Prostate Stereotactic Body Radiotherapy — First UK Experience

Tree, A.; Ostler, P.; Hoskin, Peter; Dankulchai, Pittaya; Nariyangadu, P.; Hughes, Robert J.; Wells, E.; Taylor, H.; Khoo, Vincent; As, Nicholas van

doi:10.1016/j.clon.2014.08.007

Cited by 36 publications

(29 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Stereotactic body radiotherapy (SBRT) is a potentially effective treatment method for clinically localized prostate cancer, radiobiologically well matched to prostate cancer due to its purported high sensitivity to fraction size, with encouraging short to intermediate-term SBRT results reported from a number of authors and institutions (1–7). Due to the still relative newness of the SBRT approach additional confirmatory data are desirable.…”

Section: Introductionmentioning

confidence: 99%

Virtual HDR CyberKnife SBRT for Localized Prostatic Carcinoma: 5-Year Disease-Free Survival and Toxicity Observations

2014

View full text Add to dashboard Cite

Purpose: Prostate stereotactic body radiotherapy (SBRT) may substantially recapitulate the dose distribution of high-dose-rate (HDR) brachytherapy, representing an externally delivered “Virtual HDR” treatment method. Herein, we present 5-year outcomes from a cohort of consecutively treated virtual HDR SBRT prostate cancer patients.Methods: Seventy-nine patients were treated from 2006 to 2009, 40 low-risk, and 39 intermediate-risk, under IRB-approved clinical trial, to 38 Gy in four fractions. The planning target volume (PTV) included prostate plus a 2-mm volume expansion in all directions, with selective use of a 5-mm prostate-to-PTV expansion and proximal seminal vesicle coverage in intermediate-risk patients, to better cover potential extraprostatic disease; rectal PTV margin reduced to zero in all cases. The prescription dose covered >95% of the PTV (V100 ≥95%), with a minimum 150% PTV dose escalation to create “HDR-like” PTV dose distribution.Results: Median pre-SBRT PSA level of 5.6 ng/mL decreased to 0.05 ng/mL 5 years out and 0.02 ng/mL 6 years out. At least one PSA bounce was seen in 55 patients (70%) but only 3 of them subsequently relapsed, biochemical-relapse-free survival was 100 and 92% for low-risk and intermediate-risk patients, respectively, by ASTRO definition (98 and 92% by Phoenix definition). Local relapse did not occur, distant metastasis-free survival was 100 and 95% by risk-group, and disease-specific survival was 100%. Acute and late grade 2 GU toxicity incidence was 10 and 9%, respectively; with 6% late grade 3 GU toxicity. Acute urinary retention did not occur. Acute and late grade 2 GI toxicity was 0 and 1%, respectively, with no grade 3 or higher toxicity. Of patient’s potent pre-SBRT, 65% remained so at 5 years.Conclusion: Virtual HDR prostate SBRT creates a very low PSA nadir, a high rate of 5-year disease-free survival and an acceptable toxicity incidence, with results closely resembling those reported post-HDR brachytherapy.

show abstract

Section: Introductionmentioning

confidence: 99%

Virtual HDR CyberKnife SBRT for Localized Prostatic Carcinoma: 5-Year Disease-Free Survival and Toxicity Observations

2014

View full text Add to dashboard Cite

show abstract

“…The NRIG report supported the use of SBRT for other treatment sites, provided this was in the context of prospective clinical trials aimed at further evaluation of this technology. A multicentre randomised trial of SBRT versus conventional radiotherapy for prostate cancer is underway [38] and randomised trials investigating the role of SBRT in oligometastatic disease will hopefully follow soon.…”

Section: Evaluating Stereotactic Body Radiotherapy Against Fractionatmentioning

confidence: 99%

“…This illustrates that it is possible to recruit large numbers of patients into randomised trials with very different management arms, provided the trial is designed appropriately. In addition to the randomisation between SBRT and conventionally fractionated radiotherapy, the PACE study [38], also contains a randomisation for surgically suitable patients between radical prostatectomy and SBRT. It is hoped that this surgical randomisation will recruit well enough to provide a useful comparison of the two modalities.…”

Section: Evaluating Stereotactic Body Radiotherapy Against Surgerymentioning

confidence: 99%

Evaluating Competing and Emerging Technologies for Stereotactic Body Radiotherapy and Other Advanced Radiotherapy Techniques

et al. 2015

View full text Add to dashboard Cite

“…30 Longer follow-up of existing studies is required and Phase III clinical trials are under way. 31 If radical CaP treatments of five fractions or less are demonstrated to have efficacy equal to or better than conventional radiotherapy, then the use of radiosensitizing nanoparticles, delivered intravenously or intratumorally, becomes feasible with a reduced likelihood of off-target effects from multiple administrations.…”

Section: Current State Of the Art In Prostate Cancer Diagnosis And Trmentioning

confidence: 99%

Prostate cancer radiotherapy: potential applications of metal nanoparticles for imaging and therapy

Coulter

Butterworth

Jain

2015

BJR

View full text Add to dashboard Cite

Prostate cancer (CaP) is the most commonly diagnosed cancer in males. There have been dramatic technical advances in radiotherapy delivery, enabling higher doses of radiotherapy to primary cancer, involved lymph nodes and oligometastases with acceptable normal tissue toxicity. Despite this, many patients relapse following primary radical therapy, and novel treatment approaches are required. Metal nanoparticles are agents that promise to improve diagnostic imaging and image-guided radiotherapy and to selectively enhance radiotherapy effectiveness in CaP. We summarize current radiotherapy treatment approaches for CaP and consider pre-clinical and clinical evidence for metal nanoparticles in this condition.

show abstract

Prostate Stereotactic Body Radiotherapy — First UK Experience

Cited by 36 publications

References 29 publications

Virtual HDR CyberKnife SBRT for Localized Prostatic Carcinoma: 5-Year Disease-Free Survival and Toxicity Observations

Virtual HDR CyberKnife SBRT for Localized Prostatic Carcinoma: 5-Year Disease-Free Survival and Toxicity Observations

Evaluating Competing and Emerging Technologies for Stereotactic Body Radiotherapy and Other Advanced Radiotherapy Techniques

Prostate cancer radiotherapy: potential applications of metal nanoparticles for imaging and therapy

Contact Info

Product

Resources

About