Hypofractionated Radiotherapy in Intermediate-Risk Prostate Cancer Patients: Long-Term Results
Background: To evaluate outcomes in terms of survival and toxicity in a series of intermediate-risk prostate cancer (PCa) patients treated with hypofractionated radiotherapy (HyRT) + hormonal therapy (HT) with or without image guidance (IGRT) and to investigate the impact of different variables. Met...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-08-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/16/4783 |
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| author | Maurizio Valeriani Mario Di Staso Giuseppe Facondo Gianluca Vullo Vitaliana De Sanctis Giovanni Luca Gravina Milena di Genesio Pagliuca Mattia Falchetto Osti Pierluigi Bonfili |
| author_facet | Maurizio Valeriani Mario Di Staso Giuseppe Facondo Gianluca Vullo Vitaliana De Sanctis Giovanni Luca Gravina Milena di Genesio Pagliuca Mattia Falchetto Osti Pierluigi Bonfili |
| author_sort | Maurizio Valeriani |
| collection | DOAJ |
| description | Background: To evaluate outcomes in terms of survival and toxicity in a series of intermediate-risk prostate cancer (PCa) patients treated with hypofractionated radiotherapy (HyRT) + hormonal therapy (HT) with or without image guidance (IGRT) and to investigate the impact of different variables. Methods: This is a multi-centric study. From January 2005 to December 2019, we treated 313 intermediate-risk PCa patients (T2b–T2c, Gleason score 7, or pre-treatment PSA 10 to 20 ng/mL) with HyRT. Patients received 54.75 Gy in 15 fractions in 5 weeks plus 9 months of neo-adjuvant, concomitant, and adjuvant HT with or without IGRT. Results: Median follow-up was 91.6 months (range 5.1–167.8 months). Median OS was not reached, and the 8- and 10-year OS was 81.9% and 72.4%, respectively. Median CSS was not reached, and the 8- and 10-year CSS was 97.9% and 94.5%, respectively. PSA at first follow-up <0.8 ng/mL was significantly related to better oncological outcomes (CSS, bRFS, LRFS, cPFS, and MFS) in both univariate and multivariate analysis. After Propensity Score matching, grade 2–3 acute and cumulative late GU (<i>p</i> = 0.153 and <i>p</i> = 0.581, respectively) and GI (<i>p</i> = 0.196 and <i>p</i> = 0.925, respectively) toxicity were not statistically different in patients treated with or without IGRT. Conclusions: HyRT is effective and safe regardless of the use of IGRT. PSA at first follow-up is an easily accessible prognostic factor that may help the clinicians to identify patients who require a treatment intensification. |
| first_indexed | 2024-03-09T13:11:21Z |
| format | Article |
| id | doaj.art-2477827d59a34e98837c3fe4c0354c37 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T13:11:21Z |
| publishDate | 2022-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-2477827d59a34e98837c3fe4c0354c372023-11-30T21:41:08ZengMDPI AGJournal of Clinical Medicine2077-03832022-08-011116478310.3390/jcm11164783Hypofractionated Radiotherapy in Intermediate-Risk Prostate Cancer Patients: Long-Term ResultsMaurizio Valeriani0Mario Di Staso1Giuseppe Facondo2Gianluca Vullo3Vitaliana De Sanctis4Giovanni Luca Gravina5Milena di Genesio Pagliuca6Mattia Falchetto Osti7Pierluigi Bonfili8Department of Medicine and Surgery and Translational Medicine, Sapienza University of Rome, Radiotherapy Oncology, St Andrea Hospital, 00189 Rome, ItalyRadiotherapy Oncology Unit, University of L’Aquila, St Salvatore Hospital, 67100 L’Aquila, ItalyDepartment of Medicine and Surgery and Translational Medicine, Sapienza University of Rome, Radiotherapy Oncology, St Andrea Hospital, 00189 Rome, ItalyDepartment of Medicine and Surgery and Translational Medicine, Sapienza University of Rome, Radiotherapy Oncology, St Andrea Hospital, 00189 Rome, ItalyDepartment of Medicine and Surgery and Translational Medicine, Sapienza University of Rome, Radiotherapy Oncology, St Andrea Hospital, 00189 Rome, ItalyRadiotherapy Oncology Unit, University of L’Aquila, St Salvatore Hospital, 67100 L’Aquila, ItalyRadiotherapy Oncology Unit, Giuseppe Mazzini Hospital, 64100 Teramo, ItalyDepartment of Medicine and Surgery and Translational Medicine, Sapienza University of Rome, Radiotherapy Oncology, St Andrea Hospital, 00189 Rome, ItalyRadiotherapy Oncology Unit, Pescara Hospital, 65121 Pescara, ItalyBackground: To evaluate outcomes in terms of survival and toxicity in a series of intermediate-risk prostate cancer (PCa) patients treated with hypofractionated radiotherapy (HyRT) + hormonal therapy (HT) with or without image guidance (IGRT) and to investigate the impact of different variables. Methods: This is a multi-centric study. From January 2005 to December 2019, we treated 313 intermediate-risk PCa patients (T2b–T2c, Gleason score 7, or pre-treatment PSA 10 to 20 ng/mL) with HyRT. Patients received 54.75 Gy in 15 fractions in 5 weeks plus 9 months of neo-adjuvant, concomitant, and adjuvant HT with or without IGRT. Results: Median follow-up was 91.6 months (range 5.1–167.8 months). Median OS was not reached, and the 8- and 10-year OS was 81.9% and 72.4%, respectively. Median CSS was not reached, and the 8- and 10-year CSS was 97.9% and 94.5%, respectively. PSA at first follow-up <0.8 ng/mL was significantly related to better oncological outcomes (CSS, bRFS, LRFS, cPFS, and MFS) in both univariate and multivariate analysis. After Propensity Score matching, grade 2–3 acute and cumulative late GU (<i>p</i> = 0.153 and <i>p</i> = 0.581, respectively) and GI (<i>p</i> = 0.196 and <i>p</i> = 0.925, respectively) toxicity were not statistically different in patients treated with or without IGRT. Conclusions: HyRT is effective and safe regardless of the use of IGRT. PSA at first follow-up is an easily accessible prognostic factor that may help the clinicians to identify patients who require a treatment intensification.https://www.mdpi.com/2077-0383/11/16/4783intermediate-risk prostate cancerhypofractionated radiotherapyprognostic factors3D-CRTPSA |
| spellingShingle | Maurizio Valeriani Mario Di Staso Giuseppe Facondo Gianluca Vullo Vitaliana De Sanctis Giovanni Luca Gravina Milena di Genesio Pagliuca Mattia Falchetto Osti Pierluigi Bonfili Hypofractionated Radiotherapy in Intermediate-Risk Prostate Cancer Patients: Long-Term Results Journal of Clinical Medicine intermediate-risk prostate cancer hypofractionated radiotherapy prognostic factors 3D-CRT PSA |
| title | Hypofractionated Radiotherapy in Intermediate-Risk Prostate Cancer Patients: Long-Term Results |
| title_full | Hypofractionated Radiotherapy in Intermediate-Risk Prostate Cancer Patients: Long-Term Results |
| title_fullStr | Hypofractionated Radiotherapy in Intermediate-Risk Prostate Cancer Patients: Long-Term Results |
| title_full_unstemmed | Hypofractionated Radiotherapy in Intermediate-Risk Prostate Cancer Patients: Long-Term Results |
| title_short | Hypofractionated Radiotherapy in Intermediate-Risk Prostate Cancer Patients: Long-Term Results |
| title_sort | hypofractionated radiotherapy in intermediate risk prostate cancer patients long term results |
| topic | intermediate-risk prostate cancer hypofractionated radiotherapy prognostic factors 3D-CRT PSA |
| url | https://www.mdpi.com/2077-0383/11/16/4783 |
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