Acute toxicities of moderately hypofractionated radiotherapy in the treatment of localised prostate cancer

Abstract

Background: Moderately hypofractionated radiotherapy (MHRT) is the standard of care for localised prostate cancer. It is valuable in resource-constrained settings where prostate cancer is the most prevalent cancer in males.
Aim: This study aims to evaluate the incidence and severity of acute genitourinary toxicity (GUT) and gastrointestinal toxicity (GIT) in patients receiving moderately hypofractionated radiotherapy for localised prostate cancer.
Setting: This study was conducted at the Department of Radiation Oncology, Steve Biko Academic Hospital.
Methods: This study involves a retrospective review of 120 patients with localised prostate cancer treated using a 60 Gy in 20 fraction HRT regimen. Acute GU and GI toxicities were graded according to the Radiation Therapy Oncology Group (RTOG) morbidity scale. The correlation between dose–volume histogram (DVH) constraints for the bladder and rectum and the severity of acute toxicity were analysed.
Results: Gastrointestinal toxicity was minimal, with only four cases during radiotherapy. Genitourinary toxicity was more prevalent, peaking at week 4 of treatment (n = 44, 37%), declining at week 6 (n = 21, 18%) and again at week 12 (n = 9, 8%). Bladder dose constraints were frequently exceeded, with V30 > 30 Gy in 36% (n = 43) and V60 > 60 Gy in 33% (n = 30) of cases. There was no statistically significant relationship between bladder dose parameters and the odds of grade 1 or 2 GU toxicity (p = 0.98, p = 0.70, p = 0.28 and p = 0.43, respectively).
Conclusion: Moderately hypofractionated radiotherapy can be effectively implemented in high-volume centres.
Contribution: This study validated the successful implementation of MHRT in a busy academic centre.