• Jarad M Martin, Tara Rosewall, Andrew Bayley, Robert Bristow, Peter Chung, Juanita Crook, Mary Gospodarowicz, Michael McLean, Cynthia Ménard, Michael Milosevic, Padraig Warde, and Charles Catton.
• Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, ON, Canada.
• Int. J. Radiat. Oncol. Biol. Phys. 2007 Nov 15; 69 (4): 1084-9.

PurposeTo assess in a prospective trial the feasibility and late toxicity of hypofractionated radiotherapy (RT) for prostate cancer.Methods And MaterialsEligible patients had clinical stage T1c-2cNXM0 disease. They received 60 Gy in 20 fractions over 4 weeks with intensity-modulated radiotherapy including daily on-line image guidance with intraprostatic fiducial markers.ResultsBetween June 2001 and March 2004, 92 patients were treated with hypofractionated RT. The cohort had a median prostate-specific antigen value of 7.06 ng/mL. The majority had Gleason grade 5-6 (38%) or 7 (59%) disease, and 82 patients had T1c-T2a clinical staging. Overall, 29 patients had low-risk, 56 intermediate-risk, and 7 high-risk disease. Severe acute toxicity (Grade 3-4) was rare, occurring in only 1 patient. Median follow-up was 38 months. According to the Phoenix definition for biochemical failure, the rate of biochemical control at 14 months was 97%. According to the previous American Society for Therapeutic Radiology and Oncology definition, biochemical control at 3 years was 76%. The incidence of late toxicity was low, with no severe (Grade > or =3) toxicity at the most recent assessment.ConclusionsHypofractionated RT using 60 Gy in 20 fractions over 4 weeks with image guidance is feasible and is associated with low rates of late bladder and rectal toxicity. At early follow-up, biochemical outcome is comparable to that reported for conventionally fractionated controls. The findings are being tested in an ongoing, multicenter, Phase III trial.

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