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- Title
Cyberknife stereotactic radiosurgery for organ confined prostate cancer.
- Authors
Beltramo, G.; Bergantin, A.; Martinotti, A. S.; Vite, C.; Ria, F.; Invernizzi, M.; Bianchi, L. C.
- Abstract
Purpose: Recent technological developments, combined with modern understanding on prostate radiobiology have generated enthusiasm for hypofractionated regimens. We report our preliminary results with Cyberknife stereotactic radiosurgery in patients with clinically localized prostate cancer. Methods and Materials: From July 2007 to October 2011, 107 patients with a median age of 75 (range 60 - 86) years, a T1c -T2 b prostate cancer were treated with Cyberknife stereotactic radiosurgery at our institution. The majority of patients 59 (55%) were low risk, 28 pts (26%) were intermediate risk and 19 pts (19%) were high risk patients using the NCCN criteria . Pre-treatment PSAs ranged from 1.75 to 23.88 ng.ml (median 7.4 ng.ml). Among the entire study cohort 7 of 19 high risks patients received androgen deprivation therapy (ADT), ADT was not administered to any low - intermediate risk patients A prescribed dose of 38 Gy in four fraction was delivered to the PTV, which was defined as the prostate (plus seminal vesicles in High risk patients) expanded 3 mm posteriorly and 5 mm elsewhere. Biochemical control was assessed using the nadir+2 (Phoenix) definition. Results: All patients were placed on A-blockade medication at the beginning of Cyberknife radiosurgery treatment. Acute side effects were generally mild and resolved shortly after treatment. .No rtog grade 4 acute or late ractal/urinary complications was observed. 3 patients developed Grade 3 late urinary toxicity following repeated urological instrumentation, including cistoscopy and urethral dilatation. Four patients, one with prior Turp, experienced incontinence, One 9 months after treatment, two 12 months after treatment, one 27 months later. One patient experienced rectal incontinence 12 months after treatment. The actuarial median follow up is 30 months (range 12 - 60 months). The four years actuarial psa relapse free survival rate is 93.9% (CI: 88.0%-99..8%) To date 5 patients failed biochemically. One low risk patient revealed local relapse 30 months after Cyberknife treatment. One high risk patient developed bone metastases, in 2 intermediate and in 1 high risk patient we observed nodal metastases. All patients are alive except four died of unrelated causes. Conclusions: Early clinical results are encouraging and we conclude that Cyberknife robotic radiosurgery is a feasible and an emerging non invasive treatment approach to deliver Hypofractionated radiotherapy for localized prostate cancer. Disclosure: No significant relationships.
- Subjects
PROSTATE cancer treatment; RADIOBIOLOGY research; STEREOTACTIC radiosurgery; BONE metastasis; TREATMENT of fecal incontinence
- Publication
Journal of Radiosurgery & SBRT, 2013, Vol 2, p41
- ISSN
2156-4639
- Publication type
Article