lunes, 17 de junio de 2013

Hypofractionation for clinically localized prostate cancer

 2013 Jul;23(3):191-7. doi: 10.1016/j.semradonc.2013.01.005.

Source

Department of Radiation Oncology, Duke Cancer Institute, Durham, NC. Electronic address: alvin.cabrera@duke.edu.

Abstract
This manuscript reviews the clinical evidence for hypofractionation in prostate cancer, focusing on data from prospective trials. For the purposes of this manuscript, we categorize hypofractionation as moderate (2.4-4 Gy per fraction) or extreme (6.5-10 Gy per fraction). Five randomized controlled trials have evaluated moderate hypofractionation in >1500 men, with most followed for >4-5 years. The results of these randomized trials are inconsistent. No randomized trials or other rigorous comparisons of extreme hypofractionation with conventional fractionation have been reported. Prospective single-arm studies of extreme hypofractionation appear favorable, but small sample sizes preclude precise estimates of efficacy and short follow-up prevents complication estimates beyond 3-5 years. Over the next several years, the results of 3 large noninferiority trials of moderate hypofractionation and 2 randomized trials of extreme hypofractionation should help clarify the role of hypofractionation in prostate cancer therapy.


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