Radiation oncology journal · 2026
Acute toxicity and quality of life in postoperative prostate cancer patients treated with ultra-hypofractionated pelvic radiation therapy.
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King Isidora, Gabler Carolina, Catalan Camila, Silva Javiera
Аннотация
PURPOSE: This study aimed to report acute toxicity and quality of life (QoL) outcomes in postoperative prostate cancer patients treated with stereotactic body radiation therapy (SBRT) to the prostate bed and pelvic lymph nodes.
MATERIALS AND METHODS: Patients with prostate cancer who underwent radical prostatectomy and were referred for salvage radiotherapy between January and December 2023 were included. Treatment consisted of 25 Gy to the pelvic nodal areas with a simultaneous integrated boost delivering a total of 30 Gy to the prostate bed, all in 5 fractions, delivered with an empty rectum and comfortably full bladder. Acute gastrointestinal (GI) and genitourinary (GU) toxicities were graded according to Common Terminology Criteria for Adverse Events v5.0. QoL was assessed via phone interview using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-PR25) questionnaire.
RESULTS: A total of 166 patients were treated, of whom 61 had at least 6 months of follow-up. Median age was 65 years, and 77.0% received androgen deprivation therapy. Indications for radiotherapy included biochemical persistence (36.1%), biochemical recurrence (27.9%), local recurrence (21.3%), regional recurrence (6.6%), and combined recurrence (8.2%). All plans met organ-at-risk constraints (mean rectal D1cm³ [dose to the most irradiated 1 cm³] 3,000.7 cGy; bowel D1cm³ 2,457.8 cGy). Acute toxicity data was available for 47 patients. No grade ≥3 acute GI or GU toxicity was observed. Grade 2 GI and GU toxicities occurred in 25.5% and 2.1% of patients, respectively. Among the 62.3% who completed the QoL survey, mean symptom scores were low (urinary, 19.1; bowel, 4.2), and sexual functioning averaged 44.4.
CONCLUSION: Postoperative pelvic SBRT demonstrated low acute toxicity and favorable short-term QoL outcomes, supporting its feasibility and safety for further prospective evaluation.
MATERIALS AND METHODS: Patients with prostate cancer who underwent radical prostatectomy and were referred for salvage radiotherapy between January and December 2023 were included. Treatment consisted of 25 Gy to the pelvic nodal areas with a simultaneous integrated boost delivering a total of 30 Gy to the prostate bed, all in 5 fractions, delivered with an empty rectum and comfortably full bladder. Acute gastrointestinal (GI) and genitourinary (GU) toxicities were graded according to Common Terminology Criteria for Adverse Events v5.0. QoL was assessed via phone interview using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-PR25) questionnaire.
RESULTS: A total of 166 patients were treated, of whom 61 had at least 6 months of follow-up. Median age was 65 years, and 77.0% received androgen deprivation therapy. Indications for radiotherapy included biochemical persistence (36.1%), biochemical recurrence (27.9%), local recurrence (21.3%), regional recurrence (6.6%), and combined recurrence (8.2%). All plans met organ-at-risk constraints (mean rectal D1cm³ [dose to the most irradiated 1 cm³] 3,000.7 cGy; bowel D1cm³ 2,457.8 cGy). Acute toxicity data was available for 47 patients. No grade ≥3 acute GI or GU toxicity was observed. Grade 2 GI and GU toxicities occurred in 25.5% and 2.1% of patients, respectively. Among the 62.3% who completed the QoL survey, mean symptom scores were low (urinary, 19.1; bowel, 4.2), and sexual functioning averaged 44.4.
CONCLUSION: Postoperative pelvic SBRT demonstrated low acute toxicity and favorable short-term QoL outcomes, supporting its feasibility and safety for further prospective evaluation.