Safety and feasibility of image-guided robotic radiosurgery for patients with limited bone metastases of prostate cancer

Muacevic, Alexander; Kufeld, Markus; Rist, Carsten; Wowra, Berndt; Stief, Christian G.; Staehler, Michael

doi:10.1016/j.urolonc.2011.02.023

Cited by 100 publications

(122 citation statements)

References 18 publications

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“…In their group (42/124 patients with prostate cancer) they found that irradiation to the single dose of 23-24Gy resulted in better local control of the lesions (2-year LC of 82% in whole group) although no correlation between the dose and LC was observed in prostate cancer group [12]. Very good results were also published by Muacevic et al [13,14,16]. Results obtained in our group are comparable to those reported in literature.…”

Section: Discussionsupporting

confidence: 84%

“…Also other researchers observed a decrease in PSA concentration during follow-up [11,13,14,17]. PSA concentration at last control was lower in patients with PSA below 20 ng/ml at the time of metastasis detection and based on data of other researchers similar observations can be made [11].…”

Section: Discussionmentioning

confidence: 59%

“…Reports concerning SRS/ SABR of patients with oligometastatic prostate cancer showed better OS compared to standard treatment results. Muacevic A et al reported OS of 80% after median time of follow-up of 10.2 months [13]. Decaestecker K et al treated 50 patients with oligometastatic prostate cancer (44% bone metastases) and reported 2-year OS of 96% [14].…”

Section: Discussionmentioning

confidence: 99%

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CyberKnife stereotactic radiosurgery and stereotactic ablative radiation therapy of patients with prostate cancer bone metastases.

Napieralska¹,

Miszczyk²,

Stąpór-Fudzińska³

2016

neo

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The aim of the study was to evaluate the effectiveness and toxicity of CyberKnife (CK) stereotactic radiosurgery (SRS) and stereotactic ablative radiation therapy (SABR) of patients with prostate cancer bone metastases. Analysis of prognostic and predictive factors was also performed.Material consisted of 51 patients with 71 bone oligometastases treated using CK SRS/SABR. In half of the patients single lesion was treated, in half 2-5 lesions. Median PSA concentration at the time of metastasis detection was 5.75 ng/ml. Total dose of 6-45Gy (median 20) was delivered with 1-5 fractions of 6-15 Gy (median 9). Biologic equivalent dose (BED) (α/ β=1.6) over 100 Gy was delivered to 45 lesions (63%) in 38 patients (75%).In statistical analysis Kaplan-Meier method, log-rank test and the Cox proportional hazard model were used. One-, two-and three-year overall survival (OS) was 90%, 76% and 70%, respectively. All patients having PSA concentration lower that 1 ng/ml at last control lived at least three years. One-, two-and three-year local control (LC) was 97%, 70% and 30%. Patients with PSA below 20 ng/ml at the time of metastasis detection had better local control of lesions and lower PSA at the last control. Median of PSA concentration after CK based SRS/SABR remains stable during first 12 months of follow-up, dropped during the next months and at last control was comparable to initial level. Median PSA at last control in patients without disease progression was 1.67ng/ml and 20 patients had PSA below 1.0ng/ml. At the last control 59% of patients had no other metastases. Rapid pain decrease was observed in analysed group and during each control about 90% of patients had pain relief. No major toxicity was observed, 3 patients suffered from fracture of irradiated bone. SRS/SABR of prostate cancer bone oligometastases provides good LC of lesions, excellent pain control without additional toxicity. Patients with PSA concentration below 20ng/ml at the time of metastasis detection have better LC and PSA concentration response.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 99%

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CyberKnife stereotactic radiosurgery and stereotactic ablative radiation therapy of patients with prostate cancer bone metastases.

Napieralska¹,

Miszczyk²,

Stąpór-Fudzińska³

2016

neo

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“…[44][45][46][47][48][49][50][51][52][53][54][55] There were a total of 391 patients out of the 11 studies that reported on the number of prostate cancer patients. Modality of radiotherapy was conventional EBRT in three studies [44][45][46] and SABR [56][57][58] in nine studies.…”

Section: Modality Of Radiotherapymentioning

confidence: 99%

“…Modality of radiotherapy was conventional EBRT in three studies [44][45][46] and SABR [56][57][58] in nine studies. [47][48][49][50][51][52][53][54][55] SABR precisely targets a tumor lesion with a very high dose of radiation in a single or limited number of fractions, while minimizing the radiation exposure to adjacent normal tissues. 57 Studies suggest SABR's mechanism of action to be different from conventional EBRT, 57,59,60 and may induce an immune response with potential of tumor control beyond typical localized cytotoxic effects.…”

Section: Modality Of Radiotherapymentioning

confidence: 99%

Advances in local and ablative treatment of oligometastasis in prostate cancer

Yao

Hong

Corcoran

et al. 2014

Asia-Pac J Clin Oncol

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Oligometastasis is a state of limited metastatic disease that may be amenable to aggressive local therapy to achieve long-term survival. This review aims to explore the role of ablative radiotherapy and surgical management of prostate cancer (CaP) patients with oligometastasis. We performed a systematic review of the literature from November 2003 to November 2013 in the PubMed and EMBASE databases using structured search terms. From our literature search, we identified 13 cases of oligometastatic CaP managed by surgery. The longest disease-free survival documented was 12 years following pulmonary metastasectomy. We also found 12 studies using radiotherapy to treat oligometastatic CaP with median follow-up ranging from 6 to 43 months. Local control rates and overall survival at 3 years range from 66 to 90% and from 54 to 92%, respectively. Most patients did not report any significant toxicity. The limited current literature suggests oligometastatic CaP may be amenable to more aggressive local ablative therapy to achieve prolonged local control and delay to androgen deprivation therapy (ADT). There is a larger body of evidence supporting the use of radiotherapy than surgery in this disease state. However, no direct comparison with ADT is available to suggest an improvement in overall survival. Further studies are required to determine the role of aggressive-targeted local therapy in oligometastatic CaP.

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Safety and Survival Rates Associated With Ablative Stereotactic Radiotherapy for Patients With Oligometastatic Cancer

et al. 2021

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The oligometastatic paradigm postulates that patients with a limited number of metastases can be treated with ablative local therapy to each site of disease with curative intent. Stereotactic ablative radiotherapy (SABR) is a radiation technique that has become widely used in this setting. However, prospective data are limited and are mainly from single institutional studies.OBJECTIVE To conduct a meta-analysis to characterize the safety and clinical benefit of SABR in oligometastatic cancer.DATA SOURCES A comprehensive search was conducted in PubMed/MEDLINE, Embase, Cochrane Database of Systematic Reviews, and Cumulative Index to Nursing and Allied Health Literature on December 23, 2019, that included prospective clinical trials and review articles that were published within the past 15 years.STUDY SELECTION Inclusion criteria were single-arm or multiarm prospective trials including patients with oligometastatic cancer (ie, Յ5 sites of extracranial disease), and SABR was administered in less than or equal to 8 fractions with greater than or equal to 5 Gy/fraction. DATA EXTRACTION AND SYNTHESISThe Population, Intervention, Control, Outcomes and Study Design; Preferred Reporting Items for Systematic Reviews and Meta-analyses; and Meta-analysis of Observational Studies in Epidemiology methods were used to identify eligible studies. Study eligibility and data extraction were reviewed by 3 authors independently. Random-effects meta-analyses using the Knapp-Hartung correction, arcsine transformation, and restricted maximum likelihood method were conducted.MAIN OUTCOMES AND MEASURES Safety (acute and late grade 3-5 toxic effects) and clinical benefit (1-year local control, 1-year overall survival, and 1-year progression-free survival).RESULTS Twenty-one studies comprising 943 patients and 1290 oligometastases were included. Median age was 63.8 years (interquartile range, 59.6-66.1 years) and median follow-up was 16.9 months (interquartile range, 13.7-24.5 months). The most common primary sites were prostate (22.9%), colorectal (16.6%), breast (13.1%), and lung (12.8%). The estimate for acute grade 3 to 5 toxic effect rates under the random-effects models was 1.

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Safety and feasibility of image-guided robotic radiosurgery for patients with limited bone metastases of prostate cancer

Cited by 100 publications

References 18 publications

CyberKnife stereotactic radiosurgery and stereotactic ablative radiation therapy of patients with prostate cancer bone metastases.

CyberKnife stereotactic radiosurgery and stereotactic ablative radiation therapy of patients with prostate cancer bone metastases.

Advances in local and ablative treatment of oligometastasis in prostate cancer

Safety and Survival Rates Associated With Ablative Stereotactic Radiotherapy for Patients With Oligometastatic Cancer

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