Prostate SBRT: Comparison the Efficacy and Toxicity of Two Different Dose Fractionation Schedules

Frontiers in Oncology
Donald Blake FullerGeorge Mardirossian

Abstract

Background: CyberKnife SBRT is capable of producing dosimetry comparable to that created by HDR brachytherapy. Our original CyberKnife prostate SBRT schedule of 3,800 cGy/4 fractions ("high dose") was based upon favorable published prostate HDR brachytherapy experience. Subsequently, our trial was modified to allow a lower dose of 3,400 cGy/5 fractions ("moderate dose") in selected cases. Methods: Two hundred eighty-nine low and intermediate-risk patients were treated to either high dose (178 pts) or moderate dose (111 pts). The dose selection was individualized; high dose more commonly used in younger, intermediate-risk patients, and moderate dose more commonly used in older, low-risk patients. Results: Median PSA reached 5-year nadir levels of 0.034 ng/mL in the high dose, vs. 0.1 ng/mL in the moderate dose groups, respectively (p = 0.044 by year 4), with 62 vs. 44% reaching an ablation PSA nadir (<0.1 ng/mL) by year 5, respectively. Five year biochemical relapse free survival rates measured 98.3% for moderate dose and 94.3% for high dose groups, respectively (p = 0.1946). Five-year actuarial grade 2 genitourinary (GU) toxicity rates measured 11.6 vs. 8.7% for high dose vs. moderate dose groups, respectively, with a far lower...Continue Reading

References

Apr 1, 2008·International Journal of Radiation Oncology, Biology, Physics·Donald B FullerHaoran Jin
Feb 9, 2011·International Journal of Radiation Oncology, Biology, Physics·Christopher R KingJoseph C Presti
Sep 26, 2013·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Christopher R KingAlan Katz
Mar 29, 2018·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Yasir AlayedD Andrew Loblaw
Sep 8, 2018·International Journal of Radiation Oncology, Biology, Physics·Robert M MeierIrving D Kaplan
Jan 7, 2019·International Journal of Radiation Oncology, Biology, Physics·Michael J ZelefskyBrett W Cox
Jul 6, 2019·International Journal of Radiation Oncology, Biology, Physics·Naomi Y JiangAmar U Kishan

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BETA
biopsy

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NCT10145148

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