Systematic review of hypofractionated radiation therapy for prostate cancer

Nicholas G. Zaorsky, Nitin Ohri, Timothy N. Showalter, Adam P. Dicker, Robert B. Den

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Prostate cancer is the second most prevalent solid tumor diagnosed in men in the United States and Western Europe. Conventionally fractionated external beam radiation therapy (1.8-2.0. Gy/fraction) is an established treatment modality for men in all disease risk groups. Emerging evidence from experimental and clinical studies suggests that the α/β ratio for prostate cancer may be as low as 1.5. Gy, which has prompted investigators around the world to explore moderately hypofractionated radiation therapy (2.1-3.5. Gy/fraction). We review the impetus behind moderate hypofractionation and the current clinical evidence supporting moderate hypofractionated radiation therapy for prostate cancer. Although hypofractionated radiation therapy has many theoretical advantages, there is no clear evidence from prospective, randomized, controlled trials showing that hypofractionated schedules have improved outcomes or lower toxicity than conventionally fractionated regimens. Currently, hypofractionated schedules should only be used in the context of clinical trials. High dose rate brachytherapy and stereotactic body radiation therapy (fraction size 3.5. Gy and greater) are alternative approaches to hypofractionation, but are beyond the scope of this report.

Original languageEnglish (US)
Pages (from-to)726-736
Number of pages11
JournalCancer Treatment Reviews
Volume39
Issue number7
DOIs
StatePublished - Nov 2013
Externally publishedYes

Fingerprint

Prostatic Neoplasms
Radiotherapy
Appointments and Schedules
Brachytherapy
Randomized Controlled Trials
Research Personnel
Clinical Trials
Neoplasms
Therapeutics

Keywords

  • Hypofractionation
  • Prostate cancer
  • Quality of life
  • Radiotherapy
  • Toxicity

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging

Cite this

Systematic review of hypofractionated radiation therapy for prostate cancer. / Zaorsky, Nicholas G.; Ohri, Nitin; Showalter, Timothy N.; Dicker, Adam P.; Den, Robert B.

In: Cancer Treatment Reviews, Vol. 39, No. 7, 11.2013, p. 726-736.

Research output: Contribution to journalArticle

Zaorsky, Nicholas G. ; Ohri, Nitin ; Showalter, Timothy N. ; Dicker, Adam P. ; Den, Robert B. / Systematic review of hypofractionated radiation therapy for prostate cancer. In: Cancer Treatment Reviews. 2013 ; Vol. 39, No. 7. pp. 726-736.
@article{65eec39a7d4145b186009f4044a45d40,
title = "Systematic review of hypofractionated radiation therapy for prostate cancer",
abstract = "Prostate cancer is the second most prevalent solid tumor diagnosed in men in the United States and Western Europe. Conventionally fractionated external beam radiation therapy (1.8-2.0. Gy/fraction) is an established treatment modality for men in all disease risk groups. Emerging evidence from experimental and clinical studies suggests that the α/β ratio for prostate cancer may be as low as 1.5. Gy, which has prompted investigators around the world to explore moderately hypofractionated radiation therapy (2.1-3.5. Gy/fraction). We review the impetus behind moderate hypofractionation and the current clinical evidence supporting moderate hypofractionated radiation therapy for prostate cancer. Although hypofractionated radiation therapy has many theoretical advantages, there is no clear evidence from prospective, randomized, controlled trials showing that hypofractionated schedules have improved outcomes or lower toxicity than conventionally fractionated regimens. Currently, hypofractionated schedules should only be used in the context of clinical trials. High dose rate brachytherapy and stereotactic body radiation therapy (fraction size 3.5. Gy and greater) are alternative approaches to hypofractionation, but are beyond the scope of this report.",
keywords = "Hypofractionation, Prostate cancer, Quality of life, Radiotherapy, Toxicity",
author = "Zaorsky, {Nicholas G.} and Nitin Ohri and Showalter, {Timothy N.} and Dicker, {Adam P.} and Den, {Robert B.}",
year = "2013",
month = "11",
doi = "10.1016/j.ctrv.2013.01.008",
language = "English (US)",
volume = "39",
pages = "726--736",
journal = "Cancer Treatment Reviews",
issn = "0305-7372",
publisher = "W.B. Saunders Ltd",
number = "7",

}

TY - JOUR

T1 - Systematic review of hypofractionated radiation therapy for prostate cancer

AU - Zaorsky, Nicholas G.

AU - Ohri, Nitin

AU - Showalter, Timothy N.

AU - Dicker, Adam P.

AU - Den, Robert B.

PY - 2013/11

Y1 - 2013/11

N2 - Prostate cancer is the second most prevalent solid tumor diagnosed in men in the United States and Western Europe. Conventionally fractionated external beam radiation therapy (1.8-2.0. Gy/fraction) is an established treatment modality for men in all disease risk groups. Emerging evidence from experimental and clinical studies suggests that the α/β ratio for prostate cancer may be as low as 1.5. Gy, which has prompted investigators around the world to explore moderately hypofractionated radiation therapy (2.1-3.5. Gy/fraction). We review the impetus behind moderate hypofractionation and the current clinical evidence supporting moderate hypofractionated radiation therapy for prostate cancer. Although hypofractionated radiation therapy has many theoretical advantages, there is no clear evidence from prospective, randomized, controlled trials showing that hypofractionated schedules have improved outcomes or lower toxicity than conventionally fractionated regimens. Currently, hypofractionated schedules should only be used in the context of clinical trials. High dose rate brachytherapy and stereotactic body radiation therapy (fraction size 3.5. Gy and greater) are alternative approaches to hypofractionation, but are beyond the scope of this report.

AB - Prostate cancer is the second most prevalent solid tumor diagnosed in men in the United States and Western Europe. Conventionally fractionated external beam radiation therapy (1.8-2.0. Gy/fraction) is an established treatment modality for men in all disease risk groups. Emerging evidence from experimental and clinical studies suggests that the α/β ratio for prostate cancer may be as low as 1.5. Gy, which has prompted investigators around the world to explore moderately hypofractionated radiation therapy (2.1-3.5. Gy/fraction). We review the impetus behind moderate hypofractionation and the current clinical evidence supporting moderate hypofractionated radiation therapy for prostate cancer. Although hypofractionated radiation therapy has many theoretical advantages, there is no clear evidence from prospective, randomized, controlled trials showing that hypofractionated schedules have improved outcomes or lower toxicity than conventionally fractionated regimens. Currently, hypofractionated schedules should only be used in the context of clinical trials. High dose rate brachytherapy and stereotactic body radiation therapy (fraction size 3.5. Gy and greater) are alternative approaches to hypofractionation, but are beyond the scope of this report.

KW - Hypofractionation

KW - Prostate cancer

KW - Quality of life

KW - Radiotherapy

KW - Toxicity

UR - http://www.scopus.com/inward/record.url?scp=84881557290&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84881557290&partnerID=8YFLogxK

U2 - 10.1016/j.ctrv.2013.01.008

DO - 10.1016/j.ctrv.2013.01.008

M3 - Article

VL - 39

SP - 726

EP - 736

JO - Cancer Treatment Reviews

JF - Cancer Treatment Reviews

SN - 0305-7372

IS - 7

ER -