15 Feb Hypofractionated Radiation for Low Risk Prostate Cancer Saves Time and Money
MedicalResearch.com Interview with:
Dr. Bruner
Deborah Watkins Bruner RN, PhD, FAAN
Senior Vice President of Research
Emory University
Professor and Robert W. Woodruff Chair in Nursing
Nell Hodgson Woodruff School of Nursing
Professor, Department of Radiation Oncology
Emory University School of Medicine
MedicalResearch.com: What is the background for this study?
Response: In a randomized clinical trial entitled, “Quality of Life in Patients With Low-Risk Prostate Cancer Treated With Hypofractionated vs Conventional Radiotherapy” the NRG Oncology Group previously demonstrated that men with low risk prostate cancer had similar 5-year disease- free survival of about 85% when treated with either conventional radiotherapy (C-RT) of 73.8 Gy in 41 fractions over 8.2 weeks, or with hypofractionated radiotherapy (H-RT) of 70 Gy in 28 fractions over 5.6 weeks. However, late physician reported side effects of mild bowel and bladder symptoms were increased in patients treated with H-RT and raised questions if the H-RT arm is acceptable to patients.
The current study asked the patient’s directly about their bowel, bladder, sexual function, anxiety, depression and general quality of life using valid patient reported questionnaires. These questionnaires have been found to be more accurate for reporting patient symptoms than physician report alone.
MedicalResearch.com: What are the main findings?
Response: Study results showed that patients were unable to detect any difference in any of their symptoms or quality of life between treatments. The same level of survival with less radiation and no noticeable differences in patient reported symptoms is of significant benefit to patients,
MedicalResearch.com: What should readers take away from your report?
Response: H-RT decreases over 2.6 weeks of treatment time and daily visits to the hospital as well as a decrease in cost of approximately $7700 per patient, just for the radiation treatments, excluding travel, parking, time off work and inconvenience.
This study is a tipping as it adds the patient perspective to similar published studies that provide evidence that H-RT should be a clinical practice standard for treatment of men with low-risk prostate cancer.
Citation:
Bruner DW, Pugh SL, Lee WR, Dignam JJ, Low D, Swanson GP, Shah AB, Malone S, Michalski JM, Dayes IS, Seaward SA, Nguyen PL, Hall WA, Pisansky TM, Chen Y, Sandler HM, Movsas B. Quality of Life in Patients With Low-Risk Prostate Cancer Treated With Hypofractionated vs Conventional Radiotherapy: A Phase 3 Randomized Clinical Trial. JAMA Oncol. 2019 Feb 14. doi: 10.1001/jamaoncol.2018.6752. [Epub ahead of print] PubMed PMID: 30763425.
Conflict of Interest Disclosures: Dr Malone reports consulting with Amgen, Sanofi, AstraZeneca, Bayer, Janssen, AbbVie, and TerSera., Dr Movsas reports grants from the National Cancer Institute, during the conduct of the study; grants from Varian Inc, and grants from Philips Inc, as well as personal fees from ViewRay Inc., Dr Nguyen reports personal fees from Ferring Pharmaceuticals, personal fees from Nanobiotix, Janssen, personal fees and other from Augmenix, personal fees from Dendreon, personal fees from Bayer, grants and personal fees from Astellas Pharma, personal fees from Genome DX, personal fees from and Blue Earth Diagnostics, as well as grants from Janssen and Astellas Pharma., Dr. Sandler reports personal fees from Ferring Pharmaceuticals, personal fees from Blue Earth Diagnostics, personal fees from Janssen, personal fees from and Caribou Publishing, as well as grants from the American College of
Radiology- NRG Oncology., during the conduct of the study; Dr Pugh reports travel from Millennium.
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Last Updated on February 15, 2019 by Marie Benz MD FAAD