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A single-center study of 100 consecutive patients with localized prostate cancer treated with stereotactic body radiotherapy.

Bolzicco G, Favretto MS, Satariano N, Scremin E, Tambone C, Tasca A - BMC Urol (2013)

Bottom Line: In the SBRT-monotherapy group, the median PSA nadir at 36 months was 0.62 ng/ml; in the ADT-SBRT group, it was 0.18 ng/ml.Four patients had clinical recurrence: one local, two lymph nodes, and one to the bone.Ninety-six patients had no evidence of biochemical or clinical recurrence.

View Article: PubMed Central - HTML - PubMed

Affiliation: Departments of Radiation Oncology, San Bortolo Hospital, Vicenza, Italy. giampaolo.bolzicco@ulssvicenza.it.

ABSTRACT

Background: Radiotherapy is an increasingly preferred treatment option for localized prostate cancer, and stereotactic body radiation therapy (SBRT) a relatively established modality of therapeutic irradiation. The present study analyzes the toxicity and biochemical efficacy of SBRT in 100 consecutive prostate cancer patients treated with CyberKnife Robotic Radiosurgery System.

Methods: One hundred patients were treated with SBRT at the Radiation Oncology department of San Bortolo Hospital, Vicenza, Italy. All patients included in this IRB-approved protocol-driven prospective study had biopsy-proven prostate cancer. Risk category was low in 41, intermediate in 42, and high in 17 patients. The patients were treated with CyberKnife-SBRT (CK-SBRT), the prescription dose was 35 Gy in five fractions, corresponding to 92 Gy in 2-Gy fractions (α/β =1.5 Gy); 29 patients also received androgen deprivation therapy (ADT).

Results: Median follow-up was 36 months (range, 6-76 months). Acute Grade 2 genitourinary and gastrointestinal toxicity occurred in respectively 12% and 18% of the patients; there were no Grade 3 or higher acute toxicities. Late Grade 1, 2, and 3 genitourinary toxicities occurred in 4%, 3%, and 1% of the patients, respectively; late Grade 1 gastrointestinal toxicity occurred in two patients and Grade 2 toxicity in one patient; no late gastrointestinal toxicities of grade 3 or 4 were observed. Median PSA nadir was 0.45 ng/ml at 36 months for all patients. In the SBRT-monotherapy group, the median PSA nadir at 36 months was 0.62 ng/ml; in the ADT-SBRT group, it was 0.18 ng/ml. Four patients had clinical recurrence: one local, two lymph nodes, and one to the bone. Ninety-six patients had no evidence of biochemical or clinical recurrence. A benign PSA bounce of median 1.08 ng/ml occurred in 12% of the 71 SBRT monotherapy patients at a mean 23 months (range, 18-30 months).

Conclusions: In this study CK-SBRT has provided promising outcomes in localized prostate cancer with good PSA response, minimal toxicity and patient inconvenience.

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Related in: MedlinePlus

Typical dose volume histogram (DVH) for the target (PTV) and normal tissues (urethra, rectum and bladder).
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Figure 2: Typical dose volume histogram (DVH) for the target (PTV) and normal tissues (urethra, rectum and bladder).

Mentions: To optimize treatment planning, the same team of radiation oncologists performed the contouring of the prostate, seminal vesicles, rectum, bladder, penile bulb, bowel, and femoral heads. The prostate and one third of the seminal vesicle volumes were expanded by 5 mm, except posteriorly, where a 3-mm margin was applied. As for the dose volumes, the whole of the bladder, bulb, and femoral heads received 40 Gy to 5%, 29 Gy to 25%, and 25 Gy to 25% of their volumes, respectively; a part of the urethra – a mean 2-cc volume – received 40 Gy to 5% volume; a part of the rectum – mean 50 cc – received 38 Gy to 5%. In Figure 2, several CyberKnife isodose lines are shown in a typical dose-volume histogram.


A single-center study of 100 consecutive patients with localized prostate cancer treated with stereotactic body radiotherapy.

Bolzicco G, Favretto MS, Satariano N, Scremin E, Tambone C, Tasca A - BMC Urol (2013)

Typical dose volume histogram (DVH) for the target (PTV) and normal tissues (urethra, rectum and bladder).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4016542&req=5

Figure 2: Typical dose volume histogram (DVH) for the target (PTV) and normal tissues (urethra, rectum and bladder).
Mentions: To optimize treatment planning, the same team of radiation oncologists performed the contouring of the prostate, seminal vesicles, rectum, bladder, penile bulb, bowel, and femoral heads. The prostate and one third of the seminal vesicle volumes were expanded by 5 mm, except posteriorly, where a 3-mm margin was applied. As for the dose volumes, the whole of the bladder, bulb, and femoral heads received 40 Gy to 5%, 29 Gy to 25%, and 25 Gy to 25% of their volumes, respectively; a part of the urethra – a mean 2-cc volume – received 40 Gy to 5% volume; a part of the rectum – mean 50 cc – received 38 Gy to 5%. In Figure 2, several CyberKnife isodose lines are shown in a typical dose-volume histogram.

Bottom Line: In the SBRT-monotherapy group, the median PSA nadir at 36 months was 0.62 ng/ml; in the ADT-SBRT group, it was 0.18 ng/ml.Four patients had clinical recurrence: one local, two lymph nodes, and one to the bone.Ninety-six patients had no evidence of biochemical or clinical recurrence.

View Article: PubMed Central - HTML - PubMed

Affiliation: Departments of Radiation Oncology, San Bortolo Hospital, Vicenza, Italy. giampaolo.bolzicco@ulssvicenza.it.

ABSTRACT

Background: Radiotherapy is an increasingly preferred treatment option for localized prostate cancer, and stereotactic body radiation therapy (SBRT) a relatively established modality of therapeutic irradiation. The present study analyzes the toxicity and biochemical efficacy of SBRT in 100 consecutive prostate cancer patients treated with CyberKnife Robotic Radiosurgery System.

Methods: One hundred patients were treated with SBRT at the Radiation Oncology department of San Bortolo Hospital, Vicenza, Italy. All patients included in this IRB-approved protocol-driven prospective study had biopsy-proven prostate cancer. Risk category was low in 41, intermediate in 42, and high in 17 patients. The patients were treated with CyberKnife-SBRT (CK-SBRT), the prescription dose was 35 Gy in five fractions, corresponding to 92 Gy in 2-Gy fractions (α/β =1.5 Gy); 29 patients also received androgen deprivation therapy (ADT).

Results: Median follow-up was 36 months (range, 6-76 months). Acute Grade 2 genitourinary and gastrointestinal toxicity occurred in respectively 12% and 18% of the patients; there were no Grade 3 or higher acute toxicities. Late Grade 1, 2, and 3 genitourinary toxicities occurred in 4%, 3%, and 1% of the patients, respectively; late Grade 1 gastrointestinal toxicity occurred in two patients and Grade 2 toxicity in one patient; no late gastrointestinal toxicities of grade 3 or 4 were observed. Median PSA nadir was 0.45 ng/ml at 36 months for all patients. In the SBRT-monotherapy group, the median PSA nadir at 36 months was 0.62 ng/ml; in the ADT-SBRT group, it was 0.18 ng/ml. Four patients had clinical recurrence: one local, two lymph nodes, and one to the bone. Ninety-six patients had no evidence of biochemical or clinical recurrence. A benign PSA bounce of median 1.08 ng/ml occurred in 12% of the 71 SBRT monotherapy patients at a mean 23 months (range, 18-30 months).

Conclusions: In this study CK-SBRT has provided promising outcomes in localized prostate cancer with good PSA response, minimal toxicity and patient inconvenience.

Show MeSH
Related in: MedlinePlus