Cancer Institute A national cancer institute
designated cancer center

Mark Buyyounouski

Publication Details

  • Randomized Trial of Hypofractionated External-Beam Radiotherapy for Prostate Cancer JOURNAL OF CLINICAL ONCOLOGY Pollack, A., Walker, G., Horwitz, E. M., Price, R., Feigenberg, S., Konski, A. A., Stoyanova, R., Movsas, B., Greenberg, R. E., Uzzo, R. G., Ma, C., Buyyounouski, M. K. 2013; 31 (31): 3860-?

    Abstract:

    To determine if escalated radiation dose using hypofractionation significantly reduces biochemical and/or clinical disease failure (BCDF) in men treated primarily for prostate cancer.Between June 2002 and May 2006, men with favorable- to high-risk prostate cancer were randomly allocated to receive 76 Gy in 38 fractions at 2.0 Gy per fraction (conventional fractionation intensity-modulated radiation therapy [CIMRT]) versus 70.2 Gy in 26 fractions at 2.7 Gy per fraction (hypofractionated IMRT [HIMRT]); the latter was estimated to be equivalent to 84.4 Gy in 2.0 Gy fractions. High-risk patients received long-term androgen deprivation therapy (ADT), and some intermediate-risk patients received short-term ADT. The primary end point was the cumulative incidence of BCDF. Secondarily, toxicity was assessed.There were 303 assessable patients with a median follow-up of 68.4 months. No significant differences were seen between the treatment arms in terms of the distribution of patients by clinicopathologic or treatment-related (ADT use and length) factors. The 5-year rates of BCDF were 21.4% (95% CI, 14.8% to 28.7%) for CIMRT and 23.3% (95% CI, 16.4% to 31.0%) for HIMRT (P = .745). There were no statistically significant differences in late toxicity between the arms; however, in subgroup analysis, patients with compromised urinary function before enrollment had significantly worse urinary function after HIMRT.The hypofractionation regimen did not result in a significant reduction in BCDF; however, it is delivered in 2.5 fewer weeks. Men with compromised urinary function before treatment may not be ideal candidates for this approach.

    View details for DOI 10.1200/JCO.2013.51.1972

    View details for Web of Science ID 000330540700006

    View details for PubMedID 24101042

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