La radiothérapie du cancer de la prostate : Place de l’hypo-fractionnement modéré.

Abstract

Introduction: Hypo-fractionated radiotherapy (HF) is becoming an important therapeutic option for localized prostate cancer; we conducted a study to compare hypo-fractionated with normo-(NF) radiotherapy in terms of efficacy, tolerability, quality of life and socio-economic impact. and methods: This was a prospective, randomized, non-inferiority therapeutic study comparing hypo-fractionated radiotherapy versus normo-, mono-centric at the radiotherapy department at the Mokhtari Abdelghani cancer center (CLCC) in Sétif. From 2019 to 2024, including patients with localized prostate cancer. Doses delivered were 60 Gy in 3 Gy per fraction in the (HF) group and 74 Gy to 76 Gy in 2 Gy, per fraction in the (NF) group. The primary endpoint was biochemical recurrence-free survival (BRFS), secondary endpoints were overall survival (OS), cancer-specific survival (CSS), progression-free survival (PFS), acute and late toxicities, quality of life and overall costs. Finally, the release of radiotherapy service capacity. Results: After 38 months of median follow-up (18-61), 154 patients were included: 77 in the (NF) group and 77 in the (HF) group, median age are 72 years (50-80); four patients recurred and seven died. There was no significant difference in survival between the two groups, either in terms of OS of 95% in the (HF) group and 90% in the (NF) group, (p= 0.757), bRFS was 100% (NF), and 93% (CI95%: 82-98) in the (HF) group, PFS was 100% in the (NF) group and 98.7% in the (NF) group, (p=0.317). No grade 4 or 5 toxicities were observed. There were no significant differences in either acute or late toxicities, but a higher of acute urinary toxicity in the (NF) group. There was no difference in quality of life between the two p=0.234), a significant gain in treatment in terms of treatment costs, duration of and access to radiotherapy, and reduction in radiotherapy treatment, and reduced waiting times. Conclusion: Hypo-fractionated radiotherapy (HF) for prostate cancer is to normo-fractionated (NF) radiotherapy, whether in terms of treatment efficacy, equivalent toxicities, quality of life, but a gain in terms of cost and waiting times. , a larger number of patients and a longer follow-up period are required to validate our results.