Hypofractionated stereotactic body radiation therapy as monotherapy for intermediate-risk prostate cancer
<p>Abstract</p> <p>Background</p> <p>Hypofractionated stereotactic body radiation therapy (SBRT) has been advanced as monotherapy for low-risk prostate cancer. We examined the dose distributions and early clinical outcomes using this modality for the treatment of interm...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2013-01-01
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| Series: | Radiation Oncology |
| Subjects: | |
| Online Access: | http://www.ro-journal.com/content/8/1/30 |
| _version_ | 1828494706193989632 |
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| author | Ju Andrew W Wang Hongkun Oermann Eric K Sherer Benjamin A Uhm Sunghae Chen Viola J Pendharkar Arjun V Hanscom Heather N Kim Joy S Lei Siyuan Suy Simeng Lynch John H Dritschilo Anatoly Collins Sean P |
| author_facet | Ju Andrew W Wang Hongkun Oermann Eric K Sherer Benjamin A Uhm Sunghae Chen Viola J Pendharkar Arjun V Hanscom Heather N Kim Joy S Lei Siyuan Suy Simeng Lynch John H Dritschilo Anatoly Collins Sean P |
| author_sort | Ju Andrew W |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Hypofractionated stereotactic body radiation therapy (SBRT) has been advanced as monotherapy for low-risk prostate cancer. We examined the dose distributions and early clinical outcomes using this modality for the treatment of intermediate-risk prostate cancer.</p> <p>Methods</p> <p>Forty-one sequential hormone-naïve intermediate-risk prostate cancer patients received 35–36.25 Gy of CyberKnife-delivered SBRT in 5 fractions. Radiation dose distributions were analyzed for coverage of potential microscopic ECE by measuring the distance from the prostatic capsule to the 33 Gy isodose line. PSA levels, toxicities, and quality of life (QOL) measures were assessed at baseline and follow-up.</p> <p>Results</p> <p>All patients completed treatment with a mean coverage by the 33 Gy isodose line extending >5 mm beyond the prostatic capsule in all directions except posteriorly. Clinical responses were documented by a mean PSA decrease from 7.67 ng/mL pretreatment to 0.64 ng/mL at the median follow-up of 21 months. Forty patients remain free from biochemical progression. No Grade 3 or 4 toxicities were observed. Mean EPIC urinary irritation/obstruction and bowel QOL scores exhibited a transient decline post-treatment with a subsequent return to baseline. No significant change in sexual QOL was observed.</p> <p>Conclusions</p> <p>In this intermediate-risk patient population, an adequate radiation dose was delivered to areas of expected microscopic ECE in the majority of patients. Although prospective studies are needed to confirm long-term tumor control and toxicity, the short-term PSA response, biochemical relapse-free survival rate, and QOL in this interim analysis are comparable to results reported for prostate brachytherapy or external beam radiotherapy.</p> <p>Trial registration</p> <p>The Georgetown Institutional Review Board has approved this retrospective study (IRB 2009–510).</p> |
| first_indexed | 2024-12-11T12:00:39Z |
| format | Article |
| id | doaj.art-4465d6524c794f78baff8b5d6eb3dee0 |
| institution | Directory Open Access Journal |
| issn | 1748-717X |
| language | English |
| last_indexed | 2024-12-11T12:00:39Z |
| publishDate | 2013-01-01 |
| publisher | BMC |
| record_format | Article |
| series | Radiation Oncology |
| spelling | doaj.art-4465d6524c794f78baff8b5d6eb3dee02022-12-22T01:08:05ZengBMCRadiation Oncology1748-717X2013-01-01813010.1186/1748-717X-8-30Hypofractionated stereotactic body radiation therapy as monotherapy for intermediate-risk prostate cancerJu Andrew WWang HongkunOermann Eric KSherer Benjamin AUhm SunghaeChen Viola JPendharkar Arjun VHanscom Heather NKim Joy SLei SiyuanSuy SimengLynch John HDritschilo AnatolyCollins Sean P<p>Abstract</p> <p>Background</p> <p>Hypofractionated stereotactic body radiation therapy (SBRT) has been advanced as monotherapy for low-risk prostate cancer. We examined the dose distributions and early clinical outcomes using this modality for the treatment of intermediate-risk prostate cancer.</p> <p>Methods</p> <p>Forty-one sequential hormone-naïve intermediate-risk prostate cancer patients received 35–36.25 Gy of CyberKnife-delivered SBRT in 5 fractions. Radiation dose distributions were analyzed for coverage of potential microscopic ECE by measuring the distance from the prostatic capsule to the 33 Gy isodose line. PSA levels, toxicities, and quality of life (QOL) measures were assessed at baseline and follow-up.</p> <p>Results</p> <p>All patients completed treatment with a mean coverage by the 33 Gy isodose line extending >5 mm beyond the prostatic capsule in all directions except posteriorly. Clinical responses were documented by a mean PSA decrease from 7.67 ng/mL pretreatment to 0.64 ng/mL at the median follow-up of 21 months. Forty patients remain free from biochemical progression. No Grade 3 or 4 toxicities were observed. Mean EPIC urinary irritation/obstruction and bowel QOL scores exhibited a transient decline post-treatment with a subsequent return to baseline. No significant change in sexual QOL was observed.</p> <p>Conclusions</p> <p>In this intermediate-risk patient population, an adequate radiation dose was delivered to areas of expected microscopic ECE in the majority of patients. Although prospective studies are needed to confirm long-term tumor control and toxicity, the short-term PSA response, biochemical relapse-free survival rate, and QOL in this interim analysis are comparable to results reported for prostate brachytherapy or external beam radiotherapy.</p> <p>Trial registration</p> <p>The Georgetown Institutional Review Board has approved this retrospective study (IRB 2009–510).</p>http://www.ro-journal.com/content/8/1/30Stereotactic body radiotherapyProstate cancerSBRTCyberKnifeIntermediate-riskMonotherapyHypofractionation |
| spellingShingle | Ju Andrew W Wang Hongkun Oermann Eric K Sherer Benjamin A Uhm Sunghae Chen Viola J Pendharkar Arjun V Hanscom Heather N Kim Joy S Lei Siyuan Suy Simeng Lynch John H Dritschilo Anatoly Collins Sean P Hypofractionated stereotactic body radiation therapy as monotherapy for intermediate-risk prostate cancer Radiation Oncology Stereotactic body radiotherapy Prostate cancer SBRT CyberKnife Intermediate-risk Monotherapy Hypofractionation |
| title | Hypofractionated stereotactic body radiation therapy as monotherapy for intermediate-risk prostate cancer |
| title_full | Hypofractionated stereotactic body radiation therapy as monotherapy for intermediate-risk prostate cancer |
| title_fullStr | Hypofractionated stereotactic body radiation therapy as monotherapy for intermediate-risk prostate cancer |
| title_full_unstemmed | Hypofractionated stereotactic body radiation therapy as monotherapy for intermediate-risk prostate cancer |
| title_short | Hypofractionated stereotactic body radiation therapy as monotherapy for intermediate-risk prostate cancer |
| title_sort | hypofractionated stereotactic body radiation therapy as monotherapy for intermediate risk prostate cancer |
| topic | Stereotactic body radiotherapy Prostate cancer SBRT CyberKnife Intermediate-risk Monotherapy Hypofractionation |
| url | http://www.ro-journal.com/content/8/1/30 |
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