Abstract

Introduction: Radiotherapy is standard treatment option in the management of Prostate cancer.The  α/β of Prostate cancer is low similar to that of late reacting tissues. Hence the fraction size has an impact on the response to radiation. Extreme hypofractionation with single doses of >4–10 Gy up to total doses of 35–50 Gy is achieved with stereotactic body radiotherapy (SBRT) techniques. We report outcomes of twenty cases of intermediate risk prostate cancer treated with extreme hypofractionation using standard linear accelerator.

Materials and Methods: Twenty patients of Intermediate risk Prostate adenocarcinoma were treated using Stereotactic Body Radiotherapy with a dose of 37.5 Gy in 5 fractions at 7.5 Gy per fraction on Novalis Tx linear accelerator.

Results: All patients tolerated hypofractionated treatment well. There were no acute Grade 3 or Grade 4 Gastrointestinal (GI) or Genitourinary (GU) toxicity. Seven patients(35%) had Grade 1 GU Acute toxicity and Four patients(20%) had dysuria-Grade 2 GU Acute toxicity. Four patients (20%) had Grade 1 Acute GI toxicity and two (10%) had Grade 2 Acute GI toxicity.There has been no late GI and no late Grade 3-4 GU toxicity till one year of follow up. All the patients are symptom free and have good biochemical control at one year of follow up.

Conclusion: Extreme hypofractionation is feasible with linear accelerators with low toxicity profile and good outcomes.