The authors then looked at long-term side effects, or late toxicities, which are a concern when condensing radiotherapy. The two most worrisome areas of long-term concern for patients who get prostate cancer radiotherapy are gastrointestinal, such as diarrhea and bleeding, and genitourinary complications, such as urinary frequency and urgency.
They found that throughout the 5 years, the cumulative incidence of grade 3 or higher gastrointestinal toxicity was 16.7%, and the cumulative incidence of grade 3 or higher genitourinary toxicity was 13%. But at the end of 5 years, the incidences of these toxicities dropped dramatically to 0% of men with severe gastrointestinal toxicities and 1.9% of men with severe genitourinary toxicities.
“These rates are very acceptable, as well. When you look at all of our results, we showed that we can safely compress radiation into a shorter time frame, into fewer treatments, at higher dose per fraction, with similar clinical outcomes and similar toxicity profiles,” Dr. Wang said.
While there are ongoing phase III trials looking at hypofractionation for high-risk prostate cancer, the treatment approach is considered to be on par with the standard 39 radiotherapy treatments. And preliminary findings on quality of life in work that has not yet been published are equally as promising, suggesting quality of life is comparable in patients getting the condensed 25-treatment approach, according to Dr. Wang.
When high-risk prostate cancer patients are eligible for hypofractionated intensity-modulated radiotherapy, there are clear benefits in patient convenience, health care utilization, and health care costs, according to Dr. Wang.
Dr. Usmani is a consultant/adviser for Amgen, Bayer, and Janssen.
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