A Multicenter Phase 2 Study of Ultrahypofractionated Stereotactic Boost After External Beam Radiotherapy in Intermediate-risk Prostate Carcinoma: A Very Long-term Analysis of the CKNO-PRO Trial
Background: Genitourinary (GU) or gastrointestinal (GI) complications and tumor relapse can occur in the long term after radiotherapy for prostate cancer. Objective: To assess the late tolerance and relapse-free survival (RFS) in patients undergoing hypofractionated stereotactic boost therapy after...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-08-01
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| Series: | European Urology Open Science |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666168323003567 |
| _version_ | 1827890705121411072 |
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| author | David Pasquier Philippe Nickers Didier Peiffert Philippe Maingon Pascal Pommier Thomas Lacornerie Emmanuelle Tresch Maël Barthoulot Eric Lartigau |
| author_facet | David Pasquier Philippe Nickers Didier Peiffert Philippe Maingon Pascal Pommier Thomas Lacornerie Emmanuelle Tresch Maël Barthoulot Eric Lartigau |
| author_sort | David Pasquier |
| collection | DOAJ |
| description | Background: Genitourinary (GU) or gastrointestinal (GI) complications and tumor relapse can occur in the long term after radiotherapy for prostate cancer. Objective: To assess the late tolerance and relapse-free survival (RFS) in patients undergoing hypofractionated stereotactic boost therapy after external beam radiotherapy (EBRT) for intermediate-risk prostate cancer. Design, setting, and participants: Seventy-six patients with intermediate-risk prostate carcinoma between August 2010 and April 2013 were included. The first course delivered a dose of 46 Gy by conventional fractionation; the second course was a boost of 18 Gy (3 × 6 Gy) within 10 d. Outcome measurements and statistical analysis: GU and GI toxicities were evaluated as the primary outcomes. The secondary outcomes were overall survival and RFS. The cumulative incidence of toxicity was calculated using a competing-risk approach. Overall survival and RFS were estimated using the Kaplan-Meier method. Results and limitations: The median follow-up period was 88 mo (range, 81–99 mo). Sixty (79%) patients were treated with the CyberKnife and 16 (21%) using a linear accelerator. The cumulative incidences of GU and GI grade ≥2 toxicities at 120 mo were 1.4% (95% confidence interval [CI]: 0.1–6.6%) and 11.0% (95% CI: 5.1–19.4%), respectively. The overall survival and RFS rates at 8 yr were 89.1% (95% CI: 77–95%) and 76.9% (95% CI: 63.1–86.1), respectively. Conclusions: A very long follow-up showed low GU and GI toxicities after a hypofractionated stereotactic boost after EBRT for intermediate-risk prostate cancer. Dose escalation of the boost delivered by hypofractionated radiation therapy appears safe for use in future trials. Patient summary: We found low toxicity and good survival rates after a short and high-precision boost after external beam radiotherapy for intermediate-risk prostate cancer, with a long-term follow-up of 88 mo. This long-term treatment is safe and should be considered in future trials. |
| first_indexed | 2024-03-12T21:14:26Z |
| format | Article |
| id | doaj.art-ef790effe22f49c6b85858cadf3a5122 |
| institution | Directory Open Access Journal |
| issn | 2666-1683 |
| language | English |
| last_indexed | 2024-03-12T21:14:26Z |
| publishDate | 2023-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | European Urology Open Science |
| spelling | doaj.art-ef790effe22f49c6b85858cadf3a51222023-07-30T04:23:01ZengElsevierEuropean Urology Open Science2666-16832023-08-01548087A Multicenter Phase 2 Study of Ultrahypofractionated Stereotactic Boost After External Beam Radiotherapy in Intermediate-risk Prostate Carcinoma: A Very Long-term Analysis of the CKNO-PRO TrialDavid Pasquier0Philippe Nickers1Didier Peiffert2Philippe Maingon3Pascal Pommier4Thomas Lacornerie5Emmanuelle Tresch6Maël Barthoulot7Eric Lartigau8Academic Department of Radiation Oncology, Centre Oscar Lambret, Lille, France; Univ. Lille, &, CNRS, Centrale Lille, UMR 9189 - CRIStAL, Lille, France; Corresponding author. Academic Department of Radiation Oncology, Centre Oscar Lambret, 3 rue Combemale, 59020 Lille, France. Tel. +33 (0)3 20 29 59 11; Fax: +33 (0)3 20 29 59 71.Academic Department of Radiation Oncology, Centre Oscar Lambret, Lille, FranceInstitut de Cancérologie de Lorraine-Alexis Vautrin, Nancy, FranceGHU La Pitié Salpêtrière, Sorbonne Université, Paris, FranceDepartment of Radiation Oncology, Centre Leon Berard, Lyon, FranceMedical Physics, Centre Oscar Lambret, Lille, FranceDepartment of Biostatistics, Centre Oscar Lambret, Lille, FranceDepartment of Biostatistics, Centre Oscar Lambret, Lille, FranceAcademic Department of Radiation Oncology, Centre Oscar Lambret, Lille, France; Univ. Lille, &, CNRS, Centrale Lille, UMR 9189 - CRIStAL, Lille, FranceBackground: Genitourinary (GU) or gastrointestinal (GI) complications and tumor relapse can occur in the long term after radiotherapy for prostate cancer. Objective: To assess the late tolerance and relapse-free survival (RFS) in patients undergoing hypofractionated stereotactic boost therapy after external beam radiotherapy (EBRT) for intermediate-risk prostate cancer. Design, setting, and participants: Seventy-six patients with intermediate-risk prostate carcinoma between August 2010 and April 2013 were included. The first course delivered a dose of 46 Gy by conventional fractionation; the second course was a boost of 18 Gy (3 × 6 Gy) within 10 d. Outcome measurements and statistical analysis: GU and GI toxicities were evaluated as the primary outcomes. The secondary outcomes were overall survival and RFS. The cumulative incidence of toxicity was calculated using a competing-risk approach. Overall survival and RFS were estimated using the Kaplan-Meier method. Results and limitations: The median follow-up period was 88 mo (range, 81–99 mo). Sixty (79%) patients were treated with the CyberKnife and 16 (21%) using a linear accelerator. The cumulative incidences of GU and GI grade ≥2 toxicities at 120 mo were 1.4% (95% confidence interval [CI]: 0.1–6.6%) and 11.0% (95% CI: 5.1–19.4%), respectively. The overall survival and RFS rates at 8 yr were 89.1% (95% CI: 77–95%) and 76.9% (95% CI: 63.1–86.1), respectively. Conclusions: A very long follow-up showed low GU and GI toxicities after a hypofractionated stereotactic boost after EBRT for intermediate-risk prostate cancer. Dose escalation of the boost delivered by hypofractionated radiation therapy appears safe for use in future trials. Patient summary: We found low toxicity and good survival rates after a short and high-precision boost after external beam radiotherapy for intermediate-risk prostate cancer, with a long-term follow-up of 88 mo. This long-term treatment is safe and should be considered in future trials.http://www.sciencedirect.com/science/article/pii/S2666168323003567Intermediate-risk prostate cancerProstate cancerStereotactic body radiotherapyStereotactic body radiotherapy boost |
| spellingShingle | David Pasquier Philippe Nickers Didier Peiffert Philippe Maingon Pascal Pommier Thomas Lacornerie Emmanuelle Tresch Maël Barthoulot Eric Lartigau A Multicenter Phase 2 Study of Ultrahypofractionated Stereotactic Boost After External Beam Radiotherapy in Intermediate-risk Prostate Carcinoma: A Very Long-term Analysis of the CKNO-PRO Trial European Urology Open Science Intermediate-risk prostate cancer Prostate cancer Stereotactic body radiotherapy Stereotactic body radiotherapy boost |
| title | A Multicenter Phase 2 Study of Ultrahypofractionated Stereotactic Boost After External Beam Radiotherapy in Intermediate-risk Prostate Carcinoma: A Very Long-term Analysis of the CKNO-PRO Trial |
| title_full | A Multicenter Phase 2 Study of Ultrahypofractionated Stereotactic Boost After External Beam Radiotherapy in Intermediate-risk Prostate Carcinoma: A Very Long-term Analysis of the CKNO-PRO Trial |
| title_fullStr | A Multicenter Phase 2 Study of Ultrahypofractionated Stereotactic Boost After External Beam Radiotherapy in Intermediate-risk Prostate Carcinoma: A Very Long-term Analysis of the CKNO-PRO Trial |
| title_full_unstemmed | A Multicenter Phase 2 Study of Ultrahypofractionated Stereotactic Boost After External Beam Radiotherapy in Intermediate-risk Prostate Carcinoma: A Very Long-term Analysis of the CKNO-PRO Trial |
| title_short | A Multicenter Phase 2 Study of Ultrahypofractionated Stereotactic Boost After External Beam Radiotherapy in Intermediate-risk Prostate Carcinoma: A Very Long-term Analysis of the CKNO-PRO Trial |
| title_sort | multicenter phase 2 study of ultrahypofractionated stereotactic boost after external beam radiotherapy in intermediate risk prostate carcinoma a very long term analysis of the ckno pro trial |
| topic | Intermediate-risk prostate cancer Prostate cancer Stereotactic body radiotherapy Stereotactic body radiotherapy boost |
| url | http://www.sciencedirect.com/science/article/pii/S2666168323003567 |
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