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Hypofractionated stereotactic body radiation therapy as monotherapy for intermediate-risk prostate cancer

BACKGROUND: 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. METHODS: Forty-one sequent...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3570380/
https://www.ncbi.nlm.nih.gov/pubmed/23369294
http://dx.doi.org/10.1186/1748-717X-8-30
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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 PubMed
description BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. TRIAL REGISTRATION: The Georgetown Institutional Review Board has approved this retrospective study (IRB 2009–510).
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spelling pubmed-35703802013-02-13 Hypofractionated stereotactic body radiation therapy as monotherapy for intermediate-risk prostate cancer 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 Radiat Oncol Research BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. TRIAL REGISTRATION: The Georgetown Institutional Review Board has approved this retrospective study (IRB 2009–510). BioMed Central 2013-01-31 /pmc/articles/PMC3570380/ /pubmed/23369294 http://dx.doi.org/10.1186/1748-717X-8-30 Text en Copyright ©2013 Ju et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research
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
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 Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3570380/
https://www.ncbi.nlm.nih.gov/pubmed/23369294
http://dx.doi.org/10.1186/1748-717X-8-30
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