Session Item

A local evaluation of clinician reported toxicity and patient reported outcome measures of patients with low or intermediate risk prostate receiving a course of ultrahypofractionated external beam radiotherapy.

A total of 78 patients with low or intermediate risk prostate cancer received either ultrahypofractionated external beam radiotherapy  (42.7Gy/7 fractions over 2 ½ weeks) or moderate hypo fractionated external beam radiotherapy (60Gy/20 fractions over 4 weeks). Clinician reported gastrointestinal (GI) and genitourinary (GU) toxicity was measured using RTOG grading criteria and recorded during formal clinical assessments: week 1, end of treatment, 6 weeks post treatment and 7/8 months post radiotherapy. Patient reported outcomes were recorded using the  EPIC 26 short questionnaire at the start of radiotherapy, end of treatment, 6 weeks post treatment and 7/8 months post radiotherapy.

There were generally low rates of acute GU RTOG grade 2 ≥toxicity in both groups at 6 weeks post treatment and no statistically significant differences between ultrahypofractionated and moderate hyofractioanted radiotherapy treatment groups. (2% UHT vs 0% MHT, P=0.74). At 7/8 months late GU RTOG grade 2 ≥toxicity remained low in both groups (2% UHT vs 3% MHT P=0.321).

There was more pronounced  acute GI RTOG grade 2 ≥ toxicity at 6 weeks post treatment in both treatment groups (9% UHT vs 7% MHT p=0.469). There was an increase in late GI RTOG grade 2 ≥toxicity in the ultrahypofractionated group at 7-8 months following completion of radiotherapy although this did not reach statistical significance comapred to the moderate hypofractionated group (11% UHT vs 0% MHT,p=0.209).

Patient quality of life scores remained similar across all EPIC sub domains in both the ultrahypofractionated  and moderate hypofractionated groups radiotherapy groups from baseline to 7/8 months post radiotherapy.

The EPIC bowel domain was the only sub domain were there was  a clinically meaningful reduction from the baseline mean score at all timepoints, with the 7-8 month mean scores lower than baseline EPIC mean scores. 

The acute and late clinician reported toxicity outcomes and patient reported outcomes reported confirm that external beam ultra hypofractionated prostate radiotherapy can be safely delivered with a comparable toxicity profile to moderate hypofractionated prostate radiotherapy, yet it  is a more convenient option  for patients and may have economic advantages for radiotherapy departments.