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Table 2 Hypofractionated adjuvant/salvage radiotherapy

From: Hypofractionated radiotherapy for prostate cancer

Reference

Study design

Institution

Patient collection

Fractionation(total dose/singel dose/fractions)

EQD for tumor α/β ratio 1.4Gy

EQD for normal tissue α/β ratio 3Gy

IMRT

Follow-up

Acute GU toxicitiy

Late GU toxicity

Acute GI toxicity

Late GI toxicity

Therapeutic outcomes

Cozzarini, C. [23]

Prospective phase I-II for adjuvant RT

Milan, Italy

247 patients

65.8Gy/2.35Gy/28 fractions adj. RT for 117 pat.; 71.4-72.8Gy/2.55Gy/28 fractions salvage RT for 80 pat.; 58Gy/2.9Gy/20 fractions for 50 pat. Conventional arm 929 pat. 70.2Gy/1.8Gy/39 fractions

72.6Gy adjuvant RT; 83.0Gy salvage RT; 73.4Gy for the other 50 pat.

α/β ratio = 5Gy for late GU toxicity! 69.14Gy adjuvant RT; 77.1Gy salvage RT; 65.5Gy for the other 50 pat.

Tomo-RT

68 months median

-

41/247 (16.5%) ≥ III° GU in hypofraction arm; 72/929 (7.7%) in conventional arm

-

-

-

Kruse, T.J. [26]

Retrospective for salvage RT

Madison, Wisconsin

108 patients

65Gy/2.5Gy/26 fractions

74.6Gy

71.5Gy

IMRT

32.4 months median

8 pat. (7%) II° and 1 pat. III° GU RTOG.

16 pat. (15%) II° GU RTOG.

15 pat. (14%) II GI RTOG.

4 (4%) pat. II° GI RTOG.

freedom from biochem. failure at 4 years 67% ± 5.3%.

Ippolito, E. [24]

Prospective phase I for dose-escalation, adjuvant RT

Campobasso, Italy

25 patients

7 pat. 56.8Gy/2.27Gy/25 fractions; 6 pat. 59.7Gy/2.39Gy/25fractions; 6 pat. 61.25Gy/2.45Gy/25fractions; 6 pat. 62.5Gy/2.5Gy/25 fractions

7 pat. 61.3Gy; 6 pat. 66.5Gy; 6 pat. 69.4Gy; 6 pat. 71.7Gy.

7 pat. 59.9Gy; 6 pat. 64.4Gy; 6 pat. 66.8Gy; 6 pat. 68.8Gy.

IMRT

19 months median

9/25 (36%) II° GU.

-

5/25 (20%) II° GI.

-

-

Lee, W. [52]

Retrospective for salvage RT

Manchester

37 patients

50-52.5Gy/2.5-2.63Gy/20 fractions

57.4-62.2Gy

55-59.1Gy

-

30.6 months median

0% II° GU.

16 pat. I° GU, 0 pat. II° GU.

0% II° GI.

4 pat. I° GI, 1 pat. II° GI.

3-year disease-free survival is 74%.