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© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

Simple Summary

This retrospective study presents the clinical outcomes of the largest cohort of patients (853 patients) with low-, favorable intermediate-, and unfavorable intermediate-risk prostate cancer treated with ultra-hypofractionated proton beam radiotherapy (36.25 GyE/five fractions). The median follow-up time was 62.7 months. Ultra-hypofractionated proton beam radiotherapy is an effective treatment for low- and favorable intermediate-risk prostate cancer, with long-term bDFS rates comparable to other techniques. It is promising for unfavorable intermediate-risk prostate cancer and has acceptable long-term GI and favorable GU toxicity.

Abstract

Background: We retrospectively analyzed the 5-year biochemical disease-free survival (bDFS) and occurrence of late toxicity in prostate cancer patients treated with pencil beam scanning (PBS) proton radiotherapy. Methodology: In the period from January 2013 to June 2018, 853 patients with prostate cancer were treated with an ultra-hypofractionated schedule (36.25 GyE/five fractions). The mean PSA value was 6.7 (0.7–19.7) µg/L. There were 318 (37.3%), 314 (36.8%), and 221 (25.9%) patients at low (LR), favorable intermediate (F-IR), and unfavorable intermediate risk (U-IR), respectively. Neoadjuvant hormonal therapy was administered to 197 (23.1%) patients, and 7 (0.8%) patients had adjuvant hormonal therapy. The whole group of patients reached median follow-up time at 62.7 months, and their mean age was 64.8 (40.0–85.7) years. The bDFS rates and late toxicity profile were evaluated. Results: Median treatment time was 10 (7–38) days. Estimated 5-year bDFS rates were 96.5%, 93.7%, and 91.2% for low-, favorable intermediate-, and unfavorable intermediate-risk groups, respectively. Cumulative late toxicity (CTCAE v4.0) of G2+ was as follows: gastrointestinal (GI)—G2: 9.1%; G3: 0.5%; genitourinary (GU)—G2: 4.3%, and no G3 toxicity was observed. PSA relapse was observed in 58 (6.8%) patients: 16 local, 22 lymph node, 4 bone recurrences, and 10 combined sites of relapse were detected. Throughout the follow-up period, 40 patients (4.7%) died, though none due to prostate cancer. Conclusion: Ultra-hypofractionated proton beam radiotherapy is an effective treatment for low- and favorable intermediate-risk prostate cancer, with long-term bDFS rates comparable to other techniques. It is promising for unfavorable intermediate-risk prostate cancer and has acceptable long-term GI and favorable GU toxicity.

Details

Title
5-Years Analysis of Effectivity and Toxicity of Ultra-Hypofractionated Proton Radiotherapy in the Treatment of Low- and Intermediate-Risk Prostate Cancer—A Retrospective Analysis
Author
Kubeš, Jiri 1 ; Sláviková, Silvia 2 ; Vítek, Pavel 3 ; Haas, Alexandra 2 ; Ondrová, Barbora 2 ; Dedečková, Kateřina 2 ; Andrlík, Michal 2   VIAFID ORCID Logo  ; Domanský, Martin 2 ; Jiránková, Kateřina 2 ; Schlencová, Veronika 2 ; Harazimová, Anh 2 ; Turková, Barbora 4   VIAFID ORCID Logo  ; Doležal, Tomáš 4 ; Sarah Falah Abass Al-Hamami 2 ; Vondráček, Vladimír 2   VIAFID ORCID Logo 

 Proton Therapy Center Czech, Budínova 1a, 180 00 Prague, Czech Republic; [email protected] (J.K.); [email protected] (S.S.); [email protected] (P.V.); [email protected] (A.H.); [email protected] (B.O.); [email protected] (K.D.); [email protected] (M.D.); [email protected] (K.J.); [email protected] (V.S.); [email protected] (A.H.); [email protected] (S.F.A.A.-H.); [email protected] (V.V.); Department of Health Care Disciplines and Population Protection, Faculty of Biomedical Engineering, Czech Technical University Prague, Sítná Square 3105, 272 01 Kladno, Czech Republic 
 Proton Therapy Center Czech, Budínova 1a, 180 00 Prague, Czech Republic; [email protected] (J.K.); [email protected] (S.S.); [email protected] (P.V.); [email protected] (A.H.); [email protected] (B.O.); [email protected] (K.D.); [email protected] (M.D.); [email protected] (K.J.); [email protected] (V.S.); [email protected] (A.H.); [email protected] (S.F.A.A.-H.); [email protected] (V.V.) 
 Proton Therapy Center Czech, Budínova 1a, 180 00 Prague, Czech Republic; [email protected] (J.K.); [email protected] (S.S.); [email protected] (P.V.); [email protected] (A.H.); [email protected] (B.O.); [email protected] (K.D.); [email protected] (M.D.); [email protected] (K.J.); [email protected] (V.S.); [email protected] (A.H.); [email protected] (S.F.A.A.-H.); [email protected] (V.V.); Department of Oncology, 1st Faculty of Medicine and General University Hospital, Charles University, Kateřinská 32, 121 08 Praha, Czech Republic 
 Value Outcomes Ltd., Václavská 316/12, 120 00 Praha, Czech Republic; [email protected] (B.T.); [email protected] (T.D.) 
First page
4571
Publication year
2023
Publication date
2023
Publisher
MDPI AG
e-ISSN
20726694
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2869283430
Copyright
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.