A prospective observational study on Hypo-fractionated Radical Radiotherapy for non-metastatic prostate cancer using Image Guided Radiotherapy: Assessing the toxicity and Quality of life
Beena Kunheri1, JS Lakshmi2, Rajashree Rajan2, Athira Krishnan3, Shabin K Sidhique2, Bibin Rose2
1 National Centre for Cancer Care and Research, NCCCR Hamad Medical Corporation, Doha, Qatar; Department of Radiation Oncology, Amrita School of Medicine, AIMS, Amrita Vishwa Vidyapeetham, Coimbatore, Tamil Nadu, India
2 Department of Radiation Oncology, Amrita School of Medicine, AIMS, Amrita Vishwa Vidyapeetham, Coimbatore, Tamil Nadu, India
3 Department of Radiation Oncology, Rajiv Gandhi Cancer Institute and Research Centre, Delhi, India
Dr. J S Lakshmi
Department of Radiation Oncology, Amrita Institute of Medical Sciences, AIMS, Amrita Vishwa Vidyapeetham, Coimbatore, Tamil Nadu
Source of Support: None, Conflict of Interest: None
BACKGROUND: Prostate cancer is the second most frequent cancer in men. There are no randomized data comparing the outcome, toxicities, and quality of life (QOL) of these patients receiving treatment. This is a prospective study evaluating acute toxicities and QOL of patients receiving radical Radiotherapy (RT) for localized prostate cancer.
MATERIALS AND METHODS: All localized prostate patients reporting for radical radiotherapy were included for this analysis. All patients received image-guided RT. Toxicity analyzed weekly during RT and then at 3 and 6 months. QOL was assessed pre- and post-RT, then at 3 and 6 months.
RESULTS: A total number of 54 patients received radical radiation were included. The median age of presentation was 71 years. Majority of our patients belong to high risk grouping and all patients received image-guided radiotherapy. The highest reported toxicity as Grade 2 and no Grade 3 or 4 genitourinary (GU) or gastrointestinal (GI) toxicities were reported. During RT six patients (11.1%) had Grade 2 GI toxicity and 3 (5.6%) patients had Grade 2 GU toxicity. At 3 months and 6 months, no Grade 2 GI/GU toxicity was recorded. Overall, no Grade 3 or 4 GI and GU toxicity was observed. Regarding QOL, we observed a statistically significant difference in IPSS symptom score between the pre-RT and at completion (P < 0.001) of treatment, 3 months (P < 0.001) and 6 months (P < 0.001) indicating improvement in the symptoms following treatment. Similarly, we noted a significant association in IPSS QOL between the pre-RT and on completion (P < 0.001) of treatment and at 3 months (P < 0.001), 6 months (P < 0.001) indicating improvement in the QOL following treatment.
CONCLUSION: Radical RT is well tolerated with no significant toxicity pattern reported in patients receiving hypo-fractionated RT. QOL assessment showed improvement in IPSS symptom score and QOL scoring and it is well tolerated.