Review Article
Hypofractionated External-Beam Radiotherapy for Prostate Cancer
Table 1
Prospective trials of hypofractionated external-beam radiotherapy (>5 fractions).
| | Author | No. of patients | Type of study | Patient characteristics NCCN risk group | HYPO FX total dose (Gy)/fractional dose (Gy) | STD FX total dose (Gy)/fractional dose (Gy) | Median follow up (months) | PSA control | Late GU toxicity | Late GI toxicity | | Hypo | STD | Hypo | STD | Toxicity | Hypo | STD | Toxicity |
| | Lukka et al. [13] | 936 | Phase III | Low-Intermediate risk | 52.5/2.63 | 66/2 | 68 | 58% | 62%* | | NS | | | NS | |
| | Pollack et al. [14, 15] | 303 | Phase III | Intermediate
High risk | 70.2 /2.7 | 76/2 | >60 months | | | 18.3% | 8.3% | ≥Gr-2 | 6.8% | 5% | ≥Gr-2 | | | | | | | | | | | P = 0.028 | NS |
| | Yeoh et al. [16] | 217 | Phase III | Low risk | 55 /2.75 | 64/2 | 90 | 53% | 34%* | | NS | | | NS | | | | | | | | | | P < 0.05 | | | | | | |
| | Coote et al. [17] | 60 | Phase I/II | T2-3 N0M0
and
GS ≥7
or
PSA 20–50
| 57–60/3 | — | 24 | 73%* | — | 4%
4% | —
— | Gr-2
Gr-3 | 9.5%
0% | —
— | Gr-2
Gr-3 |
| | Martin et al. [18] | 92 | Phase II | T1c-2 CNXM0
Low-high
risk | 60/3 | — | 38 |
97%* at 14 months | 3%
0% | —
— | Gr-2
Gr-3 | 4%
0% | —
— | Gr-2
Gr-3 |
| | Dearnaley et al. [19] | 153 | Phase III | T1B-3A
N0M0
GS 6–8
PSA < 50
Low-high risk | 57–60/3 | 74/2 | 50.5 | — | 4.82–9%
0.7–4.2% | 3.5%
1.4% | Gr- 2
Gr-3 | 4.8–6.9%
0.7% | 7.6%
0% | Gr-2
Gr-3 | | | | | | | | | | NS | NS |
| | Arcangeli et al. [20] | 168 | Phase III | High Risk | 62/3.1 | 80/2 | 32 | 87% | 70%* | NS | NS | | | | | | | | | P = 0.035 | | | | | | |
| | Norkus et al. [21, 22] | 91 | Phase III | T1-3 N0M0
GS ≤ 7
PSA ≤10 | 57/3–4.5 | 74/2 | — | NS during 1st 12 months | — | — |
| | Soete et al. [23] | 36 | Phase II | T1-T3 N0M0 | 56/3.5 | — | 2 | — | — | — |
| | Ritter et al. [24] | 307 | Phase I/II | Low-Intermediate risk | 64.7/2.94
58.08/3.63
51.6/4.3 | — | 16–42 |
95%* at 5 years | 3% | — | Gr-2 | 8.8% | — | Gr-2 |
| | | | | | | | | | | 11% | — | Gr 2 | 4% | — | Gr- 2 | | Menkarios et al. [25] | 81 | Phase I/II | Low risk | 45/5 | — | 33 | 97%* | 0% | — | Gr-3 | 0% | — | Gr- 3 | | | | | | | | | | | 4% | — | Gr-4 | 0% | — | Gr-4 | | | | | | | | | | | at 37 months | at 37 months |
|
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No.: Number, HYPO FX: hypofractionation, STD FX: standard, Gy: Gray, FX: fractionation, *: by Phoenix definition, NS: not significantly different, GS: Gleason’s score.
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