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Purpose <p>Moderately hypofractionated radiotherapy (m-HRT) is a standard of care in the radical treatment of localized prostate cancer (PCa). Still, its role after radical prostatectomy (RP) is yet to be defined. We present long-term outcome and toxicity results of m-HRT in the post-prostatectomy setting.</p> Methods and patients <p>Retrospective analysis of 172 PCa patients treated with daily volumetric image-guided Tomotherapy-based m-HRT between 2013 and 2020. For outcome and toxicity endpoints, we used Kaplan–Meier survival curves and the chi-square test for univariate analysis.</p> Results <p>The median time from RP to m-HRT was 11&#xa0;months (interquartile [IQR], 8.3–31.4). The median total dose to the prostate bed was 69.75&#xa0;Gy (IQR, 65.25–72&#xa0;Gy) (2.25&#xa0;Gy per fraction). With a median follow-up of 8.25&#xa0;years (IQR 7.06–9.17&#xa0;years), 10-year overall survival (OS), metastasis-free survival (MFS), and biochemical relapse-free survival (b-RFS) were 98.8% (95% CI, 95.4–99.7), 85.9% (95% CI, 79.7–90.3), and 82.4% (95% CI, 75.8–87.3), respectively. Late genitourinary (GU) toxicity of grade ≥ 2 was observed in 14 (8.1%) patients. The 10-year freedom from late grade ≥ 2 GU toxicity was 89.8% (95% CI, 83.2–93.8%). Late gastrointestinal (GI) toxicity grade ≥ 2 was reported in 2 (1.1%) patients. The 10-year freedom from late grade ≥ 2 GI toxicity was 98.8% (95% CI, 95.3–99.7%). At univariate analysis, acute GU toxicity was associated with late GU toxicity (<i>p</i> = 0.016).</p> Conclusions <p>Our long-term results confirm the critical role of modern radiotherapy in curing PCa in the post-operative setting, reducing overall treatment time and the risk of toxicity.</p>

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Moderate hypofractionation: long-term toxicity results of prostate bed radiotherapy (FRAME-PROSTATE)

  • 期刊论文

  • 发表日期：

    2026年4月6日

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  • Federico Camilli,
  • Saverio Caini,
  • Chiara Doccioli,
  • Simonetta Saldi,
  • Eleonora Festa,
  • Anna Giulia Becchetti,
  • Sabrina Gravante,
  • Riccardo Moretti,
  • Rita Bellavita,
  • Cynthia Aristei,
  • Gianluca Ingrosso

摘要

Purpose

Moderately hypofractionated radiotherapy (m-HRT) is a standard of care in the radical treatment of localized prostate cancer (PCa). Still, its role after radical prostatectomy (RP) is yet to be defined. We present long-term outcome and toxicity results of m-HRT in the post-prostatectomy setting.

Methods and patients

Retrospective analysis of 172 PCa patients treated with daily volumetric image-guided Tomotherapy-based m-HRT between 2013 and 2020. For outcome and toxicity endpoints, we used Kaplan–Meier survival curves and the chi-square test for univariate analysis.

Results

The median time from RP to m-HRT was 11 months (interquartile [IQR], 8.3–31.4). The median total dose to the prostate bed was 69.75 Gy (IQR, 65.25–72 Gy) (2.25 Gy per fraction). With a median follow-up of 8.25 years (IQR 7.06–9.17 years), 10-year overall survival (OS), metastasis-free survival (MFS), and biochemical relapse-free survival (b-RFS) were 98.8% (95% CI, 95.4–99.7), 85.9% (95% CI, 79.7–90.3), and 82.4% (95% CI, 75.8–87.3), respectively. Late genitourinary (GU) toxicity of grade ≥ 2 was observed in 14 (8.1%) patients. The 10-year freedom from late grade ≥ 2 GU toxicity was 89.8% (95% CI, 83.2–93.8%). Late gastrointestinal (GI) toxicity grade ≥ 2 was reported in 2 (1.1%) patients. The 10-year freedom from late grade ≥ 2 GI toxicity was 98.8% (95% CI, 95.3–99.7%). At univariate analysis, acute GU toxicity was associated with late GU toxicity (p = 0.016).

Conclusions

Our long-term results confirm the critical role of modern radiotherapy in curing PCa in the post-operative setting, reducing overall treatment time and the risk of toxicity.