Radiotherapy given in high doses over a shorter period of time is safe and effective for prostate cancer patients, according to research presented at the ESTRO 37 conference today.
The treatment, called ultra-hypofractionated radiotherapy, involves hospital treatment every other day time for two and half weeks, compared to every week day time for eight weeks for standard radiotherapy.
Researchers say this method of giving radiotherapys saves time for patients. It also frees up radiotherapy products, saving money and benefiting other individuals on the waiting list for treatment.
The study was presented by Professor Anders Widmark, a senior consultant based in the division of radiation sciences and cancer centre at Umeå University, Sweden.
He said: “We already know that radiotherapy can destroy cancer cells in the prostate and that it has advantages over surgery treatment and hormone remedy because it is less likely to cause impotence or incontinence. However, radiotherapy requires expensive professional equipment and patients can end up on a waiting list for treatment.
“Ultra-hypofractionated radiotherapys offers numerous practical benefits to patients and also time and cost-savings for hospitals, so we wanted to test if it is as safe and effective as standard radiotherapy.”
The researchers showed a trial with 1,200 patients who were treated at ten hospitals in Sweden and two in Denmark between July 2005 and November 2015. All had been diagnosed with medium or high-risk cancer, where clinical factors suggest there was a risk that the tumor could spread if it was not treated. None experienced received treatment to block the male hormone testosterone, which can stimulate prostate tumours to grow.
Half of individuals received standard radiotherapy of 39 treatments each with a standard radiation dose of two Gray (Gy), spread over eight weeks (78 Gy in total). The other half received ultra-hypofractionated radiotherapy with seven treatments of high dose radiation of 6.1 Gy, every other week day time for two and half weeks (42.7 Gy in total). Individuals were monitored for an average of five years following treatment to observe whether their cancer returned, indicated by a rising level of prostate specific antigen (PSA) and whether they suffered any side-effects.
Researchers found that at five years after treatment 83.8% of individuals treated with standard radiotherapys experienced no signs of their cancer returning and in individuals treated with ultra-hypofractionated radiotherapy the figure was 83.7%.
Although patients who had the ultra-hypofractionated treatment suffered slightly worse side-effects at the end of treatment, long-term side-effects were the same as those experienced by patients who had the standard treatment.
Professor Widmark added: “Previous research has already demonstrated that it’s possible to increase individual doses and give them over four to five weeks. Now we have demonstrated that we can condense the remedy further, raising the dose at each hospital check out to ensure that the whole schedule lasts only two and half weeks.
“This is the first large patient trial of this kind and it demonstrates ultra-hypofractionated radiotherapy is just as effective as standard radiotherapy at stopping prostate tumor from returning. Importantly, it also shows that individuals treated in this way do not suffer any more side-effects than those treated with standard radiotherapy.”
The researchers plan to continue to study the patients in the trial to check whether there are variations in their survival or side-effects in the longer-term.
The President of ESTRO and Professor Yolande Lievens, head of the division of radiation oncology at Ghent University Hospital, Belgium, said: “Improvements in radiotherapy mean that we are better able to locate and target tumours while minimising harm to close by organs. In prostate tumor, this may suggest men retaining sexual and urinary function. This also implies that we are able to consider giving higher specific dosages over a shorter period, mainly because in this scholarly research.
“Results of the trial shows that ultra-hypofractionated radiotherapy is definitely equal to regular radiotherapy. For individuals, that could mean they need to spend significantly less time going to and from medical center for treatment. For wellness services this may help them save assets and get more individuals treated sooner.”