Split-course, high-dose palliative pelvic radiotherapy for locally progressive hormone-refractory prostate cancer

Int J Radiat Oncol Biol Phys. 2012 Jun 1;83(2):e205-11. doi: 10.1016/j.ijrobp.2011.12.028. Epub 2012 Feb 16.

Abstract

Purpose: Local progression, in patients with hormone-refractory prostate cancer, often causes significant morbidity. Pelvic radiotherapy (RT) provides effective palliation in this setting, with most published studies supporting the use of high-dose regimens. The aim of the present study was to examine the role of split-course hypofractionated RT used at our institution in treating this group of patients.

Methods and materials: A total of 34 men with locoregionally progressive hormone-refractory prostate cancer, treated with a split course of pelvic RT (45-60 Gy in 18-24 fractions) between 2000 and 2008 were analyzed. The primary endpoints were the response rate and actuarial locoregional progression-free survival. Secondary endpoints included overall survival, compliance, and acute and late toxicity.

Results: The median age was 71 years (range, 53-88). Treatment resulted in an overall initial response rate of 91%, a median locoregional progression-free survival of 43 months, and median overall survival of 28 months. Compliance was excellent and no significant late toxicity was reported.

Conclusions: The split course pelvic RT described has an acceptable toxicity profile, is effective, and compares well with other high-dose palliative regimens that have been previously reported.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents, Hormonal / therapeutic use
  • Catheters, Indwelling
  • Disease-Free Survival
  • Dose Fractionation, Radiation
  • Drug Resistance, Neoplasm
  • Humans
  • Male
  • Middle Aged
  • Palliative Care / methods*
  • Prostatic Neoplasms / drug therapy
  • Prostatic Neoplasms / mortality
  • Prostatic Neoplasms / pathology
  • Prostatic Neoplasms / radiotherapy*
  • Retrospective Studies
  • Stents
  • Treatment Outcome
  • Tumor Burden
  • Urethra
  • Urination Disorders / etiology
  • Urination Disorders / therapy

Substances

  • Antineoplastic Agents, Hormonal