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Clinical outcomes of whole pelvis radiotherapy and stereotactic body radiotherapy boost for intermediate‐ and high‐risk prostate cancer
Author(s) -
Kim Hun Jung,
Phak Jeong Hoon,
Kim Woo Chul
Publication year - 2017
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/ajco.12455
Subject(s) - cyberknife , medicine , prostate cancer , genitourinary system , radiation therapy , urology , prostate specific antigen , prostate , androgen deprivation therapy , acute toxicity , pelvis , oncology , cancer , toxicity , radiology , radiosurgery
Aim We report our experience with Cyberknife to deliver hypofractionated stereotactic body radiotherapy (SBRT) boost combined with whole pelvis radiotherapy (WPRT) to patients with intermediate‐ to high‐risk prostate cancer. Methods From March 2008 to July 2014, 39 patients with newly diagnosed, intermediate‐ and high‐risk (National Comprehensive Cancer Network definition) localized prostate cancer were treated with WPRT and SBRT boost. The whole pelvis dose was 45 Gy (25 fractions of 1.8 Gy) and the SBRT boost dose was 21 Gy (3 fractions of 7 Gy). No one received androgen deprivation therapy before biochemical relapse. The acute and late toxicities were recorded using the Radiation Therapy Oncology Group scale. Prostate‐specific antigen (PSA) response was monitored. Results Thirty‐nine patients with a median 53.6 months (range 14–74 months) follow‐up were analyzed. The median pretreatment PSA was 15.97 ng/mL. The estimated 5‐year biochemical failure (BCF)‐free survival was 94.7%. Two BCFs were observed in only high‐risk group. The median PSA nadir was 0.30 ng/mL at median 36 months and PSA bounce occurred in 15.4% ( n = 6) of patients at median 12 months. No grade 3 acute toxicity was noted. A total of 23% of the patients had grade 2 acute genitourinary (GU) toxicities and 21% had grade 2 acute gastrointestinal (GI) toxicities. At 2 months, most complications had returned to baseline. GU and GI toxicities were observed. Conclusions WPRT followed by SBRT boost using Cyberknife in intermediate‐ and high‐risk prostate cancer is feasible with minimal toxicity and encouraging BCF‐free survival.