Hypofractionated Radiotherapy with or without IGRT in Prostate Cancer: Preliminary Report of Acute Toxicity

Background: To evaluate the acute tolerance to hypofractionated schedule of patients with prostate cancer. Patients and Methods: We treated 62 patients with intermediate risk prostate cancer. All patients were treated with a total dose of 43.8 Gy on seminal vesicles and 54.75 Gy on prostate, 3.65 Gy per fraction, three times a week for a total of 5 weeks. All patients underwent neoadjuvant, concomitant and adjuvant hormonal therapy. Thirty-six patients were submitted to image-guided radiation therapy (IGRT). Results: Median follow-up was 15 months (range 333 months). Toxicities during the treatment were: grade 1-2 gastrointestinal (GI) toxicity, 22.6%; grade 1-2 genitourinary (GU) toxicity, 51.6%. Toxicities 3 months after the end of the treatment were grade 1-2 GI 6.5%, grade 1-2 GU 9.7%. No statistical difference was observed comparing acute toxicity in patients treated with or without IGRT. Conclusion: This study showed that the hypofractionation schedule used is well tolerated, with a low rate of acute grade 1-2 GI toxicity and without major grade (>= 3) acute toxicity. Longer follow-up is needed to determine if this low rate of acute toxicity will be translated in a low rate of late toxicity.