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Outcomes of hypofractionated stereotactic body radiotherapy boost for intermediate and high-risk prostate cancer
BACKGROUND AND PURPOSE: Treatment of intermediate and high-risk prostate cancer with a high BED has been shown to increase recurrence free survival (RFS). While high dose rate (HDR) brachytherapy, given as a boost is effective in delivering a high BED, many patients are not candidates for the proced...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4721063/ https://www.ncbi.nlm.nih.gov/pubmed/26792201 http://dx.doi.org/10.1186/s13014-016-0585-y |
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author | Anwar, Mekhail Weinberg, Vivian Seymour, Zachary Hsu, I. Joe Roach, Mack Gottschalk, Alex R. |
author_facet | Anwar, Mekhail Weinberg, Vivian Seymour, Zachary Hsu, I. Joe Roach, Mack Gottschalk, Alex R. |
author_sort | Anwar, Mekhail |
collection | PubMed |
description | BACKGROUND AND PURPOSE: Treatment of intermediate and high-risk prostate cancer with a high BED has been shown to increase recurrence free survival (RFS). While high dose rate (HDR) brachytherapy, given as a boost is effective in delivering a high BED, many patients are not candidates for the procedure or wish to avoid an invasive procedure. We evaluated the use of stereotactic body radiotherapy (SBRT) as a boost, with dosimetry modeled after HDR-boost. MATERIAL AND METHODS: Fifty patients were treated with two fractions of SBRT (9.5-10.5 Gy/fraction) after 45 Gy external-beam radiotherapy, with 48 eligible for analysis at a median follow-up of 42.7 months. RESULTS: The Kaplan-Meier estimates of biochemical control post-radiation therapy (95 % Confidence Interval) at 3, 4 and 5 years were 95 % (81–99 %), 90 % (72–97 %) and 90 % (72–97 %), respectively (not counting 2 patients with a PSA bounce as failures). RFS (defined as disease recurrence or death) estimates at 3, 4 and 5 years were 92 % (77–97 %), 88 % (69–95 %) and 83 % (62–93 %) if patients with PSA bounces are not counted as failures, and were 90 % (75–96 %), 85 % (67–94 %) and 75 % (53–88 %) if they were. The median time to PSA nadir was 26.2 months (range 5.8–82.9 months), with a median PSA nadir of 0.05 ng/mL (range <0.01–1.99 ng/mL). 2 patients had a “benign PSA bounce”, and 4 patients recurred with radiographic evidence of recurrence beyond the RT fields. Treatment was well tolerated with no acute G3 or higher GI or GU toxicity and only a single G3 late GU toxicity of urinary obstruction. CONCLUSIONS: SBRT boost is well-tolerated for intermediate and high-risk prostate cancer patients with good biochemical outcomes and low toxicity. |
format | Online Article Text |
id | pubmed-4721063 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-47210632016-01-22 Outcomes of hypofractionated stereotactic body radiotherapy boost for intermediate and high-risk prostate cancer Anwar, Mekhail Weinberg, Vivian Seymour, Zachary Hsu, I. Joe Roach, Mack Gottschalk, Alex R. Radiat Oncol Research BACKGROUND AND PURPOSE: Treatment of intermediate and high-risk prostate cancer with a high BED has been shown to increase recurrence free survival (RFS). While high dose rate (HDR) brachytherapy, given as a boost is effective in delivering a high BED, many patients are not candidates for the procedure or wish to avoid an invasive procedure. We evaluated the use of stereotactic body radiotherapy (SBRT) as a boost, with dosimetry modeled after HDR-boost. MATERIAL AND METHODS: Fifty patients were treated with two fractions of SBRT (9.5-10.5 Gy/fraction) after 45 Gy external-beam radiotherapy, with 48 eligible for analysis at a median follow-up of 42.7 months. RESULTS: The Kaplan-Meier estimates of biochemical control post-radiation therapy (95 % Confidence Interval) at 3, 4 and 5 years were 95 % (81–99 %), 90 % (72–97 %) and 90 % (72–97 %), respectively (not counting 2 patients with a PSA bounce as failures). RFS (defined as disease recurrence or death) estimates at 3, 4 and 5 years were 92 % (77–97 %), 88 % (69–95 %) and 83 % (62–93 %) if patients with PSA bounces are not counted as failures, and were 90 % (75–96 %), 85 % (67–94 %) and 75 % (53–88 %) if they were. The median time to PSA nadir was 26.2 months (range 5.8–82.9 months), with a median PSA nadir of 0.05 ng/mL (range <0.01–1.99 ng/mL). 2 patients had a “benign PSA bounce”, and 4 patients recurred with radiographic evidence of recurrence beyond the RT fields. Treatment was well tolerated with no acute G3 or higher GI or GU toxicity and only a single G3 late GU toxicity of urinary obstruction. CONCLUSIONS: SBRT boost is well-tolerated for intermediate and high-risk prostate cancer patients with good biochemical outcomes and low toxicity. BioMed Central 2016-01-21 /pmc/articles/PMC4721063/ /pubmed/26792201 http://dx.doi.org/10.1186/s13014-016-0585-y Text en © Anwar et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Anwar, Mekhail Weinberg, Vivian Seymour, Zachary Hsu, I. Joe Roach, Mack Gottschalk, Alex R. Outcomes of hypofractionated stereotactic body radiotherapy boost for intermediate and high-risk prostate cancer |
title | Outcomes of hypofractionated stereotactic body radiotherapy boost for intermediate and high-risk prostate cancer |
title_full | Outcomes of hypofractionated stereotactic body radiotherapy boost for intermediate and high-risk prostate cancer |
title_fullStr | Outcomes of hypofractionated stereotactic body radiotherapy boost for intermediate and high-risk prostate cancer |
title_full_unstemmed | Outcomes of hypofractionated stereotactic body radiotherapy boost for intermediate and high-risk prostate cancer |
title_short | Outcomes of hypofractionated stereotactic body radiotherapy boost for intermediate and high-risk prostate cancer |
title_sort | outcomes of hypofractionated stereotactic body radiotherapy boost for intermediate and high-risk prostate cancer |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4721063/ https://www.ncbi.nlm.nih.gov/pubmed/26792201 http://dx.doi.org/10.1186/s13014-016-0585-y |
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