Hypofractionated, Dose-Escalated Radiation Versus Conventionally Fractionated Radiation for Localized Prostate Cancer: Long-Term Update of a Phase III, Prospective, Randomized Controlled Trial
Abstract
The MD Anderson dose-escalated, hypofractionated prostate radiation study was a phase III randomized trial comparing conventionally fractionated intensity-modulated radiation therapy (CIMRT, 75.6 Gy in 1.8-Gy fractions) with dose-escalated, hypofractionated intensity-modulated radiation (HIMRT, 72 Gy in 2.4-Gy fractions) in patients with localized prostate cancer, predominantly low-risk and intermediate-risk disease. The initial publication highlighted statistically fewer treatment failures in the HIMRT arm. We present long-term updated 13-year outcomes to determine whether cancer control benefit was maintained and to evaluate distant metastases post hoc. With a median follow-up of 13.2 years (IQR, 8.8-15.9 years), treatment failure occurred less frequently in men undergoing HIMRT (n = 13) compared with those undergoing CIMRT (n = 22), although the difference no longer meets statistical significance ( P = .08). Distant metastases were rare, and no statistically significant difference was noted ( P = .2). There remained no statistically significant difference in late GI 2+ (10-year 10% HIMRT v 4% CIMRT, P = .09) or genitourinary grade 2+ toxicity (10-year 26% v 23%, P = .5).
Article Details
Journal Info
Journal of Clinical Oncology
Lippincott Williams & Wilkins
Authors (18)
Comron Hassanzadeh
The University of Texas MD Anderson Cancer Center, Houston, TX
Deborah Kuban
Department of Genitourinary Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
Sarah Pasyar
Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX
Roland Bassett
1The University of Texas, MD Anderson Cancer Center, Stem Cell Transplantation and Cellular Therapy, Houston, United States
Patricia Troncoso
The University of Texas MD Anderson Cancer Center, Houston, TX
Maheen Ansari
Department of Genitourinary Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
Pamela Schlembach
Department of Genitourinary Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
Sean McGuire
Department of Genitourinary Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
Quynh Nguyen
Steven Frank
Department of Genitourinary Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
Henry Mok
Department of Genitourinary Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
Osama Mohamad
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
Ryan Park
1University of Chicago, Pediatric Hematology/Oncology, Chicago, United States
Chad Tang
Department of Genitourinary Medical Oncology The University of Texas MD Anderson Cancer Center Houston Texas USA
Weiliang Du
Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
Rajat Kudchadker
Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
Seungtaek Choi
Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
Karen Hoffman
Department of Genitourinary Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX