Hypo-Fractionated Intensity Modulated Radiotherapy (IMRT) After Prostatectomy: Results of a Prospective Study

Abstract

<h3>Purpose/Objective(s)</h3> To assess the toxicity profile and biochemical control of a moderately hypo-fractionated radiotherapy (RT) to the prostatic bed after prostatectomy. <h3>Materials/Methods</h3> From Sep. 2017 to Nov. 2020, 215 Patients with prostate adenocarcinoma who were recommended to receive adjuvant or salvage RT were prescribed to moderately hypo-fractionated RT (62.75 Gy delivered in 2.51 Gy per fractions) to prostatic bed. Whole-pelvis irradiation was performed in 93.0% of patients. Concurrent hormone therapy was administrated in 97.2% of patients. All patients received IMRT with daily image-guided radiotherapy (IGRT). Acute and late toxicity was recorded and graded according to CTCAE 4.0. <h3>Results</h3> The median follow-up was 22 months (range, 1-46 months). Acute grade 2 GI and GU toxicities were 9.3% (20/215) and 11.6% (25/215) respectively. Late grade 2 GI and GU toxicity were 3.7% (8/215) and 16.3% (35/215). No patients complained of acute and late grade ≥3 GI, GU toxicities. The actuarial three-year estimated biochemical progression-free survival (b-PFS) was 89.6% for the entire population. <h3>Conclusion</h3> After prostatectomy, moderately hypo-fractionated RT (2.51 Gy/f25 f) demonstrated promising early biochemical control and acceptable toxicity profile. Prospective randomized trials are warranted with longer follow-up in larger cohorts to confirm these findings.