Radiation Oncology Journal

The Korean Society for Radiation Oncology (대한방사선종양학회)
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Hypofractionated stereotactic body radiotherapy in low- and intermediate-risk prostate carcinoma

  • Kim, Hun Jung (Department of Radiation Oncology, Inha University Hospital, Inha University School of Medicine) ;
  • Phak, Jeong Hoon (Department of Radiation Oncology, Inha University Hospital, Inha University School of Medicine) ;
  • Kim, Woo Chul (Department of Radiation Oncology, Inha University Hospital, Inha University School of Medicine)
  • Received : 2015.12.01
  • Accepted : 2015.12.22
  • Published : 2016.12.31
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Abstract

Purpose: Stereotactic body radiotherapy (SBRT) takes advantage of low ${\alpha}/{\beta}$ ratio of prostate cancer to deliver a large dose in few fractions. We examined clinical outcomes of SBRT using CyberKnife for the treatment of low- and intermediate-risk prostate cancer. Materials and Methods: This study was based on a retrospective analysis of the 33 patients treated with SBRT using CyberKnife for localized prostate cancer (27.3% in low-risk and 72.7% in intermediate-risk). Total dose of 36.25 Gy in 5 fractions of 7.25 Gy were administered. The acute and late toxicities were recorded using the Radiation Therapy Oncology Group scale. Prostate-specific antigen (PSA) response was monitored. Results: Thirty-three patients with a median 51 months (range, 6 to 71 months) follow-up were analyzed. There was no biochemical failure. Median PSA nadir was 0.27 ng/mL at median 33 months and PSA bounce occurred in 30.3% (n = 10) of patients at median at median 10.5 months after SBRT. No grade 3 acute toxicity was noted. The 18.2% of the patients had acute grade 2 genitourinary (GU) toxicities and 21.2% had acute grade 2 gastrointestinal (GI) toxicities. After follow-up of 2 months, most complications had returned to baseline. There was no grade 3 late GU and GI toxicity. Conclusion: Our experience with SBRT using CyberKnife in low- and intermediate-risk prostate cancer demonstrates favorable efficacy and toxicity. Further studies with more patients and longer follow-up duration are required.

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References

  1. Jung KW, Won YJ, Kong HJ, et al. Cancer statistics in Korea: incidence, mortality, survival, and prevalence in 2012. Cancer Res Treat 2015;47:127-41. https://doi.org/10.4143/crt.2015.060
  2. Katz AJ, Santoro M, Diblasio F, Ashley R. Stereotactic body radiotherapy for localized prostate cancer: disease control and quality of life at 6 years. Radiat Oncol 2013;8:118. https://doi.org/10.1186/1748-717X-8-118
  3. Chen LN, Suy S, Uhm S, et al. Stereotactic body radiation therapy (SBRT) for clinically localized prostate cancer: the Georgetown University experience. Radiat Oncol 2013;8:58. https://doi.org/10.1186/1748-717X-8-58
  4. King CR, Brooks JD, Gill H, Presti JC Jr. Long-term outcomes from a prospective trial of stereotactic body radiotherapy for low-risk prostate cancer. Int J Radiat Oncol Biol Phys 2012;82:877-82. https://doi.org/10.1016/j.ijrobp.2010.11.054
  5. McBride SM, Wong DS, Dombrowski JJ, et al. Hypofractionated stereotactic body radiotherapy in low-risk prostate adenocarcinoma: preliminary results of a multi-institutional phase 1 feasibility trial. Cancer 2012;118:3681-90. https://doi.org/10.1002/cncr.26699
  6. Fowler JF, Ritter MA, Chappell RJ, Brenner DJ. What hypofractionated protocols should be tested for prostate cancer? Int J Radiat Oncol Biol Phys 2003;56:1093-104. https://doi.org/10.1016/S0360-3016(03)00132-9
  7. Brenner DJ, Hall EJ. Fractionation and protraction for radiotherapy of prostate carcinoma. Int J Radiat Oncol Biol Phys 1999;43:1095-101. https://doi.org/10.1016/S0360-3016(98)00438-6
  8. Arcangeli G, Fowler J, Gomellini S, et al. Acute and late toxicity in a randomized trial of conventional versus hypofractionated three-dimensional conformal radiotherapy for prostate cancer. Int J Radiat Oncol Biol Phys 2011;79:1013-21. https://doi.org/10.1016/j.ijrobp.2009.12.045
  9. Freeman DE, King CR. Stereotactic body radiotherapy for low-risk prostate cancer: five-year outcomes. Radiat Oncol 2011;6:3. https://doi.org/10.1186/1748-717X-6-3
  10. Mohler JL, Kantoff PW, Armstrong AJ, et al. Prostate cancer, version 2.2014. J Natl Compr Canc Netw 2014;12:686-718. https://doi.org/10.6004/jnccn.2014.0072
  11. Abramowitz MC, Li T, Buyyounouski MK, et al. The Phoenix definition of biochemical failure predicts for overall survival in patients with prostate cancer. Cancer 2008;112:55-60. https://doi.org/10.1002/cncr.23139
  12. Patel C, Elshaikh MA, Angermeier K, et al. PSA bounce predicts early success in patients with permanent iodine-125 prostate implant. Urology 2004;63:110-3. https://doi.org/10.1016/j.urology.2003.08.025
  13. D'Amico AV, Whittington R, Malkowicz SB, et al. Biochemical outcome after radical prostatectomy or external beam radiation therapy for patients with clinically localized prostate carcinoma in the prostate specific antigen era. Cancer 2002;95:281-6. https://doi.org/10.1002/cncr.10657
  14. Kupelian PA, Potters L, Khuntia D, et al. Radical prostatectomy, external beam radiotherapy <72 Gy, external beam radiotherapy > or =72 Gy, permanent seed implantation, or combined seeds/external beam radiotherapy for stage T1-T2 prostate cancer. Int J Radiat Oncol Biol Phys 2004;58:25-33. https://doi.org/10.1016/S0360-3016(03)00784-3
  15. Arcangeli G, Saracino B, Gomellini S, et al. A prospective phase III randomized trial of hypofractionation versus conventional fractionation in patients with high-risk prostate cancer. Int J Radiat Oncol Biol Phys 2010;78:11-8. https://doi.org/10.1016/j.ijrobp.2009.07.1691
  16. Hoskin PJ, Motohashi K, Bownes P, Bryant L, Ostler P. High dose rate brachytherapy in combination with external beam radiotherapy in the radical treatment of prostate cancer: initial results of a randomised phase three trial. Radiother Oncol 2007;84:114-20. https://doi.org/10.1016/j.radonc.2007.04.011
  17. Demanes DJ, Martinez AA, Ghilezan M, et al. High-dose-rate monotherapy: safe and effective brachytherapy for patients with localized prostate cancer. Int J Radiat Oncol Biol Phys 2011;81:1286-92. https://doi.org/10.1016/j.ijrobp.2010.10.015
  18. Anwar M, Weinberg V, Chang AJ, Hsu IC, Roach M 3rd, Gottschalk A. Hypofractionated SBRT versus conventionally fractionated EBRT for prostate cancer: comparison of PSA slope and nadir. Radiat Oncol 2014;9:42. https://doi.org/10.1186/1748-717X-9-42
  19. Lamb DS, Denham JW, Joseph D, et al. A comparison of the prognostic value of early PSA test-based variables following external beam radiotherapy, with or without preceding androgen deprivation: analysis of data from the TROG 96.01 randomized trial. Int J Radiat Oncol Biol Phys 2011;79:385-91. https://doi.org/10.1016/j.ijrobp.2009.10.071
  20. Zelefsky MJ, Chan H, Hunt M, Yamada Y, Shippy AM, Amols H. Long-term outcome of high dose intensity modulated radiation therapy for patients with clinically localized prostate cancer. J Urol 2006;176(4 Pt 1):1415-9. https://doi.org/10.1016/j.juro.2006.06.002
  21. Vu CC, Haas JA, Katz AE, Witten MR. Prostate-specific antigen bounce following stereotactic body radiation therapy for prostate cancer. Front Oncol 2014;4:8.
  22. Park YH, Choi IY, Yoon SC, et al. Prostate-specific antigen kinetics after primary stereotactic body radiation therapy using CyberKnife for localized prostate cancer. Prostate Int 2015;3:6-9. https://doi.org/10.1016/j.prnil.2015.02.003

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