Hypofractionated Radiotherapy for Localized Prostate Cancer: Clinical Outcome (Mansoura University)

Purpose: In this study, we describe the efficacy and safety of hypo fractionated radiotherapy in treating patients with localized prostate cancer.

Patients and Methods: A total of 70 patients diagnosed with localized (T1-T2) prostatic adenocarcinoma. Low and intermediate risk groups were prospectively recruited between November 2012 and November 2016. Patients were treated with hypo-fractionated RT of 60 Gy in 20 fractions over 4 weeks. Androgen deprivation therapy was permitted for intermediate risk patients. The primary outcome was biochemical relapse free survival which defined as the nadir PSA post-radiotherapy plus 2 ng/ml according to PHOENIX criteria. Overall survival and treatment toxicity were secondary end points.

Results: With medium follow-up of 30 months; the three year biochemical relapse-free survival was 93.6%. Acute GU toxicity was detected as follows: 13(18.6%) patients experienced G1 toxicities while 11(15.7%) patients developed G2 toxicities. Acute G1 toxicity was detected with, 11.4% of patients reporting G1 toxicity and 10% experiencing G 2 toxicity. During the follow-up, three patients died; two from systemic disease progression; one patient expired due to cardiac cause. The 5 years overall survival was 90%.

Conclusion: Our data show that a Hypo-RT using 3D-CRT produces an excellent biochemical control and a low incidence of late GI and GU toxicity. Also in absence of IGRT or IMRT, we should use rigid restrictions and adequate margins to get reasonable rate of late toxicity.