Dados do Trabalho

Título

STEREOTACTIC BODY RADIATION THERAPY FOR LOCALIZED PROSTATE CANCER: REPORT OF TOXICITIES AND BIOCHEMICAL CONTROL IN A UNI-INSTITUCIONAL COHORT

Resumo

Hypofractionation is gaining strength as the standard of care for prostate cancer radiotherapy. Stereotactic body radiation therapy in 5 or 7 fractions seems to be non-inferior in regard of toxicities or biochemical control. We conducted a retrospective cohort of 161 patients treated with SBRT between March/2020 and December/2022. Eligible patients were men with localized, biopsy-proven prostate cancer, aging at least 45 years, with PS 0-2. Previous transurethral resection, age above 80 years and prostate volume > 60 cm3 were not exclusion criteria. Patients had low to high risk PCa, ISUP ranged from 1 to 5 and received doses that ranged from 35 Gy/5 fractions to 42,7 Gy/7 fractions. MRI fusion was not mandatory for planning. All treatments were performed with volumetric modulated arc therapy. IGRT with Cone beam CT was done for each fraction. Androgen deprivation therapy was allowed. Primary endpoints were biochemical control and gastrointestinal and genitourinary toxicities. The mean follow-up was 15,6 months. Mean age was 74 years, 32 (19,9%) were patients with low risk PCa, 86 (53,5%) was intermediate and 43 (26,7%) was high risk. 72,7% were treated with 5 fractions and 27,3% with 7 fractions. Mean treatment duration was 13,36 days. ADT was used in 80 (49,7%). Biochemical control was achieved in 97,5% of patients, with only 4/161 (2,5%) patients having PSA progression. The toxicities were low, with 9,3% of GI G2, 6,2% of GU G2 and only 1 patient with GI G3. There was a significant decrease of toxicities from 6 months after treatment to the last follow-up, both in GI (p<0,003) and GU (p<0,001). SBRT is an effective and safe option for the primary treatment of localized prostate cancer.