Randomized Trial of Hypofractionated External-Beam Radiotherapy for Prostate Cancer

Alan Pollack; Gail Walker; Eric M Horwitz; Robert Price; Steven Feigenberg; Andre A Konski; Radka Stoyanova; Benjamin Movsas; Richard E Greenberg; Robert G Uzzo; Charlie Ma; Mark K Buyyounouski

doi:10.1200/JCO.2013.51.1972

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$Randomized Trial of Hypofractionated External-Beam Radiotherapy for Prostate Cancer$

Journal article

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Randomized Trial of Hypofractionated External-Beam Radiotherapy for Prostate Cancer

Alan Pollack, Gail Walker, Eric M Horwitz, Robert Price, Steven Feigenberg, Andre A Konski, Radka Stoyanova, Benjamin Movsas, Richard E Greenberg, Robert G Uzzo, …

Journal of clinical oncology, Vol.31(31), pp.3860-3868

2013-11-01

DOI: https://doi.org/10.1200/JCO.2013.51.1972

PMCID: PMC3805927

PMID: 24101042

Abstract

Purpose To determine if escalated radiation dose using hypofractionation significantly reduces biochemical and/or clinical disease failure (BCDF) in men treated primarily for prostate cancer. Patients and Methods 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. Results 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. Conclusion 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.

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Collaboration types: Domestic collaboration
Citation topics: 1 Clinical & Life Sciences; 1.147 Prostate Cancer; 1.147.97 Prostate Cancer
Web Of Science research areas: Oncology
ESI research areas: Clinical Medicine

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Title: Randomized Trial of Hypofractionated External-Beam Radiotherapy for Prostate Cancer
Creators: Alan Pollack - Alan Pollack, Gail Walker, and Radka Stoyanova, University of Miami Miller School of Medicine, Miami, FL; Eric M. Horwitz, Robert Price, Richard E. Greenberg, Robert G. Uzzo, Charlie Ma, and Mark K. Buyyounouski, Fox Chase Cancer Center, Philadelphia, PA; Steven Feigenberg, University of Maryland, Baltimore, MD; Andre A. Konski, Wayne State University Medical Center; and Benjamin Movsas, Henry Ford Hospital, Detroit, MI
Gail Walker - Alan Pollack, Gail Walker, and Radka Stoyanova, University of Miami Miller School of Medicine, Miami, FL; Eric M. Horwitz, Robert Price, Richard E. Greenberg, Robert G. Uzzo, Charlie Ma, and Mark K. Buyyounouski, Fox Chase Cancer Center, Philadelphia, PA; Steven Feigenberg, University of Maryland, Baltimore, MD; Andre A. Konski, Wayne State University Medical Center; and Benjamin Movsas, Henry Ford Hospital, Detroit, MI
Eric M Horwitz - Alan Pollack, Gail Walker, and Radka Stoyanova, University of Miami Miller School of Medicine, Miami, FL; Eric M. Horwitz, Robert Price, Richard E. Greenberg, Robert G. Uzzo, Charlie Ma, and Mark K. Buyyounouski, Fox Chase Cancer Center, Philadelphia, PA; Steven Feigenberg, University of Maryland, Baltimore, MD; Andre A. Konski, Wayne State University Medical Center; and Benjamin Movsas, Henry Ford Hospital, Detroit, MI
Robert Price - Alan Pollack, Gail Walker, and Radka Stoyanova, University of Miami Miller School of Medicine, Miami, FL; Eric M. Horwitz, Robert Price, Richard E. Greenberg, Robert G. Uzzo, Charlie Ma, and Mark K. Buyyounouski, Fox Chase Cancer Center, Philadelphia, PA; Steven Feigenberg, University of Maryland, Baltimore, MD; Andre A. Konski, Wayne State University Medical Center; and Benjamin Movsas, Henry Ford Hospital, Detroit, MI
Steven Feigenberg - Alan Pollack, Gail Walker, and Radka Stoyanova, University of Miami Miller School of Medicine, Miami, FL; Eric M. Horwitz, Robert Price, Richard E. Greenberg, Robert G. Uzzo, Charlie Ma, and Mark K. Buyyounouski, Fox Chase Cancer Center, Philadelphia, PA; Steven Feigenberg, University of Maryland, Baltimore, MD; Andre A. Konski, Wayne State University Medical Center; and Benjamin Movsas, Henry Ford Hospital, Detroit, MI
Andre A Konski - Alan Pollack, Gail Walker, and Radka Stoyanova, University of Miami Miller School of Medicine, Miami, FL; Eric M. Horwitz, Robert Price, Richard E. Greenberg, Robert G. Uzzo, Charlie Ma, and Mark K. Buyyounouski, Fox Chase Cancer Center, Philadelphia, PA; Steven Feigenberg, University of Maryland, Baltimore, MD; Andre A. Konski, Wayne State University Medical Center; and Benjamin Movsas, Henry Ford Hospital, Detroit, MI
Radka Stoyanova - Alan Pollack, Gail Walker, and Radka Stoyanova, University of Miami Miller School of Medicine, Miami, FL; Eric M. Horwitz, Robert Price, Richard E. Greenberg, Robert G. Uzzo, Charlie Ma, and Mark K. Buyyounouski, Fox Chase Cancer Center, Philadelphia, PA; Steven Feigenberg, University of Maryland, Baltimore, MD; Andre A. Konski, Wayne State University Medical Center; and Benjamin Movsas, Henry Ford Hospital, Detroit, MI
Benjamin Movsas - Alan Pollack, Gail Walker, and Radka Stoyanova, University of Miami Miller School of Medicine, Miami, FL; Eric M. Horwitz, Robert Price, Richard E. Greenberg, Robert G. Uzzo, Charlie Ma, and Mark K. Buyyounouski, Fox Chase Cancer Center, Philadelphia, PA; Steven Feigenberg, University of Maryland, Baltimore, MD; Andre A. Konski, Wayne State University Medical Center; and Benjamin Movsas, Henry Ford Hospital, Detroit, MI
Richard E Greenberg - Alan Pollack, Gail Walker, and Radka Stoyanova, University of Miami Miller School of Medicine, Miami, FL; Eric M. Horwitz, Robert Price, Richard E. Greenberg, Robert G. Uzzo, Charlie Ma, and Mark K. Buyyounouski, Fox Chase Cancer Center, Philadelphia, PA; Steven Feigenberg, University of Maryland, Baltimore, MD; Andre A. Konski, Wayne State University Medical Center; and Benjamin Movsas, Henry Ford Hospital, Detroit, MI
Robert G Uzzo - Alan Pollack, Gail Walker, and Radka Stoyanova, University of Miami Miller School of Medicine, Miami, FL; Eric M. Horwitz, Robert Price, Richard E. Greenberg, Robert G. Uzzo, Charlie Ma, and Mark K. Buyyounouski, Fox Chase Cancer Center, Philadelphia, PA; Steven Feigenberg, University of Maryland, Baltimore, MD; Andre A. Konski, Wayne State University Medical Center; and Benjamin Movsas, Henry Ford Hospital, Detroit, MI
Charlie Ma - Alan Pollack, Gail Walker, and Radka Stoyanova, University of Miami Miller School of Medicine, Miami, FL; Eric M. Horwitz, Robert Price, Richard E. Greenberg, Robert G. Uzzo, Charlie Ma, and Mark K. Buyyounouski, Fox Chase Cancer Center, Philadelphia, PA; Steven Feigenberg, University of Maryland, Baltimore, MD; Andre A. Konski, Wayne State University Medical Center; and Benjamin Movsas, Henry Ford Hospital, Detroit, MI
Mark K Buyyounouski - Alan Pollack, Gail Walker, and Radka Stoyanova, University of Miami Miller School of Medicine, Miami, FL; Eric M. Horwitz, Robert Price, Richard E. Greenberg, Robert G. Uzzo, Charlie Ma, and Mark K. Buyyounouski, Fox Chase Cancer Center, Philadelphia, PA; Steven Feigenberg, University of Maryland, Baltimore, MD; Andre A. Konski, Wayne State University Medical Center; and Benjamin Movsas, Henry Ford Hospital, Detroit, MI
Publication Details: Journal of clinical oncology, Vol.31(31), pp.3860-3868
Academic Unit: Leadership Department; Miller School of Medicine; UMMG Dept of Radiation Oncology
Language: English
Resource Type: Journal article
PMID: 24101042
PMCID: PMC3805927
Record Identifier: 991031559338302976