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Proton Therapy Delivery and Its Clinical Application in Select Solid Tumor Malignancies

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Prospective Observational Study on Moderate Hypofractionated Radiotherapy for Localized Prostate Cancer in Rwanda:

Felix Sinzabakira^1,2, W D Heemsbergen², Pacifique Mugenzi¹

¹Rwanda Cancer Centre, Rwanda Military Referral and Teaching Hospital, Kigali City, Rwanda.

JCO Global Oncology

|December 20, 2024

Summary

Moderate hypofractionation (MHF) for prostate cancer is safe and feasible in Rwanda. This study found MHF well-tolerated, with acute gastrointestinal and genitourinary toxicity manageable in African men.

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Area of Science:

Oncology
Radiation Oncology
Clinical Trials

Background:

Moderate hypofractionation (MHF) offers logistical and financial benefits for cancer treatment.
MHF is standard in Western countries but underutilized in Africa.
Prostate cancer treatment requires effective and accessible radiotherapy options.

Purpose of the Study:

To assess the acute gastrointestinal (GI) and genitourinary (GU) toxicity of MHF in Rwandan men with prostate cancer.
To determine the feasibility of MHF in an African healthcare setting.
To evaluate the safety and tolerability of a 20 x 3 Gy MHF regimen.

Main Methods:

A prospective study included 50 men with localized prostate adenocarcinoma at the Rwanda Cancer Centre.
Patients received 20 fractions of 3 Gy over 4 weeks using volumetric modulated arc radiotherapy.
Toxicity was assessed using the Radiation Therapy Oncology Group (RTOG) grading system at multiple time points.

Main Results:

The MHF regimen was well-tolerated, with most patients experiencing Grade 1 or 2 acute GI and GU toxicity.
No Grade 3 GI toxicity was observed.
Treatment costs and duration were reduced by 50% compared to conventional fractionation.

Conclusions:

Moderate hypofractionation (20 x 3 Gy) is a feasible and well-tolerated treatment for prostate cancer in Rwanda.
MHF demonstrates potential for wider adoption in African settings.
Further research on long-term outcomes and larger patient cohorts is recommended.