Shorter Term Precision Radiation Found Effective For Prostate Cancer Interview with:

Charles N Catton, MD, FRCPC Cancer Clinical Research Unit (CCRU) Princess Margaret Cancer Centre UHN

Dr. Catton

Charles N Catton, MD, FRCPC
Cancer Clinical Research Unit (CCRU)
Princess Margaret Cancer Centre
UHN What is the background for this study? What are the main findings?

Response: Prostate cancer is a very common malignancy which is frequently treated with external beam radiotherapy. A typical standard treatment course can extend over 7.5-8.5 weeks.

The introduction of high-precision radiotherapy treatment techniques provided the opportunity to compress treatment courses by delivering fewer, but more intensive daily treatments. The concerns with giving fewer and larger daily treatments (hypofractionation) is that toxicity may increase and that cancer control may become worse.

This international randomized trial enrolled 1206 men with intermediate risk prostate cancer and compared a standard 8 week course of external beam radiation treatment with a novel hypofractionated treatment course that was given over 4 weeks. Cancer control as measured by PSA control and clinical evidence of failure, bowel and bladder toxicity and quality of life were compared.

At a median follow-up of 6 years the hypofractionated regimen was found to be non-inferior to the standard regimen for cancer control. There was no difference early or late bladder toxicity between the two treatments. There was slightly worse early bowel toxicity during and immediately after treatment with the hypofractionated regimen, but there was actually slightly less long-term bowel toxicity with this same regimen. What should readers take away from your report?

Response: We concluded that with high precision radiation techniques 4 weeks of treatment was a safe and effective alternative to a standard 8 week course of treatment and should be considered as an option for men undergoing radiotherapy for intermediate risk prostate cancer. What recommendations do you have for future research as a result of this study?

Response: We have demonstrated that radiotherapy courses for prostate cancer can be safely compressed to 4 weeks using high-precision techniques. These same techniques may permit even shorter treatment courses in the future, but this needs to be investigated in randomized controlled trials Is there anything else you would like to add?

Response: This trial was funded by the Canadian Institutes for Health Research and was sponsored by the Ontario Clinical Oncology Group Thank you for your contribution to the community.


Randomized Trial of a Hypofractionated Radiation Regimen for the Treatment of Localized Prostate Cancer.

Catton CN, Lukka H, Gu CS, Martin JM, Supiot S, Chung PW, Bauman GS, Bahary JP, Ahmed S, Cheung P, Tai KH, Wu JS, Parliament MB, Tsakiridis T, Corbett TB, Tang C, Dayes IS, Warde P, Craig TK, Julian JA, Levine MN.

J Clin Oncol. 2017 Mar 15:JCO2016717397. doi: 10.1200/JCO.2016.71.7397. [Epub ahead of print]

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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Last Updated on March 16, 2017 by Marie Benz MD FAAD