NDLI: Stereotactic body radiation therapy (SBRT) for prostate cancer in men with large prostates (≥50 cm3)

Content Provider	Springer Nature : BioMed Central
Author	Janowski, Einsley Chen, Leonard N Kim, Joy S Lei, Siyuan Suy, Simeng Collins, Brian Lynch, John Dritschilo, Anatoly Collins, Sean
Abstract	Background Patients with large prostate volumes have been shown to have higher rates of genitourinary and gastrointestinal toxicities after conventional radiation therapy for prostate cancer. The efficacy and toxicity of stereotactic body radiation therapy (SBRT), which delivers fewer high-dose fractions of radiation treatment, is unknown for large prostate volume prostate cancer patients. We report our early experience using SBRT for localized prostate cancer in patients with large prostate volumes. Methods 57 patients with prostate volumes ≥50 cm3 prior to treatment with SBRT for localized prostate carcinoma and with a minimum follow up of two years were included in this retrospective review of prospectively collected data. Treatment was delivered using Cyberknife (Accuray) with doses of 35-36.25 Gy in 5 fractions. Biochemical control was assessed using the Phoenix definition. Toxicities were scored using the CTCAE v.4. Quality of life was assessed using the American Urological Association (AUA) Symptom Score and the Expanded Prostate Cancer Index Composite (EPIC)-26. Results 57 patients (23 low-, 25 intermediate- and 9 high-risk according to the D’Amico classification) at a median age of 69 years (range, 54-83 years) received SBRT with a median follow-up of 2.9 years. The median prostate size was 62.9 cm3 (range 50-138.7 cm3). 33.3% of patients received ADT. The median pre-treatment prostate-specific antigen (PSA) was 6.5 ng/ml and decreased to a median PSA of 0.4 ng/ml by 2 years (p <0.0001). A mean baseline AUA symptom score of 7.5 significantly increased to 13 at 1 month (p = 0.001) and returned to baseline by 3 months (p = 0.21). 23% of patients experienced a late transient urinary symptom flare in the first two years following treatment. Mean baseline EPIC bowel scores of 95.8 decreased to 78.1 at 1 month (p <0.0001), but subsequently improved to 93.5 three months (p = 0.08). The 2-year actuarial incidence rates of GU and GI toxicity ≥ grade 2 were 49.1% and 1.8%, respectively. Two patients (3.5%) experienced grade 3 urinary toxicity, and no patient experienced grade 3 gastrointestinal toxicity. Conclusions SBRT for clinically localized prostate cancer was well tolerated in men with large prostate volumes.
Related Links	https://ro-journal.biomedcentral.com/counter/pdf/10.1186/s13014-014-0241-3.pdf
Ending Page	10
Page Count	10
Starting Page	1
File Format	HTM / HTML
DOI	10.1186/s13014-014-0241-3
Journal	Radiation Oncology
Issue Number	1
Volume Number	9
Language	English
Publisher	BioMed Central
Publisher Date	2014-11-15
Access Restriction	Open
Subject Keyword	Cancer Research Oncology Radiotherapy Imaging Radiology Prostate cancer Large prostate SBRT CyberKnife Common toxicity criteria (CTC) Quality of life EPIC AUA SF-12 Urinary symptom flare
Content Type	Text
Resource Type	Article
Subject	Radiology, Nuclear Medicine and Imaging Oncology
Journal Impact Factor	3.3/2023
5-Year Journal Impact Factor	3.6/2023

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