J Korean Med Sci.
2018 Apr;33(14):e107. 10.3346/jkms.2018.33.e107.
Analysis of Motion-dependent Clinical Outcome of Tumor Tracking Stereotactic Body Radiotherapy for Prostate Cancer
- Affiliations
-
- 1Department of Radiation Oncology, Gyeongsang National University School of Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea.
- 2Institute of Health Science, Gyeongsang National University, Jinju, Korea. jeong3023@gmail.com
- 3Department of Radiation Oncology, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea.
- 4Department of Urology, Gyeongsang National University School of Medicine, Gyeongsang National University Changwon Hospital, Changwon, Korea.
- 5Department of Urology, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea.
- 6Research Center, Dongnam Institute of Radiological and Medical Science, Busan, Korea.
- KMID: 2407683
- DOI: http://doi.org/10.3346/jkms.2018.33.e107
Abstract
- BACKGROUND
To analyze clinical outcome of CyberKnife (CK) tumor-tracking stereotactic body radiotherapy (SBRT) for prostate cancer (Pca) according to the magnitude of intra-fractional prostate motion.
METHODS
Medical records and daily treatment logs for 71 patients who received CK tumor-tracking SBRT were retrospectively analyzed. Statistical relationships between prostate motion and various outcome results, including local recurrence (LR), biochemical failure (BF), and treatment-related toxicity, were investigated in order to evaluate motion-dependent efficacy of tumor-tracking SBRT for Pca.
RESULTS
In a total 71 patients, 3 (4.2%) patients with LR, 12 (16.9%) patients with BF, and 22 (31%) patients with grade-II or worse toxicities to rectal or bladder (22 to rectal, 22 to bladder and 8 patients to both) were observed in a median follow-up of 47 months. Magnitudes of intra-fractional tumor motion along superior-inferior, right-left, and anterior-posterior (AP) axes were 0.15 ± 0.31, 0.12 ± 0.19, and 0.73 ± 0.32 mm, respectively. Radial magnitude was estimated to be 1.0 ± 0.35 mm. Intra-fractional movement was not significantly correlated with tumor control. However, it was significant correlated with the incidence of grade-II or worse toxicity to rectum or bladder particularly when tumor motion was in the AP axis.
CONCLUSION
Our quantitative results revealed that toxicity related to SBRT treatment was highly sensitive to intra-fractional prostate movements, although local-tumor control was not affected by such movements. Our results demonstrate that precise motion correction is essential in prostate SBRT, even if it seems to be small.
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