Stereotactic Radiotherapy for Organ-confined Prostate Cancer: Early Toxicity and Quality of Life Outcomes from a Multi-institutional Trial

Meier, R.; Beckman, Alan; Kaplan, Irving; Mohideen, Najeeb; Shieh, Eugenie; Henning, G.; Walz, Bruce J.; Cotrutz, C.; Sanda, Martin G.

doi:10.1016/j.ijrobp.2010.07.166

Cited by 8 publications

(5 citation statements)

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“…Specifically, in this study the prostate GTV received at least 7% more dose than the PTV, yielding respective doses of about 37.50 and 38.75 Gy. In contrast, in a multi-institutional CyberKnife SBRT clinical study (Meier et al, 2010 ), the PTV is covered at 36.25 Gy, but the prostate GTV receives at least 40 Gy. Even more confounding to direct comparisons is the HDR-like dosimetry used in some centers (Fuller, 2008 ; Jabbari et al, 2010 ) whereby the prescription dose is 38 Gy delivered in four fractions, but the delivered dose to the peripheral zone is much higher and the urethra is contoured and urethral dose constrained (Fuller, 2008 ; Jabbari et al, 2010 ).…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, it should be noted that such a trend would also be true for even higher delivered SBRT doses. That is, treatment regimes delivering total doses of 38 Gy in four fractions (Fuller et al, 2010 ), 40 Gy in five fractions (Meier et al, 2010 ), and 50 Gy in five fractions (Boike et al, 2011 ) may well observe higher toxicity. The question is whether delivery of higher doses will result in a corresponding improvement in disease control or if further dose escalation is unwarranted in the population of low- to low-intermediate-risk organ confined prostate cancer patients.…”

Section: Discussionmentioning

confidence: 99%

“…As has been seen for other malignancies such as lung, liver, spine, and kidney (Svedman et al, 2008 ; Gagnon et al, 2009 ; Rusthoven et al, 2009 ; Martin and Gaya, 2010 ; Timmerman et al, 2010 ), evidence is rapidly accumulating that supports acceptable disease control and acute and late toxicity of stereotactic body radiotherapy (SBRT) for low-risk prostate cancer (Friedland et al, 2009 ; King et al, 2009 ; Bolzicco et al, 2010 ; Fuller et al, 2010 ; Jabbari et al, 2010 ; Katz et al, 2010 ; Meier et al, 2010 ; Boike et al, 2011 ; Freeman and King, 2011 ; Townsend et al, 2011 ). Indeed, initial studies on low-risk patients support SBRT’s potential for clinical efficacy while limiting treatment-related morbidity and maintaining quality of life (QOL; Friedland et al, 2009 ; King et al, 2009 ; Katz et al, 2010 ).…”

Section: Introductionmentioning

confidence: 99%

“…Additional publications with varying follow-up lengths, numbers of patients, and risk categories continue to support these findings (Bolzicco et al, 2010 ; Jabbari et al, 2010 ; Boike et al, 2011 ; Townsend et al, 2011 ). Furthermore, industry sponsored multi-institution clinical studies have reported promising preliminary results (Fuller et al, 2010 ; Meier et al, 2010 ).…”

Section: Introductionmentioning

confidence: 99%

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Stereotactic Body Radiation Therapy for Low- and Low-Intermediate-Risk Prostate Cancer: Is there a Dose Effect?

Katz¹,

Santoro²,

Ashley³

et al. 2011

Front. Oncol.

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This study examines the efficacy and toxicity of two stereotactic body radiation therapy (SBRT) dose regimens for treatment of early prostate cancer. Forty-one patients treated with 35 Gy were matched with 41 patients treated with 36.25 Gy. Both patient groups received SBRT in five fractions over five consecutive days using the CyberKnife. Each group had 37 low-risk patients and 4 intermediate-risk patients. No statistically significant differences were present for age, prostate volume, PSA, Gleason score, stage, or risk between the groups. The dose was prescribed to the 83–87% isodose line to cover the prostate and a 5-mm margin all around, except 3 mm posteriorly. The overall median follow-up is 51 months (range, 45–58 months) with a median 54 and 48 months follow-up for the 35 and 36.25-Gy dose groups, respectively. One biochemical failure occurred in each group yielding a 97.5% freedom from biochemical failure. The PSA response has been favorable for all patients with a mean PSA of 0.1 ng/ml at 4-years. Overall toxicity has been mild with 5% late grade 2 rectal toxicity in both dose groups. Late grade 1 urinary toxicity was equivalent between groups; grade 2 urinary toxicity was 5% (2/41 patients) and 10% (4/41 patients) in the 35-Gy and 36.25-Gy dose groups (p = 0.6969), respectively. Overall, the highly favorable PSA response, limited biochemical failures, limited toxicity, and limited impact on quality of life in these low- to low-intermediate-risk patients are supportive of excellent long-term results for CyberKnife delivered SBRT.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Stereotactic Body Radiation Therapy for Low- and Low-Intermediate-Risk Prostate Cancer: Is there a Dose Effect?

Katz¹,

Santoro²,

Ashley³

et al. 2011

Front. Oncol.

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“…In one of the studies, 40 Gy is delivered in 5 days in a homogeneous distribution [52], and the other 38 Gy is delivered in 4 days using heterogeneous or HDR-like dosimetry [53]. Early results on these studies were presented at ASTRO 2010 showing low toxicity and promising PSA responses [54,55].…”

Section: Cyberknife Sbrt Clinical Outcomesmentioning

confidence: 99%

Stereotactic body radiotherapy for prostate cancer: ready for prime time?

Katz

2012

J Radiat Oncol

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Stereotactic body radiotherapy (SBRT) delivers a few high doses of radiation to a target in the body with extreme accuracy and conformality. Prostate cancer's great sensitivity to dose per fraction allows SBRT's hypofractionated delivery the opportunity to increase the biological equivalent dose delivered to the prostate while relatively decreasing the dose to the normal bladder and rectal tissues. In recent years, clinical outcomes supporting the safety and increasingly longer-term efficacy of SBRT have been published. This review examines the basis of hypofractionation, current SBRT delivery mechanisms, and the growing body of clinical outcomes of SBRT for prostate cancer. In addition, given the increased interest in SBRT for prostate cancer, clinical issues in the treatment of prostate cancer with SBRT and a look into the future of SBRT for prostate cancer are examined.

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Summary of Ongoing Prospective Trials Using SBRT for Prostate Cancer

Morrison

2018

Stereotactic Radiosurgery for Prostate Cancer

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Stereotactic Radiotherapy for Organ-confined Prostate Cancer: Early Toxicity and Quality of Life Outcomes from a Multi-institutional Trial

Cited by 8 publications

References 0 publications

Stereotactic Body Radiation Therapy for Low- and Low-Intermediate-Risk Prostate Cancer: Is there a Dose Effect?

Stereotactic Body Radiation Therapy for Low- and Low-Intermediate-Risk Prostate Cancer: Is there a Dose Effect?

Stereotactic body radiotherapy for prostate cancer: ready for prime time?

Summary of Ongoing Prospective Trials Using SBRT for Prostate Cancer

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