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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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Kaplan-Meier biochemical disease-free survival curve in 100 SBRT-patients for prostate cancer.
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Figure 3: Kaplan-Meier biochemical disease-free survival curve in 100 SBRT-patients for prostate cancer.

Mentions: The 3-year biochemical progression-free survival rate was 94.4% (95% CI= 85.3%–97.9%) (Figure 3). A gradual decline in PSA levels through first, second, and third years occurred, with the median nadirs of 0.73 ng/ml, 0.67 ng/ml, and 0.45 ng/ml, respectively. Considering the 71 CK-SBRT monotherapy patients and the 29 patients who also received ADT separately, both had steadily decreasing PSA nadirs. The SBRT monotherapy patients had the PSA nadirs of 0.93 ng/ml, 0.87 ng/ml, and 0.62 ng/ml at 1, 2, and 3 years; and the adjuvant ADT patients had 0.26 ng/ml, 0.30 ng/ml, and 0.18 ng/ml at the same time points, respectively (Figure 4).


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)

Kaplan-Meier biochemical disease-free survival curve in 100 SBRT-patients for prostate cancer.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Kaplan-Meier biochemical disease-free survival curve in 100 SBRT-patients for prostate cancer.
Mentions: The 3-year biochemical progression-free survival rate was 94.4% (95% CI= 85.3%–97.9%) (Figure 3). A gradual decline in PSA levels through first, second, and third years occurred, with the median nadirs of 0.73 ng/ml, 0.67 ng/ml, and 0.45 ng/ml, respectively. Considering the 71 CK-SBRT monotherapy patients and the 29 patients who also received ADT separately, both had steadily decreasing PSA nadirs. The SBRT monotherapy patients had the PSA nadirs of 0.93 ng/ml, 0.87 ng/ml, and 0.62 ng/ml at 1, 2, and 3 years; and the adjuvant ADT patients had 0.26 ng/ml, 0.30 ng/ml, and 0.18 ng/ml at the same time points, respectively (Figure 4).

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