Moderate Hypofractionated Radiotherapy for Localized Prostate Cancer: The Triumph of Radiobiology

Title:Moderate Hypofractionated Radiotherapy for Localized Prostate Cancer: The Triumph of Radiobiology

Volume: 16 Issue: 4

Author(s): Andromachi Kougioumtzopoulou*, Kalliopi Platoni, Anna Zygogianni, George Kounadis, Konstantinos N. Syrigos, Adamantia Psyrri, Aristotelis Bamias, Nikolaos Kelekis and Vasileios Kouloulias

Affiliation:

• Radiotherapy Unit, 2nd Department of Radiology, ATTIKON University Hospital, National & Kapodistrian University of Athens, Medical School, Athens,Greece

Keywords: Prostate cancer, hypofractionation, radiobiology, radiotherapy, toxicity, efficacy, quality of life.

Abstract: Background: Radiotherapy represents one of the main therapeutic modalities for localized prostate cancer. In the last two decades, emerging data regarding the radiobiology of prostate cancer suggests a very low α/β value, which has led the scientific community to evaluate the potential advantage of hypofractionation.

Objective: The aim of this manuscript is to present the rationale of prostate radiobiology and the medical evidence of moderate hypofractionation for prostate cancer.

Methods: Existing literature was reviewed, including data from prospective clinical trials dealing with the efficacy and toxicity of hypofractionated radiotherapy. Fifteen prospective phase II studies, nine randomized phase III studies and ten meta-analyses were selected. For every study included, the equivalent dose was calculated for both biochemical control and late toxicity.

Results: The efficacy of hypofractionated radiotherapy, compared to conventional radiotherapy, regarding biochemical control, was evaluated in five superiority and four non-inferiority randomized phase III studies. The majority of participants in these studies were patients with low- and intermediate- risk prostate cancer. Even though the superiority criterion of the hypofractionation was not met in all studies, the noninferiority criterion was met. Prospective phase II studies of hypofractionation reported a low rate of acute and late toxicity. In randomized phase III studies, acute and late toxicity grade 3 and higher for the bowel and bladder was comparable between hypofractionated and conventional radiotherapy. The included meta-analyses showed no difference in efficacy and toxicity.

Conclusion: Moderate hypofractionation is feasible and safe, and may be considered as an alternative option in low- and intermediate-risk prostate cancer patients.

Cite this article as:

Kougioumtzopoulou Andromachi*, Platoni Kalliopi, Zygogianni Anna, Kounadis George, Syrigos N. Konstantinos , Psyrri Adamantia, Bamias Aristotelis, Kelekis Nikolaos and Kouloulias Vasileios, Moderate Hypofractionated Radiotherapy for Localized Prostate Cancer: The Triumph of Radiobiology, Reviews on Recent Clinical Trials 2021; 16 (4) . https://dx.doi.org/10.2174/1574887116666210509004418

DOI https://dx.doi.org/10.2174/1574887116666210509004418	Print ISSN 1574-8871
Publisher Name Bentham Science Publisher	Online ISSN 1876-1038