In a nutshell
This study investigated the outcomes of hypofractionated intensity-modulated radiation therapy (H-IMRT) to the prostate bed in patients with localized prostate cancer after prostate surgery. The data showed that H-IMRT after prostate surgery was safe and well-tolerated in these patients.
Some background
Localized prostate cancer (PCa) is a form of cancer that has not spread beyond the prostate gland. PCa can be treated by surgery, radiation, or hormone therapy. Radiotherapy (RT) can be given as first-line therapy or after surgery to make sure all cancer cells are killed. IMRT is a type of RT that uses a computer to target and destroy the prostate tumor with minimal effects on surrounding tissues. Hypofractionation refers to giving a shorter course of treatment (4-6 weeks) with larger doses of radiation (more than 2Gy) delivered in each treatment.
Studies have shown that H-IMRT is safe and effective compared to conventionally fractionated RT as a first treatment. However, whether H-IMRT after prostate surgery is safe and effective is still now known.
Methods & findings
This study involved 61 patients with PCa who had received prostate surgery. Patients were treated with H-IMRT to the prostate bed after RP. 57 patients received salvage RT (after prostate cancer returned) and 4 patients received adjuvant RT (to kill any remaining cancer cells after surgery). Patients were given a total dose of 51 Gy in 15 fractions. The average follow-up time from surgery to RT was 34.9 months. The average follow-up time was 16 months.
After 2 years, 95.1% of patients were alive without any biochemical recurrence (BCR). BCR is a rise in the blood level of prostate-specific antigen (PSA; a protein made by cells of the prostate gland) after treatment with surgery. BCR indicates relapse. None of the patients developed metastasis (spread of cancer to distant organs).
11.5% of patients experienced short-term genitourinary (GU; genitals and urinary organs) moderate-severe toxic effects. 8.2% had long-term GU side effects. 13.1% of patients experienced short-term moderate-to-severe gastrointestinal (GI) side effects and 11.5% of patients experienced GI side effects.
The bottom line
This study concluded that hypofractionated IMRT to the prostate bed after prostate surgery was safe and effective in patients with PCa.
The fine print
The study was conducted at a single institution. Long-term follow-up with more patients is necessary to validate the conclusions.
Published By :
International journal of radiation oncology, biology, physics
Date :
Dec 17, 2020
