| Title: |
Salvage radiotherapy after radical prostatectomy: analysis of toxicity by dose-fractionation in the RADICALS-RT trial |
| Authors: |
Petersen, Peter Meidahl; Cook, Adrian D; Sydes, Matthew R; Clarke, Noel; Cross, William; Kynaston, Howard; Logue, John; Neville, Peter; Payne, Heather; Parmar, Mahesh Kb; Parulekar, Wendy; Persad, Rajendra; Saad, Fred; Stirling, Alan; Parker, Christopher C; Catton, Charles |
| Source: |
International Journal of Radiation: Oncology - Biology - Physics (2023) (In press). |
| Publisher Information: |
Elsevier |
| Publication Year: |
2023 |
| Collection: |
University College London: UCL Discovery |
| Subject Terms: |
Late effects; moderate hypofractionation; Prostate cancer; Salvage radiotherapy |
| Description: |
Emerging data indicate comparable disease control and toxicity of postoperative normo-fractionation and moderate hypofractionation radiotherapy (RT) in prostate cancer. In RADICALS-RT, patients were planned for treatment with either 66Gy in 33 fractions over 6.5 weeks or 52.5Gy in 20 fractions over 4 weeks. In this non-randomized, exploratory analysis, we explore the toxicity of these two schedules in patients who had adjuvant RT. METHODS: Information on RT dose was collected in all patients. Radiation Therapy Oncology Group toxicity score was recorded every 4 months for 2 years, 6-monthly until 5 years, then annually until 15 years. Patient-reported data were collected at baseline, 1, 5, and 10 years with use of standard questionnaires including Vaizey (bowel) and International Continence Society Male Short-Form (urinary incontinence). The highest grade of event was recorded within the first 2 years, and beyond 2 years, and compared between treatment groups using the χ² test. RESULTS: 217/634 (34%) patients were planned for 52.5Gy/20f and 417/634 (66%) for 66Gy/33f. In the first two years, grade 1 - 2 cystitis was reported more frequently among the 66Gy/33f group (52.5Gy/20f: 20% vs 66Gy/33f: 30%, p=0.04). After two years, grade 1-2 cystitis was reported in 16% in the 66Gy group, and 9% in the 52.5Gy group (p=0.08). Other toxicities were similar in the two groups and very few patients had any grade 3 - 4 toxicity. Patients reported slightly higher urinary and faecal incontinence scores at one year than at baseline, but no clinically meaningful differences were reported between 52.5Gy/20f and 66Gy/33f groups. Patient reported health was similar at baseline and at one year, and similar between 52.5Gy/20f and 66Gy/33f groups. CONCLUSION: Severe toxicity is rare after prostate bed radiotherapy with either 52.5Gy/20f or 66Gy/33f. Only modest differences were recorded in toxicity or in patient reported outcomes between these two schedules. |
| Document Type: |
article in journal/newspaper |
| File Description: |
text |
| Language: |
English |
| Relation: |
https://discovery.ucl.ac.uk/id/eprint/10169601/ |
| Availability: |
https://discovery.ucl.ac.uk/id/eprint/10169601/7/Sydes_Sider%20fra%20ROB-D-23-00167_R2_edited_2_.pdf; https://discovery.ucl.ac.uk/id/eprint/10169601/ |
| Rights: |
open |
| Accession Number: |
edsbas.14439200 |
| Database: |
BASE |