Research Article Volume 11 Issue 5 - August 2018 DOI: 10.19080/CTOIJ.2018.11.555823 Canc Therapy & Oncol Int J Copyright © All rights are reserved by Monidipa Mondal Preliminary Results of Clinical Outcomes with Hypofractionated Intensity Modulated Radiotherapy in Organ Confined Prostate Cancer: An Indian Experience Jyotirup Goswami 1 , Suman Mallik 1 , Monidipa Mondal 1 *, Saikat Sheet 1 , Sayan Das 1 , Arijit Sen 1 , Bipasha Pal 2 , Suresh Das 3 and Soura Palit 3 1 Radiation Oncology Department, Narayana Superspeciality Hospital, India 2 Radiation Physics&Radiation OncologyDepartment, Narayana Superspeciality Hospital, India 3 Medical Physicist& Radiation Oncology Department, Narayana Superspeciality Hospital, India Submission: August 11, 2018; Published: August 31, 2018 * Correspondence Address: Monidipa Mondal, Junior Consultant, Radiation Oncology Department, Narayana Superspeciality Hospital, 120/1 Andul road, Howrah, West Bengal-711103, India, Tel: ; Email: Canc Therapy & Oncol Int J 11(5): CTOIJ.MS.ID.555823 (2018) 001 Cancer Therapy & Oncology International Journal ISSN: 2473-554X Introduction Radiotherapy is a mainstay of treatment for organ-confined prostate cancer. In low-risk disease, surgery in the form of radical prostatectomy is equivalent, whereas in intermediate- & high-risk disease, radiotherapy is combined with short-course (6-month) & long-course (2-3 years) androgen deprivation therapy, respectively. Dose escalation to prostate, up to 81.6 Gy, resulted in higher disease control but was also associated with increased Abstract Introduction: Recent evidences suggest that hypofractionated radiotherapy (HFRT) has comparable clinical outcome as conventionally fractionated radiotherapy in organ-confined prostate cancer. We hereby report our initial data of clinical outcomes of organ-confined prostate cancer patients treated with HFRT. Material and Methods: 45 consecutive organ-confined prostate cancer patients (1 low- risk, 5 intermediate- risk, and 39 high-risk) received hypofractionated intensity modulated radiotherapy (HF-IMRT), from July 2012 to June 2017. The prescribed dose to the prostate was 77Gy/35 fractions (before 2014, n=8) or 60Gy/20 fractions (from 2014 onwards, n=37). Irradiation of pelvic lymph nodes was done where required. Androgen deprivation therapy was given for 6 months in intermediate risk and 24-36 months in high risk patients. Biochemical relapse free survival (bRFS) [Phoenix definition], prostate cancer-specific and overall survival (pCSS and OS) actuarial curves were assessed using Kaplan Meier survival curve. Acute and late toxicities were recorded according to the RTOG morbidity scoring system. Results: Median follow was 26 months (range, 6-54 months). 6 biochemical relapses occurred (1 in intermediate and 5 in high risk group) of whom 3 died of distant metastasis. The 2-year actuarial bRFS was 92.3%, pCSS was 93.9% and OS was 91.5%. RTOG grade 2 or worse acute and late gastrointestinal toxicities were 20% and 13.3%; genitourinary toxicity were 8.9% and 11.1% respectively. Only 1 patient had Grade 3 rectal toxicity, and none had Grade 3 bladder toxicity. Conclusion: HF-IMRT in our settings has a comparable biochemical relapse rate and toxicity profile with that of the published literature. Keywords: Dose Hypofractionation; Intensity-Modulated Radiotherapy; Prostate Neoplasms; Treatment Outcome Abbreviations: HFRT: HypofractionatedRadiotherapy; HF-IMRT: HypofractionatedIntensity Modulated Radiotherapy; bRFS- Biochemical Relapse Free Survival; pCSS: Prostate cancer-specific survival; OS: Overall Survival; RTOG: Radiation Therapy Oncology Group; CFRT: Conventionally Fractionated Radiotherapy; NCCN: National Comprehensive Cancer Network; PSA: Prostate Specific Antigen; EORTC: European Organization for Research and Treatment of Cancer; CTV:Clinical Target Volume; PTV: Planning Target Volume; VMAT: Volume Modulated Arc Therapy; QUANTEC: Quantitative Analysis Of Normal Tissue Effects In The Clinic; EQD2- Equivalent Dose in 2 Gy per Fraction; SPSS: Statistical Package for Social Sciences; SD: Standard Deviation;BED:Biological Effective Dos; GI/GU: Gastrointestinal/Genitourinary; ADT: Androgen Deprivation Therapy; TURP: Trans Urethral Resection of Prostate