J Korean Med Sci.  2015 Jun;30(6):710-715. 10.3346/jkms.2015.30.6.710.

Stereotactic Body Radiation Therapy for Low- to Intermediate-risk Prostate Adenocarcinoma

• Jeong BK
• Jeong H
• Ha IB
• Choi HS
• Kam SC
• Hwa JS
• Hyun JS
• Chung KH
• Choi SM
• Kang KM

• KMID: 2160598
• DOI: http://doi.org/10.3346/jkms.2015.30.6.710

Abstract

The aim of the present study was to evaluate the efficacy and toxicity of stereotactic body radiation therapy (SBRT) for low- to intermediate-risk prostate adenocarcinoma. Thirty-nine patients were retrospectively reviewed. The SBRT was delivered using the CyberKnife with the fiducial tracking method combined with In-tempo imaging. The gross target volume, which included the prostate only, was delineated on the fused CT/MRI scans. The prescription dose was delivered every other day as 5 fractions of 7.5 Gy. Venous blood was obtained before and after SBRT to assess the prostate-specific antigen (PSA) level. Toxicity was evaluated using the CTCAE, v4.03. The median follow-up time was 30.0 months. The median initial PSA level was 7.7 ng/mL. PSA levels decreased in all patients treated with SBRT, and after 5 months, the median PSA was less than 2 ng/mL. The rate of overall 3-yr actuarial biochemical failure free survival was 93.9%. Acute side effects were generally comparable with those of previous studies. The PSA change and toxicity after SBRT for low- to intermediate-risk prostate adenocarcinoma indicates favorable biochemical responses and tolerable levels of toxicity. Additionally short course treatment may produce cost benefit and convenience to patients.

Keyword

Prostate Neoplasms; Stereotactic Body Radiation Therapy; Cyberknife Radiosurgery; Prostate-Specific Antigen

MeSH Terms

Adenocarcinoma/*diagnosis/*surgery
Aged
Aged, 80 and over
Humans
Male
Middle Aged
Prostatic Neoplasms/*diagnosis/*surgery
Radiosurgery/*methods
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted
Radiotherapy, Image-Guided/*methods
Risk Assessment
Treatment Outcome

Figure

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  Fig. 1 Example of CyberKnife SBRT treatment plan showing an axial view in a 70-yr old man who was diagnosed with adenocarcinoma of the prostate (cT1c; initial PSA: 3.01; GS: 7).

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  Fig. 2 Change of median PSA value with IQR after SBRT (25%-75%).

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  Fig. 3 BFFS for the low- to intermediate-risk group patients with prostate adenocarcinoma.

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