Hypofractionated Intensity Modulated Helical Tomotherapy for Localized Prostate Cancer

Abstract

This study aimed to compare Moderate Hypofractionated Radiotherapy (H-RT) and Conventional Fractionated Radiotherapy (CFRT) in terms of toxicity and quality of life in patients with localized prostate cancer.

Patients who were delivered 70 Gy H-RT at 2.5 Gy per fraction in 28 fractions, and 72 Gy CFRT at 2 Gy per fraction in 36 fractions, were evaluated retrospectively. The Radiation Therapy Oncology Group and the European Organization for Research and Treatment of Cancer (RTOG/EORTC) toxicity scales were used to evaluate treatment-related acute and late toxicities in the patients. The Expanded Prostate Cancer Index Composite for Clinical Practice (EPIC-CP) and International Prostatism Symptom Score (IPSS) questionnaire surveys were used to evaluate baseline, completion RT and post-RT quality of life (QoL) follow-ups.

Forty patients were included in our study with 20 patients each in the H-RT and CFRT groups. The mean age of the patients was 68.5 old years and the median follow-up duration was 26.2 months. Grade 3–4 toxicity was not observed in any of the patients in our study. When the patients were evaluated in terms of QoL based on the EPIC-CP questionnaire, urinary incontinence, bowel symptoms, hormonal and sexual symptoms were comparable for both groups, but EPIC-CP urinary irritation scores were unfavourably higher in the Control Group (p<0.05). The IIEF-5 score, which evaluates the quality of erectile function, was found to be unfavourable decreasing with erectile function over time in the study group compared to control group (p=0.038).

Moderate H-RT delivered with the Helical Tomotherapy system is an effective treatment radiotherapy regimen that reduces toxicity without impairing patient QoL and well tolerated by patient.