Acute and late complications after hypofractionated intensity modulated radiotherapy in prostate cancer

• Published in: Japanese journal of radiology Vol. 35; no. 5; pp. 269 - 278
• Main Authors: Kozuka, Takuyo, Nakano, Masahiro, Hashimoto, Masatoshi, Gomi, Kotaro, Murofushi, Keiko Nemoto, Sumi, Minako, Yonese, Junji, Oguchi, Masahiko
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.05.2017; Springer Nature B.V
• Subjects: Aged; Aged, 80 and over; Cancer; Complications; Dose Fractionation; Hemorrhage; Humans; Imaging; Incidence; Male; Medicine; Medicine & Public Health; Middle Aged; Nuclear Medicine; Original Article; Prostate cancer; Prostatic Neoplasms - radiotherapy; Quality; Radiation; Radiation Injuries - etiology; Radiation therapy; Radiology; Radiotherapy; Radiotherapy, Intensity-Modulated - adverse effects; Radiotherapy, Intensity-Modulated - methods; Rectum; Terminology; Toxicity; Hypofractionation; Intensity modulated radiotherapy; Late toxicity; Prostate cancer; Acute toxicity
• ISSN: 1867-1071; 1867-108X
• DOI: 10.1007/s11604-017-0630-2

Purpose The present study compared the complications associated with hypofractionated intensity-modulated radiation therapy (Hypo-IMRT) of prostate cancer to conventionally fractionated IMRT (Conv-IMRT). Materials and methods Hypo-IMRT delivered 70 Gy in 28 fractions, whereas Conv-IMRT delivered 78 Gy in 39 fractions. Toxicity was graded with the Common Terminology Criteria for Adverse Events, version 4.0, weekly during radiotherapy, 1 month after radiotherapy, and annually in both patient groups. Results The median follow-ups were 39.1 and 38.7 months for patients in the Hypo- and Conv-IMRT groups, respectively. There was no significant difference in rates of acute and late adverse events. The proportions of grade 2 acute genitourinary complications were 48.4 and 51.2% in the Hypo- and Conv-IMRT groups, respectively. The presence of a baseline International Prostate Symptom Score (IPSS) of ten or more was the only significant prognostic factor for grade 2 acute genitourinary toxicity. The incidence of grade 2 late rectal hemorrhage at 3 years was 3.2 and 3.5% in the Hypo- and Conv-IMRT groups, respectively. Small rectal volume was significantly associated with grade 2 late rectal hemorrhage. Conclusion Regarding acute and late adverse events, hypofractionated IMRT for prostate cancer was well tolerated and comparable with conventionally fractionated IMRT. Clinical trial registration no. UMIN000003218.