The tolerance to multiple daily fractionated radiotherapy for the treatment of prostatic and bladder carcinoma: A feasibility study

Abstract

A modified fractionation schedule was designed with the purpose of reducing the treatment burden. Three fractions of 2 Gy with four hours interval were given during 5 days. The whole scheme was repeated after a rest period of 4 weeks. This makes it possible to deliver a dose of 60 Gy in 10 treatment days and over a total time of 6 weeks. A total of 30 patients, 22 with prostatic cancer and 8 with invasive bladder carcinoma, have been treated. The feasibility has been found to be very good. Forty-seven percent of the patients had acute morbidity, although it was mild in all patients. One patient had a persistent, another had a transient delayed symptom, and one had a severe late complication. The tolerance to this schedule is better than that observed with conventional fractionation schedules. Together with the drastical reduction of the total treatment days, this multiple daily fractionation (MDF) schedule has already been shown to improve the therapeutic ratio by diminishing the burden on the patients. Longer follow-up is necessary for the assessment of the efficacy of this schedule for local tumor control. However, with a follow-up period of 7 to 16 months no recurrence of the prostate cancer in the pelvis has been observed. These results warrant further exploration of the possible benefits of modifications in time-dose-fractionation schedules.