• Daisuke Shimizu, Hideya Yamazaki, Takuya Nishimura, Norihiro Aibe, and Haruumi Okabe.
• Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto, Japan dshimizu@koto.kpu-m.ac.jp.
• Anticancer Res. 2017 Oct 1; 37 (10): 5829-5835.

AimWe report the long-term tumor control and toxicity outcomes of patients undergoing hypofractionated (2.2 Gy) image-guided intensity-modulated radiotherapy (IG-IMRT) using tomotherapy for clinically localized prostate cancer.Patients And MethodsWe examined the cases of 138 consecutive patients with stage T1-T3 prostate cancer that were treated with IG-IMRT from June 2007 to July 2009. The median follow-up time was 79 months (range=31-96 months). The planning target volume received a dose of 72.6-74.8 Gy in 33-34 fractions (2.2 Gy/fraction). Megavoltage computed tomographic (CT) scans were performed before each treatment and corrected to the registered positions on the planning CT scans using prostate soft-tissue matching.ResultsThe 5-year biochemical and clinical relapse-free survival rates were 95% for the low-risk group, 92% for the intermediate-risk group, and 77% for the high-risk group. The 5-year incidence rates of grade 2 and 3 late gastrointestinal toxicities were 6.3% and 3.1%, respectively, and those of grade 2 and 3 late genitourinary toxicities were 7.9% and 0%, respectively. Multivariate analysis indicated that T-stage is a prognostic factor for biochemical relapse-free survival rates.ConclusionThis report involved the longest followed-up cohort of patients to have received hypofractionated (2.2 Gy) soft tissue-matched IG-IMRT using tomotherapy. The findings of this study indicate that hypofractionated IMRT is well tolerated and is associated with good long-term tumor-control outcomes in patients with localized prostate cancer.Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

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