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Hypofractionated Radiotherapy in Prostate Cancer: A State of the Art in 2019

Abstract

Sami H, Barkiche S, Kaiss H, Elouarzazi S, Lalya I, Elomrani A and Khouchani M

The low α/β ratio in prostate cancer has prompted several teams to propose and evaluate hypofractionated protocols for moderate or stereotactic radiotherapy, in order to deliver larger doses per session over a shorter spread. This allows a better observance of the treatment, while arriving at equivalent radiobiological doses, or even higher than in the standard irradiation protocols. Moreover, the fear of generating intolerable toxicities, especially urinary and gastrointestinal compromising the quality of life of patients has always been a barrier to the generalization and approval of these schemes hypofractionated by all centers. The objective of this article is to present several studies evaluating hypofractionated radiotherapy for localized prostate cancer, whether performed alone or as an adjunct to surgery. We will also discuss the role of new radiotherapy techniques and control imaging in the realization of this treatment. Finally, we discuss the practical recommendations of the hypofractionated protocol.

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