Chemoradiotherapy Plus Hormonal Therapy in Localized Prostate Cancer: Late Toxicity Analysis
Posted: Thursday, November 29, 2018
Based upon a study presented at the 2018 Annual Meeting of the American Society for Radiation Oncology (ASTRO) in San Antonio (Abstract 204), a team of investigators discussed the potential issue of late toxicity associated with concomitant radiation therapy and low doses of docetaxel plus standard hormonal treatment in patients with high-risk localized prostate cancer. According to Palmira Foro, MD, PhD, of the Hospital del Mar, Barcelona, and her colleagues, standard doses of concurrent radiation therapy and weekly docetaxel can be administered safely without an increase in late toxicity.
In this phase IIB study, 130 patients were randomly assigned to one of 2 groups. Arm A received luteinizing hormone–releasing hormone (LH-RH) analogs every 3 months for 3 years and radiation therapy (74 Gy total given as 2 Gy x 37 fractions). Arm B received LH-RH analogs every 3 months for 3 years, radiation therapy (73.8 Gy total given as 1.8 Gy x 41 fractions), and concurrent weekly docetaxel at 20 mg/m2 for 9 weeks.
After a median follow-up of 58.3 months, grade ≥ 1 genitourinary (GU) toxicity was reported in 27.9% in arm A and 22.4% in arm B. Grade ≥ 1 gastrointestinal toxicity was observed in 18% in arm A and 10.3% in arm B. The most common grade ≥ 1 GU toxicities (arm A vs. arm B) were an increase in urinary frequency (8.2% vs. 10.3%), hematuria (8.2% vs. 5.1%), and urinary incontinence (6.5% vs. 1.7%).
