Patient Reported Outcomes/Quality of Life

PV QA 4 - Poster Viewing Q&A 4

TU_42_3726 - Feasibility of a Post Prostatectomy Hypofractionated Treatment, and its Impact on Acute Toxicity, Quality of Life and Local Control

Tuesday, October 23
2:45 PM - 4:15 PM
Location: Innovation Hub, Exhibit Hall 3

Feasibility of a Post Prostatectomy Hypofractionated Treatment, and its Impact on Acute Toxicity, Quality of Life and Local Control
G. A. Ferraris Sr1, D. Davalos1, M. Diaz Vazquez1, L. Caussa1, D. R. Fernandez Sr1, R. Choque1, and E. Fernandez2; 1Centro Medico Dean Funes, Cordoba, Argentina, 221st Century Oncology, Fort Lauderdale, FL

Purpose/Objective(s): To report on quality of life (QoL), acute toxicity and efficacy of a hypofractionated radiation course in the salvage post prostatectomy setting, when compared with standard fractionation.

Materials/Methods: This is a retrospective analysis of 70 consecutive patients prospectively evaluated, treated between February 2015 to September 2017 with salvage radiation therapy with either standard fractionation of 35 daily sessions (n: 35), or hypofractionated course of 26 days (n: 35), with volumetric modulated-arc therapy (VMAT) technique and IGRT. For standard fractionation, we used 70 Gy (2 Gy per fraction) and the hypofractionated scheme was 65 Gy (2.5 Gy per fraction). The treatment target area was the prostatic fossa only. Radiation treatment was then correlated with clinical outcome (local control with PSA value less than 0.2 ng/mL), acute toxicity (using Acute toxicity score according to the Radiation Therapy and Oncology Group (RTOG) scale), and quality of life (using polls EORTC 25 and 30 pre-and post-radiation treatment in both arms). A Wilcoxon test was used to compare patient characteristics and treatment parameters between the two arms.

Results: The mean follow-up was 12.3 months in the standard arm, and 7 months in the hypo fractionated; the mean age was 65 years old, and the mean pre-salvage PSA was 1.4 ng/mL (0.25 – 9.0). The most common Gleason score according with ISUP 2014 group grade was 3 (23.5%) in the standard treatment arm and group grade 4 (38.1%) in the hypo fractionated arm. In both groups only three patients (14.2%) received androgen deprivation therapy following surgery or concomitant with radiation. We did not find statistically significant differences in acute urinary toxicity (p=0.484) or gastrointestinal toxicity (p=0.157) between arms. No grade 3 or greater toxicities were found in either group. The QoL according with the two mentioned polls in the hypo fractionated arm revealed no differences in urinary symptoms (p=0.377) or digestive (p=0.527), and the global health status showed no meaningful differences (p=0.445) between pre-and post-treatment polls. Also, with this short follow-up, we no found statistically significant differences in loco regional control were found between the two arms (P=NS)

Conclusion: Moderate Hypofractionation with Volumetric arc therapy provides a convenient, resource efficient and well-tolerated salvage approach for the men that experience biochemical recurrence after radical prostatectomy due to low rates of toxicity without affecting quality of life and demonstrates encouraging efficacy at 6 months. We found no differences between the two arms of treatment. Longer term data are needed to confirm late toxicity profiles and local control.

Author Disclosure: G.A. Ferraris: None. D. Davalos: None. M. Diaz Vazquez: None. D.R. Fernandez: None. R. Choque: None. E. Fernandez: SVP Medical Affairs & Medical Director for Latam; 21st Century Oncology. board member and treasurer; 21C CARE. Board member and VP; ACRO.

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TU_42_3726 - Feasibility of a Post Prostatectomy Hypofractionated Treatment, and its Impact on Acute Toxicity, Quality of Life and Local Control



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