Background: We sought to characterize and compare late patient-reported outcomes (PROs) after moderately hypofractionated intensity modulated radiation therapy (IMRT) and proton beam therapy (PBT) for localized prostate cancer (PC).
Methods: This multi-institutional analysis included low- or intermediate-risk group PC patients treated with moderately hypofractionated radiation to an intact prostate stratified by treatment modality: IMRT or PBT. The primary outcomes were prospectively collected patient-reported late gastrointestinal (GI) and genitourinary (GU) toxicity assessed by International Prostate Symptom Score (IPSS) and Expanded PC Index Composite (EPIC). Multivariable regression analysis (MVA) controlling for age, race, and risk group tested the effect of time, treatment, and their interaction.
Results: 287 IMRT and 485 PBT patients were included. Intermediate risk group (81.2 vs. 68.2%; p < 0.001) and median age at diagnosis (70 vs. 67 years; p < 0.001) were higher in the IMRT group. On MVA, there was no significant difference between modalities. PBT IPSS did not differ from IMRT IPSS at 12 months (odds ratio [OR], 1.19; p = 0.08) or 24 months (OR, 0.99; p = 0.94). PBT EPIC overall GI function at 12 months (OR, 3.68; p = 0.085) and 24 months (OR 2.78; p = 0.26) did not differ from IMRT EPIC overall GI function. At 24 months, urinary frequency was no different between PBT and IMRT groups (OR 0.35; p = 0.096).
Conclusions: This multi-institutional analysis of low- or intermediate-risk PC treated with moderately hypofractionated PBT and IMRT demonstrated low rates of late patient-reported GI and GU toxicities. After covariate adjustment, late GI and GU PROs were not significantly different between PBT or IMRT cohorts.
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http://dx.doi.org/10.1002/pros.24660 | DOI Listing |
JCO Glob Oncol
December 2024
Department of Radiotherapy, Erasmus MC Cancer Institute, Rotterdam, the Netherlands.
Purpose: Moderate hypofractionation (MHF) offers logistical and financial advantages, and has become standard in Western countries but not yet in Africa. This study assessed GI and genitourinary (GU) acute toxicity in Rwandan men undergoing MHF (20 × 3 Gy) treatment.
Materials And Methods: Since 2021, patients with prostate cancer at the Rwanda Cancer Centre have been informed about the study on MHF treatment and could participate by signing an informed consent.
Front Oncol
November 2024
Department of Radiation Oncology, Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing, China.
Objective: To assess the efficacy and safety of linear accelerator-based fractionated stereotactic radiotherapy (LINAC-FSRT) in patients with brain metastases (BM).
Methods: We retrospectively analyzed 214 patients treated with LINAC-FSRT, categorized based on biologically effective dose (BED10, / = 10) into two groups (≤55 Gy, >55 Gy). Stratified analyses were conducted based on targeted therapy to compare survival outcomes.
Int J Radiat Oncol Biol Phys
December 2024
Department of Radiation Oncology, NYU Langone Hospital, Brooklyn, NY.
Purpose: To assess the efficacy of moderately hypofractionated intensity-modulated proton therapy (IMPT) targeting the prostate/seminal vesicles and pelvic lymph nodes for high-risk (HR) or unfavorable intermediate-risk (UIR) prostate cancer (PCa) MATERIALS/METHODS: A prospective study (ClinicalTrials.gov: NCTXXX) of moderately hypofractionated IMPT accrued a target sample size of 56 patients with HR or UIR-PCa . The prostate/seminal vesicles and pelvic lymph nodes were treated simultaneously with 67.
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November 2024
Department of Radiology, Radiation Oncology and Nuclear Medicine, University of Montreal Health Centre, Montreal, QC, Canada.
Introduction: This study develops two new multi-institutional hippocampal-sparing whole-brain RapidPlan™ models (HLS-EC-WB and HMS-EC-WB) inspired by CCTG-CE.7 featuring enhanced target coverage with varying hippocampal sparing (limited and moderate).
Methods: New dosimetric scorecards were created to quantify the models' clinical intent.
J Med Radiat Sci
December 2024
Central West Cancer Centre, Orange Health Service, Orange, New South Wales, Australia.
Ultra-Hypofractionated Whole Breast Radiotherapy (U-WBRT) has been proven to be a viable treatment option for breast cancer patients receiving radiation therapy, however, due to its novelty our understanding of its non-clinical benefits is still evolving. With increasing U-WBRT selection during COVID and in rural and regional settings such as the Western New South Wales Local Health District (WNSWLHD), it's important to quantify the savings when compared to other fractionation schedules (e.g.
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