Acute toxicity of moderate hypofractionated radiotherapy in localized carcinoma prostate: An observational study

Abstract

Purpose: This study evaluates acute toxicities in localized prostate cancer patients undergoing moderately hypofractionated radiotherapy.

Materials and methods: Seventy-four patients with biopsy-proven adenocarcinoma prostate who underwent image-guided intensity-modulated radiotherapy were included. Patient characteristics like age, comorbidities, initial PSA, Gleason score, stage, risk grouping, and duration of hormone treatment were captured in a structured format. All patients were treated to a dose of 60 Gy/20 F over 4 weeks. Acute toxicities were assessed using standardized criteria weekly during radiotherapy and at the 8th and 12th weeks of the start of radiation. Statistical analysis was carried out using descriptive statistics and the Mann-Whitney U test.

Results: The genitourinary toxicities peaked at the third week of treatment but decreased by the eighth week. Gastrointestinal toxicities were lesser in incidence which also peaked during weeks 3 and 4 of treatment. Bladder toxicities were more pronounced in diabetic patients (P value 0.023) and correlated with pretreatment IPSS scores (P value 0.001). Diabetes was a significant predictor of rectal toxicities also (P value 0.003), along with dosimetric parameters (PTV60 volume, P value 0.042; PTV57.6 volume, P value 0.036). However, age, stage, initial PSA, Gleason score, and risk grouping did not significantly impact acute toxicity incidence.

Conclusion: Moderately hypofractionated radiotherapy for localized prostate cancer is well tolerated with manageable acute toxicities. Larger trials with more patients and longer follow-ups may be required to confirm the results and evaluate late toxicities and tumor control in our population.

Keywords: Acute toxicities; hypofractionated radiotherapy; prostate cancer.