatectomy Radiotherapy in 16 Fractions: A Single-Institution Outcome
title_sort hypofractionated post-prostatectomy radiotherapy in 16 fractions: a single-institution outcome
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10381816/
https://www.ncbi.nlm.nih.gov/pubmed/37511985
http://dx.doi.org/10.3390/life13071610
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