Abstract：
BACKGROUND: To retrospectively report long term outcomes following postoperative hypofractionated radiotherapy (RT) for prostate cancer, emphasizing treatment related toxicity.
METHODS: Patients for whom adjuvant or salvage RT was indicated after prostatectomy were treated with a course of moderate hypofractionation consisting in the delivery of 62.5 Gy in 25 fractions (2.5 Gy per fraction) on the prostate bed in 5 consecutive weeks (EQD21.5 = 70 Gy) by means of 3D-CRT in most of them. Androgen deprivation therapy (ADT) was allowed at physician\'s discretion. Patients were evaluated for urinary and rectal complications according to the Common Terminology Criteria for Adverse Events v4 (CTCAE v.4). Overall survival (OS), biochemical recurrence free survival (bRFS), and metastasis-free survival (MFS) were estimated using the Kaplan-Meier method.
RESULTS: One hundred and ten patients with a median age of 67 years (range 51-78) were enrolled. The majority of them (82%) had adverse pathologic features only, while 31 (28%) had early biochemical relapse. Median PSA level before RT was 0.12 ng/mL (range 0-9 ng/mL). Median time from surgery was 4 months (range 1-136 months). Twenty-eight patients (25.4%) also received ADT. At a median follow up of 103 months (range 19-138 months), late Grade 3 and Grade 4 rectal toxicity were 0.9% (1 case of hematochezia) and 0.9% (1 case of fistula), respectively, while late Grade 3 GU side effects (urethral stenosis) occurred in 9 cases (8%). No late Grade 4 events were observed, respectively. Ten-year OS, b-RFS and MFS were 77.3% (95%CI: 82.1%-72.5%), 53.3% (95%CI: 59.9%-47.6%), and 76.7% (95%CI: 81.2%-72.2%), respectively.
CONCLUSIONS: Our study provides long term data that a shortened course of postoperative RT is as safe and effective as a long course of conventionally fractionated RT and would improve patients\' convenience and significantly reduce RT department workloads.
METHODS: Patients for whom adjuvant or salvage RT was indicated after prostatectomy were treated with a course of moderate hypofractionation consisting in the delivery of 62.5 Gy in 25 fractions (2.5 Gy per fraction) on the prostate bed in 5 consecutive weeks (EQD21.5 = 70 Gy) by means of 3D-CRT in most of them. Androgen deprivation therapy (ADT) was allowed at physician\'s discretion. Patients were evaluated for urinary and rectal complications according to the Common Terminology Criteria for Adverse Events v4 (CTCAE v.4). Overall survival (OS), biochemical recurrence free survival (bRFS), and metastasis-free survival (MFS) were estimated using the Kaplan-Meier method.
RESULTS: One hundred and ten patients with a median age of 67 years (range 51-78) were enrolled. The majority of them (82%) had adverse pathologic features only, while 31 (28%) had early biochemical relapse. Median PSA level before RT was 0.12 ng/mL (range 0-9 ng/mL). Median time from surgery was 4 months (range 1-136 months). Twenty-eight patients (25.4%) also received ADT. At a median follow up of 103 months (range 19-138 months), late Grade 3 and Grade 4 rectal toxicity were 0.9% (1 case of hematochezia) and 0.9% (1 case of fistula), respectively, while late Grade 3 GU side effects (urethral stenosis) occurred in 9 cases (8%). No late Grade 4 events were observed, respectively. Ten-year OS, b-RFS and MFS were 77.3% (95%CI: 82.1%-72.5%), 53.3% (95%CI: 59.9%-47.6%), and 76.7% (95%CI: 81.2%-72.2%), respectively.
CONCLUSIONS: Our study provides long term data that a shortened course of postoperative RT is as safe and effective as a long course of conventionally fractionated RT and would improve patients\' convenience and significantly reduce RT department workloads.
摘要：
背景：回顾性报道前列腺癌术后大分割放疗（RT）后的长期结果，强调治疗相关的毒性。
方法：对前列腺切除术后需要辅助或挽救性RT的患者进行中等程度的低分割治疗，其中大多数患者通过3D-CRT连续5周（EQD21.5=70Gy）在前列腺床上以25个部分（每个部分2.5Gy）输送62.5Gy。根据医生的判断，允许雄激素剥夺治疗（ADT）。根据不良事件通用术语标准v4（CTCAEv.4）评估患者的泌尿和直肠并发症。总生存期（OS），生化无复发生存率（bRFS），使用Kaplan-Meier方法估计无转移生存期（MFS）。
结果：纳入110例中位年龄为67岁（范围51-78）的患者。其中大多数（82％）仅具有不良病理特征，31（28％）有早期生化复发。RT前PSA中位数为0.12ng/mL（范围为0-9ng/mL）。手术的中位时间为4个月（范围1-136个月）。28名患者（25.4%）也接受了ADT。中位随访103个月（范围19-138个月），晚期3级和4级直肠毒性分别为0.9%(1例便血)和0.9%(1例瘘管),分别,晚期3级GU副作用(尿道狭窄)9例(8%)。未观察到4级晚期事件，分别。十年OS,b-RFS和MFS为77.3%（95CI：82.1%-72.5%），53.3%（95CI：59.9%-47.6%），和76.7%（95CI：81.2%-72.2%），分别。
结论：我们的研究提供了长期数据，即缩短术后放疗的疗程与常规分割放疗的长疗程一样安全有效，可以提高患者的便利性并显著减少放疗部门的工作量。
方法：对前列腺切除术后需要辅助或挽救性RT的患者进行中等程度的低分割治疗，其中大多数患者通过3D-CRT连续5周（EQD21.5=70Gy）在前列腺床上以25个部分（每个部分2.5Gy）输送62.5Gy。根据医生的判断，允许雄激素剥夺治疗（ADT）。根据不良事件通用术语标准v4（CTCAEv.4）评估患者的泌尿和直肠并发症。总生存期（OS），生化无复发生存率（bRFS），使用Kaplan-Meier方法估计无转移生存期（MFS）。
结果：纳入110例中位年龄为67岁（范围51-78）的患者。其中大多数（82％）仅具有不良病理特征，31（28％）有早期生化复发。RT前PSA中位数为0.12ng/mL（范围为0-9ng/mL）。手术的中位时间为4个月（范围1-136个月）。28名患者（25.4%）也接受了ADT。中位随访103个月（范围19-138个月），晚期3级和4级直肠毒性分别为0.9%(1例便血)和0.9%(1例瘘管),分别,晚期3级GU副作用(尿道狭窄)9例(8%)。未观察到4级晚期事件，分别。十年OS,b-RFS和MFS为77.3%（95CI：82.1%-72.5%），53.3%（95CI：59.9%-47.6%），和76.7%（95CI：81.2%-72.2%），分别。
结论：我们的研究提供了长期数据，即缩短术后放疗的疗程与常规分割放疗的长疗程一样安全有效，可以提高患者的便利性并显著减少放疗部门的工作量。
