Ultrahypofractionated CyberKnifeTM based stereotactic radiotherapy versus conventional radiotherapy in patients with prostate cancer – acute toxicity evaluation in two phase II prospective studies

Abstract

Our purpose was to compare the acute toxicity of ultrahypofractionated CyberKnifeTM based stereotactic radiotherapy (SBRT Arm) and conventional radiotherapy (EBRT Arm) in prostate cancer patients. Two-hundred-sixteen men with prostate cancer were enrolled in our prospective studies. One-hundred and nine were irradiated using CyberKnife to total dose of 36,25 Gy in 5 fractions. One-hundred and seven were irradiated conventionally to total dose of 76 Gy in 38 fractions. Mean age of patients was 69. Acute genitourinary (GU) and gastrointestinal (GI) adverse-events were collected. The maximal acute toxicity EORTC/RTOG score was assumed. A total of 41%, 44%, 12% and 3% of patients presented grade 0, 1, 2 and 3 acute genitourinary toxicity in SBRT arm, respectively. A total of 21%, 33%, 43% and 3% of patients demonstrated acute grade 0, 1, 2 and 3 genitourinary toxicity in EBRT arm. A significant difference between number of patients with grade 2 GU toxicity was observed (p-0.000) and between patients without any toxicity (p-0.0017).A significant difference in frequency of acute GI toxicity between both groups was observed, too. 71% vs. 44% had no toxicity (p-0.0001), and 3% vs. 18% (p-0.0004) presented grade 2 GI toxicity in SBRT and EBRT arms respectively.The acute toxicity rates of fractionated stereotactic radiotherapy is lower compared to conventional irradiation.

Stereotactic Body Radiation Therapy for Localized Prostate Cancer: A Systematic Review and Meta-Analysis of Over 6,000 Patients Treated On Prospective Studies

“…W.C.J and D.E.S independently extracted data from the 38 identified studies. [37][38][39][40][41][42][43][44][45][46][47][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68] Variables extracted included study and patient-level characteristics, such as study type, phase of trial, sample size, dose per fraction, fraction number, duration of follow-up, age, clinical tumor stage, baseline prostate-specific antigen, National Comprehensive Cancer Network (NCCN) 69 risk group of enrolled patients, receipt of androgen-deprivation therapy (ADT), bRFS, physician-reported toxicity, and patientreported QOL, if reported. Individual patient data was not used.…”

Stereotactic Ablative Radiotherapy for Prostate Cancer—The Treatment Results of 500 Patients and Analysis of Failures

“…The low prevalence and low intensity of adverse effects, as well as the more pronounced acute GU reactions compared to GI, are consistent with our previous reports. 12,13,17,18 Even lower toxicity was described by Meier et al 19 (309 patients treated 5 times with 8 Gy, median of FU: 61 months), there were no G3 GI adverse effects compared to 1 incidence of G4 and 3 of G3 (2 acute-0.3% 1 month and 0.2% 4 months after SABR, and 1 late-0.3% in the 20th month of FU). There were no differences in GU-4 patients experienced G3 toxicity, in comparison to 3 G3 acute incidents in our group.…”