Moderate hypofractionated radiotherapy to the pelvis and/or prostate bed after prostatectomy: a prospective trial

Abstract

Abstract Background Hypofractionated radiotherapy in the treatment of prostate cancer has been widely studied. However, in the postoperative setting it has been less explored. The objective of this prospective study is to evaluate the safety and efficacy of hypofractionated radiotherapy in postoperative prostate cancer. Methods A prospective study was designed that recruited patients with prostate cancer with an indication of postoperative radiotherapy as adjuvant or salvage. A hypofractionated radiotherapy scheme of 51 Gy in 17 fractions was performed with the possibility of treating the pelvis at a dose of 36 Gy in 12 fractions sequentially. Safety was evaluated based on acute and late toxicity (according to the RTOG scale and CTCAE v4.03), IPSS over time, and quality of life. Results From August 2020 to June 2022, 31 patients completed treatment and are included in this report. 35.5% of patients received elective treatment of pelvic nodal areas. Most patients report minimal or low acute toxicity, with an acute GI and GU grade 3 or greater toxicity of 3.2% and 0%, respectively. The evolution in time of the IPSS remained without significant differences (p 0.42). With the exception of a significant improvement in the domains of hormonal and sexual symptoms of the EPIC questionnaire, the rest of the domains EPIC, EORTC-C30 and PR-25 were maintained without significant differences over time. With a follow-up of 15.4 months, late GI and GU grade 2 toxicity was reported greater than 0% and 9.6%, respectively. Conclusions Hypofractionated radiotherapy in postoperative prostate cancer appears to be safe. Low report of relevant acute or late toxicity. Further follow-up is required to confirm these results. Trial registration The protocol was approved by the accredited Medical Ethical Committee of Pontificia Universidad Católica de Chile. All participants accepted and wrote informed consent