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Masson I, Larriviere L, Mahé MA, Azria D, Pommier P, Mesgouez-Nebout N, Giraud P, Peiffert D, Chauvet B, Dudouet P, Salem N, Noël G, Khalifa J, Latorzeff I, Guérin-Charbonnel C, Supiot S. Prospective results for 5-year survival and toxicity of moderately hypofractionated radiotherapy with simultaneous integrated boost (SIB) in (very) high-risk prostate cancer. Clin Transl Radiat Oncol 2024; 44:100702. [PMID: 38111609 PMCID: PMC10726239 DOI: 10.1016/j.ctro.2023.100702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 11/09/2023] [Accepted: 11/14/2023] [Indexed: 12/20/2023] Open
Abstract
Purpose High-risk (HR) prostate cancer patients usually receive high-dose radiotherapy (RT) using a two-phase sequential technique, but data on a simultaneous integrated boost (SIB) technique are lacking. We prospectively evaluated the long-term results of urinary (GU) and digestive (GI) toxicity and survival data for high-dose RT using a SIB technique in HR and very high-risk (VHR) prostate cancer. Methods Patients were treated using an SIB technique in 34 fractions, at a dose of 54.4 Gy to the pelvis and seminal vesicles and 74.8 Gy to the prostate, combined with 36 months of androgen-depriving therapy in a prospective multicenter study. Acute and late GU and GI toxicity data were collected. Overall survival (OS), biochemical-relapse-free survival (bRFS), loco-regional-relapse-free survival (LRRFS), metastasis-free-survival (MFS) and disease-free-survival (DFS) were assessed. Results We recruited 114 patients. After a median follow-up of 62 months, very few patients experienced acute (M0-M3) (G3-4 GU = 3.7 %; G3-4 GI = 0.9 %) or late (M6-M60) severe toxicity (G3-4 GU = 5.6 %; G3-4 GI = 2.8 %). The occurrence of acute G2 + GU or GI toxicity was significantly related to the consequential late G2 + toxicity (p < 0.01 for both GU and GI). Medians of OS, bRFS, LRRFS, MFS and DFS were not reached. At 60 months, OS, bRFS, LRRFS, MFS and DFS were 88.2 % [82.1; 94.7], 86.0 % [79.4 %;93.2 %], 95.8 % [91.8 %;99.9 %], 87.2 % [80.9 %;94.0 %] and 84.1 % [77.2 %;91.6 %] respectively. Conclusion SIB RT at a dose of 54.4 Gy to the pelvis and 74.8 Gy to the prostate is feasible, leading to satisfying tumor control and reasonable toxicity in HR and VHR prostate cancer.
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Affiliation(s)
- Ingrid Masson
- Department of Radiation Oncology, Institut de Cancérologie de l’Ouest René Gauducheau, Saint-Herblain, France
- Department of Radiataion oncology, Centre Eugène Marquis, Rennes, France
| | - Laurène Larriviere
- Department of Radiation Oncology, Institut de Cancérologie de l’Ouest René Gauducheau, Saint-Herblain, France
| | - Marc-André Mahé
- Department of Radiation Oncology, Institut de Cancérologie de l’Ouest René Gauducheau, Saint-Herblain, France
- Department of Radiation Oncology, François Baclesse Cancer Center, Caen, France
| | - David Azria
- Fédération Universitaire d’Oncologie Radiothérapie FOROM, ICM, Institut régional du Cancer Montpellier, Université de Montpellier, IRCM, Montpellier, France
| | - Pascal Pommier
- Department of Radiation Oncology, Léon Bérard Center, Lyon, France
| | - Nathalie Mesgouez-Nebout
- Department of Radiation Oncology, Institut de Cancérologie de l’Ouest Paul Papin, Angers, France
| | - Philippe Giraud
- Department of Radiation Oncology, Georges Pompidou European Hospital, Paris, France
| | - Didier Peiffert
- Department of Radiation Oncology, Lorraine Cancer Institute, Vandœuvre-lès-Nancy, France
| | - Bruno Chauvet
- Department of Radiation Oncology, Sainte Catherine Institute, Avignon, France
| | - Philippe Dudouet
- Department of Radiation Oncology, Pont de chaume Clinic, Montauban, France
| | - Naji Salem
- Department of Radiation Oncology, Paoli-Calmettes Institute, Marseille, France
| | - Georges Noël
- Department of Radiation Oncology, ICANS (Cancerology Institute of Strasbourg-Europe), Strasbourg, France
| | - Jonathan Khalifa
- Department of Radiation Oncology, IUCT Oncopole, Toulouse, France
| | - Igor Latorzeff
- Department of Radiation Oncology, Pasteur Clinic, Toulouse, France
| | - Catherine Guérin-Charbonnel
- Clinical Trial Sponsor Unit/Biometry, Institut de Cancérologie de l’Ouest René Gauducheau, Saint-Herblain, France
- Nantes Université, CNRS US2B, Nantes, France
| | - Stéphane Supiot
- Department of Radiation Oncology, Institut de Cancérologie de l’Ouest René Gauducheau, Saint-Herblain, France
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