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Hypofractionated radiotherapy for prostate cancer in the postoperative setting: What is the evidence so far?
Biomaterials ( IF 12.8 ) Pub Date : 2017-11-14 , DOI: 10.1016/j.ctrv.2017.11.004
Cristina Picardi , Ioan Perret , Raymond Miralbell , Thomas Zilli

Postoperative external beam radiation therapy (EBRT) is a validated treatment option in the adjuvant setting for prostate cancer patients with aggressive pathological features following radical prostatectomy (RP) or as salvage modality in patients with biochemical recurrence after RP. Contemporary randomized phase III trials have provided evidence for using hypofractionation in the definitive treatment setting as an alternative to standard fractionated regimens.

Biomathematical modeling for prostate cancer fractionated EBRT associated with widely available refined treatment delivery techniques such as volumetric modulated-arc therapy with image-guided RT may improve the therapeutic ratio. Nevertheless, the role of hypofractionation in the postoperative setting still remains investigational.

In this systematic review of the literature we reviewed the role of hypofractionation for postoperative EBRT in the adjuvant or salvage setting in prostate cancer patients previously treated by RP. A favorable acute toxicity profile with, at least, as good biochemical control rates with hypofractionation has been suggested. And yet conflicting results have been reported concerning long-term genitourinary late toxicity. Prospective studies are eagerly awaited to assess the role of hypofractionation in the postoperative setting.



中文翻译:

前列腺癌术后超分割放疗:迄今为止的证据是什么?

术后外部束放射疗法(EBRT)是辅助疗法中经过验证的治疗选择,适用于在前列腺癌根治性切除术(RP)后具有侵袭性病理特征的前列腺癌患者,或在RP后生化复发的患者中作为抢救方式。当代的随机III期临床试验提供了证据,证明可以在确定的治疗方案中使用超分割术来替代标准分级治疗方案。

前列腺癌分级EBRT的生物数学建模与广泛使用的精细治疗递送技术(例如以图像引导的RT进行容积调制弧光治疗)相关,可以提高治疗率。尽管如此,超分割在术后环境中的作用仍在研究中。

在本文献的系统综述中,我们回顾了超分割对于术后EBRT在先前接受RP治疗的前列腺癌患者的佐剂或治疗中的作用。已经提出了有利的急性毒性特征,至少具有良好的生化控制率和低分馏作用。然而,关于长期泌尿生殖系统晚期毒性的报道却相互矛盾。迫切需要进行前瞻性研究,以评估低分割术在术后环境中的作用。

更新日期:2017-12-14
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