Hypofractionated volumetric modulated arc radiotherapy with simultaneous elective nodal irradiation is feasible in prostate cancer patients : a single institution experience

Abstract EN

Purpose : To assess feasibility, toxicity and biochemical relapse-free survival (b-RFS) for a group of organ confined (OC) Saudi prostate cancer patients treated by hypo-fractionated Volumetric Modulated Arc Radiation Therapy (VMAT) Simultaneous Integrated Boost (SIB) Elective Nodal Irradiation (ENI) whole pelvic radiotherapy (WPRT).

Patients and methods: Between March 2009 and January 2014, 29 OC prostate cancer patients; median age 64 years, PS 0–1 were treated in King Faisal Specialist Hospital – Riyadh, Kingdom of Saudi Arabia using VMAT–SIB–ENI–WPRT, to a total dose of 70 Gy in 28 fractions.

Twenty Four patients (83 %) were treated with neo-adjuvant; concurrent androgen deprivation therapy (ADT).

Median follow-up (FU) was 42 months (range: 18–72 months).

Results: The 3-year actuarial b-RFS for low/intermediate and high risk groups were 100 %, and 48%, respectively (p = 0.09) with a median FU period of 34 months (range: 14–53 months).

Gleason Score (p = 0.02), and pretreatment PSA (p = 0.01) were predictive for biochemical failure on univariate analysis; with no observed prostate cancer-related deaths.

Grade 2 acute/late GI and GU toxicities were 28 % / 0% and 17 % / 10 % respectively with no reported grade 3 / 4 toxicities.