TY - JOUR

T1 - Ultrahypofractionation in localized prostate cancer: the first experience of using proton radiation therapy in one center. Data for the first two years

AU - Kataev, N.A.

AU - Vorobyov, N.A.

AU - Mikhailov, A.V.

AU - Kasimov, B.I.

AU - Cherkashin, M.A.

AU - Berezina, N.A.

AU - Suprun, K.S.

N1 - Export Date: 11 March 2024 Адрес для корреспонденции: Kataev, N.A.; Treatment and Diagnostic Center of the Medical Institute named after Berezin Sergey, 43, Karl Marx str., Russian Federation; эл. почта: kataev@ldc.ru Пристатейные ссылки: Jemal, A., Siegel, R., Ward, E., Cancer Statistics, 2008 (2008) CA Cancer J Clin, 58 (2), pp. 71-96; Somov, A.N., Suslin, S.A., Prostate cancer. Epidemiology, risk factors and early detection (2020) Profilakticheskaya Meditsina, 23 (3), pp. 149-155. , (in Russ)]; Ferlay, J., Steliarova-Foucher, E., Lortet-Tieulent, J., Cancer incidence and mortality patterns in Europe: Estimates for 40 countries in 2012 (2013) Eur J Cancer, 49 (6), pp. 1374-1403; Gevorkyan, A.R., The risk factors, modern features of morbidity, mortality of prostate cancer among the inhabitants of the megalopolis (in the example of Moscow) (2017) Vestnik Ivanovskoj medicinskoj akademii, 22 (1), pp. 40-46. , (in Russ)]; Zietman, A.L., DeSilvio, M.L., Slater, J.D., Comparison of conventionaldose vs. high-dose conformal radiation therapy in clinically localized adenocarcinoma of the prostate: a randomized controlled trial (2005) JAMA, 294, pp. 1233-1239; Dearnaley, D.P., Sydes, M.R., Graham, J.D., Escalated-Dose versus Standard-Dose Conformal Radiotherapy in Prostate Cancer: First Results from the MRC RT01 Randomised Controlled Trial (2007) Lancet Oncol, 8 (6), pp. 475-487; Miralbell, R., Roberts, S.A., Zubizarreta, E., Hendry, J.H., Dose-fractionation sensitivity of prostate cancer deduced from radiotherapy outcomes of 5,969 patients in seven international institutional datasets: α/β=1,4 (0.9– 2.2) Gy (2012) Int J Radiat Oncol Biol Phys, 82 (1), pp. e17-e24; Junius, S., Haustermans, K., Bussels, B., Hypofractionated intensity modulated irradiation for localized prostate cancer, results from a phase I/II feasibility study (2007) Radiat Oncol, 2, p. 29; Vorobyov, N.A., Martynova, N.I., Mikhailov, A.V., Stereotactic body radiation therapy for clinically localized prostate cancer (2018) Onkourologiya=Cancer Urology, 14 (2), pp. 122-129. , (in Russ)]; Morgan, S.C., Hoffman, K., Loblaw, D.A., Hypofractionated Radiation Therapy for Localized Prostate Cancer: Executive Summary of an ASTRO, ASCO, and AUA Evidence-Based Guideline (2018) Pract Radiat Oncol, 8 (6), pp. 354-360; Marzi, S., Saracino, B., Petrongari, M.G., Modeling of α/β for late rectal toxicity from a randomized phase II study: conventional versus hypofractionated scheme for localized prostate cancer (2009) J Exp Clin Cancer Res, 28, p. 117; Wolf, F., Sedlmayer, F., Aebersold, D., Ultrahypofractionation of localized prostate cancer: Statement from the DEGRO working group prostate cancer (2021) Strahlenther Onkol, 197 (2), pp. 89-96; Widmark, A., Gunnlaugsson, A., Beckman, L., Ultra-Hypofractionated versus Conventionally Fractionated Radiotherapy for Prostate Cancer: 5-Year Outcomes of the HYPO-RT-PC Randomised, Non-Inferiority, Phase 3 Trial (2019) Lancet, 394 (10194), pp. 385-395; Brand, D.H., Tree, A.C., Ostler, P., Intensity-modulated fractionated radiotherapy versus stereotactic body radiotherapy for prostate cancer (PACE-B): acute toxicity findings from an international, randomised, open-label, phase 3, non-inferiority trial (2019) Lancet Oncol, 20 (11), pp. 1531-1543; Beck, M., Böhmer, D., Aebersold, D.M., Role of combined radiation and androgen deprivation therapy in intermediate-risk prostate cancer: Statement from the DEGRO working group on prostate cancer (2020) Strahlenther Onkol, 196 (2), pp. 109-116; Goldner, G., Extreme Hypofraktionierung beim lokalisierten Prostatakarzinom. 5-Jahresergebnisse der HYPO-RT-PC-Studie: Kommentar II (2019) Strahlenther Onkol, 195, pp. 1119-1121; Salembier, C., Villeirs, G., De Bari, B., ESTRO ACROP consensus guideline on CT-and MRI-based target volume delineation for primary radiation therapy of localized prostate cancer (2018) Radiother Oncol, 127 (1), pp. 49-61; King, C.R., Freeman, D., Kaplan, I., Stereotactic body radiotherapy for localized prostate cancer: pooled analysis from a multi-institutional consortium of prospective phase II trials (2013) Radiother Oncol, 109 (2), pp. 217-221; Kishan, A.U., Dang, A., Katz, A.J., Long-term Outcomes of Stereotactic Body Radiotherapy for Low-Risk and Intermediate-Risk Prostate Cancer (2019) JAMA Netw Open, 2 (2), p. e188006; Jackson, W.C., Silva, J., Hartman, H.E., Stereotactic Body Radiation Therapy for Localized Prostate Cancer: A Systematic Review and MetaAnalysis of Over 6,000 Patients Treated On Prospective Studies (2019) Int J Radiat Oncol Biol Phys, 104 (4), pp. 778-789; Fowler, J.F., Toma-Dasu, I., Dasu, A., Is the α/β ratio for prostate tumours really low and does it vary with the level of risk at diagnosis? (2013) Anticancer Res, 33 (3), pp. 1009-1011. , PMID: 23482774; Kubeš, J., Vondráček, V., Andrlik, M., Extreme hypofractionated proton radiotherapy for prostate cancer using pencil beam scanning: Dosimetry, acute toxicity and preliminary results (2019) J Med Imaging Radiat Oncol, 63 (6), pp. 829-835; Kirk, M.L., Tang, S., Zhai, H., Comparison of prostate proton treatment planning technique, interfraction robustness, and analysis of single-field treatment feasibility (2015) Pract Radiat Oncol, 5 (2), pp. 99-105; Kole, T.P., Nichols, R.C., Lei, S., A dosimetric comparison of ultra-hypofractionated passively scattered proton radiotherapy and stereotactic body radiotherapy (SBRT) in the definitive treatment of localized prostate cancer (2015) Acta Oncol, 54 (6), pp. 825-831; Kubeš, J., Haas, A., Vondráček, V., Ultrahypofractionated Proton Radiation Therapy in the Treatment of Low and Intermediate-Risk Prostate Cancer-5-Year Outcomes (2021) Int J Radiat Oncol Biol Phys, 110 (4), pp. 1090-1097; Bertolet, A., Carabe-Fernandez, A., Clinical implications of variable relative biological effectiveness in proton therapy for prostate cancer (2020) Acta Oncol, 59 (10), pp. 1171-1177

PY - 2023

Y1 - 2023

N2 - Aim: to analyze our experience of using the ultra-hypofractionated proton radiation therapy for patients with localized prostate cancer (PC) with an assessment of late toxicity according to data for the first two years of using this therapy. Patients and Methods: 73 patients with PC were treated using intensity modulated proton therapy (IMPT) in ultra-hypofractionation mode from February 2019 to February 2021. We studied data on late toxicity of radiotherapy and biochemical recurrence-free survival (BRFS) in 56 patients, 17 were excluded from the follow-up. Data on the level of prostate-specific antigen (PSA) in patients and late toxicity of prostate cancer radiotherapy (PCRT) were collected based on the results of a telephone survey using a standardized questionnaire and analyzed after 22 (2; 46) months. Results: late toxicity according to the criteria of NCI CTCAEv.5.0 was from the gastrointestinal (GI) tract: grade 1 phenomena developed in 10 (17.9%) patients, grade 2 — in 3 (5.3%). None of the patients reported grade 3 (or higher) chronic GI toxicity. From the genitourinary system: grade 1 toxicity was observed in 8 (14.3%) patients, grade 2 — in 6 (10.7%), none of the patients reported grade 3 (or higher) toxicity. The erectile dysfunction was also registered in 8 (14.3%) patients. Two (2.7%) patients died from causes unrelated to PC. No progression was observed when analyzing the data of the biochemical and clinical studies. There have been no reported fatal outcomes related to PC. Conclusion: in patients who received IMPT in the ultra-hypofractionated mode, the level of late toxicity from the genitourinary system and gastrointestinal tract was similar to the data of the only foreign literature study on the use of ultra-hypofractionated proton radiation therapy. The level of biochemical control we obtained was similar to other methods of radiation therapy with similar modes of dose adjustment. © 2023, Meditsina-Inform LLC. All rights reserved.

AB - Aim: to analyze our experience of using the ultra-hypofractionated proton radiation therapy for patients with localized prostate cancer (PC) with an assessment of late toxicity according to data for the first two years of using this therapy. Patients and Methods: 73 patients with PC were treated using intensity modulated proton therapy (IMPT) in ultra-hypofractionation mode from February 2019 to February 2021. We studied data on late toxicity of radiotherapy and biochemical recurrence-free survival (BRFS) in 56 patients, 17 were excluded from the follow-up. Data on the level of prostate-specific antigen (PSA) in patients and late toxicity of prostate cancer radiotherapy (PCRT) were collected based on the results of a telephone survey using a standardized questionnaire and analyzed after 22 (2; 46) months. Results: late toxicity according to the criteria of NCI CTCAEv.5.0 was from the gastrointestinal (GI) tract: grade 1 phenomena developed in 10 (17.9%) patients, grade 2 — in 3 (5.3%). None of the patients reported grade 3 (or higher) chronic GI toxicity. From the genitourinary system: grade 1 toxicity was observed in 8 (14.3%) patients, grade 2 — in 6 (10.7%), none of the patients reported grade 3 (or higher) toxicity. The erectile dysfunction was also registered in 8 (14.3%) patients. Two (2.7%) patients died from causes unrelated to PC. No progression was observed when analyzing the data of the biochemical and clinical studies. There have been no reported fatal outcomes related to PC. Conclusion: in patients who received IMPT in the ultra-hypofractionated mode, the level of late toxicity from the genitourinary system and gastrointestinal tract was similar to the data of the only foreign literature study on the use of ultra-hypofractionated proton radiation therapy. The level of biochemical control we obtained was similar to other methods of radiation therapy with similar modes of dose adjustment. © 2023, Meditsina-Inform LLC. All rights reserved.

KW - prostate cancer

KW - proton therapy

KW - radiation therapy

KW - survival

KW - toxicity

KW - ultra-hypofractionated mode

U2 - 10.32364/2587-6821-2023-7-4-196-201

DO - 10.32364/2587-6821-2023-7-4-196-201

M3 - статья

VL - 7

SP - 196

EP - 201

JO - Russian Medical Inquiry

JF - Russian Medical Inquiry

SN - 2587-6821

IS - 4

ER -