Outcomes of hypofractionated stereotactic body radiotherapy boost for intermediate and high-risk prostate cancer
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...
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| Veröffentlicht in: | Radiation oncology (London, England) England), 2016-01, Vol.11 (8), p.8, Article 8 |
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| creator | Anwar, Mekhail Weinberg, Vivian Seymour, Zachary Hsu, I Joe Roach, 3rd, Mack Gottschalk, Alex R |
| description | 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.
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.
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 |
| doi_str_mv | 10.1186/s13014-016-0585-y |
| format | Article |
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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.
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.
SBRT boost is well-tolerated for intermediate and high-risk prostate cancer patients with good biochemical outcomes and low toxicity.</description><identifier>ISSN: 1748-717X</identifier><identifier>EISSN: 1748-717X</identifier><identifier>DOI: 10.1186/s13014-016-0585-y</identifier><identifier>PMID: 26792201</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Adenocarcinoma - radiotherapy ; Aged ; Aged, 80 and over ; Biopsy ; Brachytherapy - methods ; Care and treatment ; Complications and side effects ; Development and progression ; Diagnosis ; Disease-Free Survival ; Dose Fractionation ; Follow-Up Studies ; Health aspects ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Prospective Studies ; Prostate cancer ; Prostate-Specific Antigen - blood ; Prostatic Neoplasms - radiotherapy ; Radioisotope brachytherapy ; Radiometry - methods ; Radiosurgery - methods ; Risk ; Treatment Outcome</subject><ispartof>Radiation oncology (London, England), 2016-01, Vol.11 (8), p.8, Article 8</ispartof><rights>COPYRIGHT 2016 BioMed Central Ltd.</rights><rights>Copyright BioMed Central 2016</rights><rights>Anwar et al. 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c564t-18d11600e1795a855aadd52970c58083963c5e560d7587ab617fa58a45bf019c3</citedby><cites>FETCH-LOGICAL-c564t-18d11600e1795a855aadd52970c58083963c5e560d7587ab617fa58a45bf019c3</cites><orcidid>0000-0002-6650-2594</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4721063/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4721063/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26792201$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Anwar, Mekhail</creatorcontrib><creatorcontrib>Weinberg, Vivian</creatorcontrib><creatorcontrib>Seymour, Zachary</creatorcontrib><creatorcontrib>Hsu, I Joe</creatorcontrib><creatorcontrib>Roach, 3rd, Mack</creatorcontrib><creatorcontrib>Gottschalk, Alex R</creatorcontrib><title>Outcomes of hypofractionated stereotactic body radiotherapy boost for intermediate and high-risk prostate cancer</title><title>Radiation oncology (London, England)</title><addtitle>Radiat Oncol</addtitle><description>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.
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.
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.
SBRT boost is well-tolerated for intermediate and high-risk prostate cancer patients with good biochemical outcomes and low toxicity.</description><subject>Adenocarcinoma - radiotherapy</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biopsy</subject><subject>Brachytherapy - methods</subject><subject>Care and treatment</subject><subject>Complications and side effects</subject><subject>Development and progression</subject><subject>Diagnosis</subject><subject>Disease-Free Survival</subject><subject>Dose Fractionation</subject><subject>Follow-Up Studies</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local</subject><subject>Prospective Studies</subject><subject>Prostate cancer</subject><subject>Prostate-Specific Antigen - blood</subject><subject>Prostatic Neoplasms - radiotherapy</subject><subject>Radioisotope brachytherapy</subject><subject>Radiometry - methods</subject><subject>Radiosurgery - methods</subject><subject>Risk</subject><subject>Treatment Outcome</subject><issn>1748-717X</issn><issn>1748-717X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNptUV1rFTEUDKLYWv0BvkjA563n7OZj90UoRa1Q6IuCbyE3yd5NvZusSW5h_7253La2IHk4Yc7MMMkQ8h7hHLEXnzJ2gKwBFA3wnjfrC3KKkvWNRPnr5ZP7CXmT8y0A4x0Mr8lJK-TQtoCnZLnZFxNnl2kc6bQucUzaFB-DLs7SXFxysRwQQzfRrjRp62OZXNLLWpGYCx1joj5U5uysrzKqg6WT305N8vk3XVIlHWCjg3HpLXk16l127-7nGfn59cuPy6vm-ubb98uL68ZwwUqDvUUUAA7lwHXPudbW8naQYHgPfTeIznDHBVjJe6k3AuWoea8Z34yAg-nOyOej77Lf1GDGhZL0Ti3JzzqtKmqvnm-Cn9Q23ikmWwTRVYOP9wYp_tm7XNRt3KdQMyuUkgEIBPzH2uqdUz6MsZqZ2WejLhgDKTiDobLO_8Oqx7rZmxjc6Cv-TIBHgam_l5MbH4MjqEP36ti9qt2rQ_dqrZoPT1_8qHgou_sLUkKr0w</recordid><startdate>20160121</startdate><enddate>20160121</enddate><creator>Anwar, Mekhail</creator><creator>Weinberg, Vivian</creator><creator>Seymour, Zachary</creator><creator>Hsu, I Joe</creator><creator>Roach, 3rd, Mack</creator><creator>Gottschalk, Alex R</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-6650-2594</orcidid></search><sort><creationdate>20160121</creationdate><title>Outcomes of hypofractionated stereotactic body radiotherapy boost for intermediate and high-risk prostate cancer</title><author>Anwar, Mekhail ; Weinberg, Vivian ; Seymour, Zachary ; Hsu, I Joe ; Roach, 3rd, Mack ; Gottschalk, Alex R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c564t-18d11600e1795a855aadd52970c58083963c5e560d7587ab617fa58a45bf019c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adenocarcinoma - radiotherapy</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biopsy</topic><topic>Brachytherapy - methods</topic><topic>Care and treatment</topic><topic>Complications and side effects</topic><topic>Development and progression</topic><topic>Diagnosis</topic><topic>Disease-Free Survival</topic><topic>Dose Fractionation</topic><topic>Follow-Up Studies</topic><topic>Health aspects</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local</topic><topic>Prospective Studies</topic><topic>Prostate cancer</topic><topic>Prostate-Specific Antigen - blood</topic><topic>Prostatic Neoplasms - radiotherapy</topic><topic>Radioisotope brachytherapy</topic><topic>Radiometry - methods</topic><topic>Radiosurgery - methods</topic><topic>Risk</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Anwar, Mekhail</creatorcontrib><creatorcontrib>Weinberg, Vivian</creatorcontrib><creatorcontrib>Seymour, Zachary</creatorcontrib><creatorcontrib>Hsu, I Joe</creatorcontrib><creatorcontrib>Roach, 3rd, Mack</creatorcontrib><creatorcontrib>Gottschalk, Alex R</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Radiation oncology (London, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Anwar, Mekhail</au><au>Weinberg, Vivian</au><au>Seymour, Zachary</au><au>Hsu, I Joe</au><au>Roach, 3rd, Mack</au><au>Gottschalk, Alex R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcomes of hypofractionated stereotactic body radiotherapy boost for intermediate and high-risk prostate cancer</atitle><jtitle>Radiation oncology (London, England)</jtitle><addtitle>Radiat Oncol</addtitle><date>2016-01-21</date><risdate>2016</risdate><volume>11</volume><issue>8</issue><spage>8</spage><pages>8-</pages><artnum>8</artnum><issn>1748-717X</issn><eissn>1748-717X</eissn><abstract>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.
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.
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.
SBRT boost is well-tolerated for intermediate and high-risk prostate cancer patients with good biochemical outcomes and low toxicity.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>26792201</pmid><doi>10.1186/s13014-016-0585-y</doi><orcidid>https://orcid.org/0000-0002-6650-2594</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adenocarcinoma - radiotherapy Aged Aged, 80 and over Biopsy Brachytherapy - methods Care and treatment Complications and side effects Development and progression Diagnosis Disease-Free Survival Dose Fractionation Follow-Up Studies Health aspects Humans Kaplan-Meier Estimate Male Middle Aged Neoplasm Recurrence, Local Prospective Studies Prostate cancer Prostate-Specific Antigen - blood Prostatic Neoplasms - radiotherapy Radioisotope brachytherapy Radiometry - methods Radiosurgery - methods Risk Treatment Outcome |
| title | Outcomes of hypofractionated stereotactic body radiotherapy boost for intermediate and high-risk prostate cancer |
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