No abstract

BACKGROUND: Recent reports using extreme hypofractionated regimens in the treatment of low‐risk prostate adenocarcinoma have been encouraging. Here, the authors report on their own multi‐institutional experience with extreme hypofractionated stereotactic radiotherapy for early stage disease. METHODS: In total, at 4 centers, 45 patients with National Comprehensive Cancer Network‐defined, low‐risk prostate adenocarcinoma were enrolled in a phase 1, multi‐institutional trial of hypofractionated radiosurgery with a proprietary radiosurgical device (CyberKnife). Thirty‐four patients received 7.5 grays (Gy) delivered in 5 fractions, 9 patients received 7.25 Gy delivered in 5 fractions, and 2 patients received other regimens. The variables evaluated were biochemical progression‐free survival (bPFS), prostate‐specific antigen (PSA) bounce, and toxicities. Health‐related quality of life was evaluated using the Sexual Health Inventory for Men (SHIM), American Urological Association (AUA), and Expanded Prostate Cancer Index Composite (EPIC) questionnaires. RESULTS: The median follow‐up for surviving patients was 44.5 months (range, 0‐62 months). The bPFS rate at 3 years was 97.7%. The median PSA declined from 4.9 ng/mL at diagnosis to 0.2 ng/mL at last follow‐up, and the median percentage PSA decline at 12 months was 80%. Nine patients experienced at least 1 PSA bounce ≥0.4 ng/mL, and 4 patients experienced 2 PSA bounces. The median time to first PSA bounce was 11.6 months (range, 7.2‐18.2 months), and the mean percentage PSA bounce was 1.07 ng/mL. There was 1 episode of late grade 3 urinary obstruction, and there were 2 episodes of late grade 3 proctitis. There was a significant late decline in SHIM and EPIC sexual scores and a small, late decline in the EPIC Bowel domain score. CONCLUSIONS: In a select population, extreme hypofractionation with stereotactic radiosurgery was safe and effective for the treatment of low‐risk prostate adenocarcinoma. Cancer 2012. © 2011 American Cancer Society.

Constitutionalsymptoms, 2 patients.

Of 22 subjects with allertic rhinitis who received a series of 6 acupuncture treatments, 11 (50%) were virtually symptom-free by the end of the series, 8 (36%) experienced a moderate reduction in symptoms, and 3 (14%) recieved no significant relief. Clinical assessment of symptoms was made on a 6-point scale before the first treatment and before each subsequent session. Laboratory tests included absolute blood eosinophils, percentage of nasal eosinophils, and radioimmunoassy of serum IgE, performed before the first treatment, at the end of the series, and 2 months later. A siginificant decrease in subjective clinical rating symptoms correlated with a concurrent drop in absolute numbers of blood eosinophils and percentage of nasal eosinophils. IgE levels decreased in 64% of the subjects by completion of treatment and in 76% at 2-month follow-up.