Stereotactic Body Radiotherapy of Prostate Cancer – Effectiveness and Toxicity
Authors:
E. Skácelíková 1; D. Feltl 1; J. Cvek 1; T. Jelenová 2; L. Knybel 1; H. Tomášková 3
Authors‘ workplace:
Onkologická klinika LF OU a FN Ostrava
1; Úsek hygienika, Ústav epidemiologie a ochrany veřejného zdraví, LF OU a FN Ostrava
2; Zdravotní ústav se sídlem v Ostravě, Ústav epidemiologie a ochrany veřejného zdraví, LF OU v Ostravě
3
Published in:
Klin Onkol 2017; 30(2): 121-127
Category:
Original Articles
doi:
https://doi.org/10.14735/amko2017121
Overview
Background:
Prostate cancer is the most prevalent cancer in males and its incidence is steadily increasing. Most cases of prostate cancer are diagnosed during the early asymptomatic period, in which case the prognosis is very good. Therapies differ widely in their efficacies and toxicities, and this is an important consideration when it comes to deciding which treatment is optimal for a particular patient. One treatment method for early stage prostate cancer is stereotactic body radiotherapy (SBRT). We present the first results obtained using this modality at our institution.
Patients and Methods:
A total of 261 patients with low or intermediate risk prostate cancer were treated with SBRT between August 2010 and July 2012. Patients received a total dose of 36.25 Gy in five fractions of 7.25 Gy every other day. The toxicity of the treatment was evaluated according to RTOG criteria. For assessment of quality of life, patients filled out a modified EPIC questionnaire (Expanded Prostate Composite index).
Results:
Overall survival (OS) in this study was 93.1%. Biochemical relapse free survival (bRFS) was 97.7%. As expected, OS and bRFS were worse in the group of patients with an intermediate risk of recurrence. Acute and chronic urinary and gastrointestinal RTOG toxicity was very low. Quality of life after treatment, as determined using the EPIC questionnaire, was slightly reduced immediately after treatment but returned to baseline or even improved during long term follow-up.
Conclusion:
SBRT is an effective therapeutic modality for early prostate cancer and has acceptable rates of acute and low late toxicity.
Key words:
prostate cancer – stereotactic body radiotherapy – quality of life
The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.
The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.
Submitted:
5. 1. 2017
Accepted:
1. 2. 2017
Sources
1. Dušek L, Mužík J, Kubásek M et al. Epidemiologie zhoubných nádorů v České republice [online]. Masarykova univerzita, c2005, [citováno 8. prosince 2016]. Dostupný z: http: //www.svod.cz.
2. Úzis.cz [online]. Zdravotnictví ČR: Nová data Národního onkologického registru ČR/NOR) za rok 2014, NZIS report č. R/1 (09/2016), 2015, [citováno 16. prosince 2016]. Dostupný z: http: //www.uzis.cz.
3. Novotný J, Vítek P et al. Onkologie v klinické praxi. Standardní přístupy v diagnostice a léčbě vybraných zhoubných nádorů. 1. vyd. Praha: Mladá fronta 2012.
4. Nccn.org [online]. Prostate cancer. version 3.2016, 05/26/16, [cited 2016 Dec 10]. Available from: http: //www.nccn.org.
5. Grepl M. Radikální prostatektomie. Onkologie 2010; 4 (2): 72–74.
6. Soumarová R, Homola L. Nové indikace a techniky brachyterapie. Postgrad Med 2009; 11 (3): 288–294.
7. Soumarová R, Homola L, Perková H et al. Místo permanentní brachyterapie v léčbě lokalizovaného karcinomu prostaty. Klin Onkol 2010; 23 (3): 141–145.
8. Hamdy FC, Donovan JL, Lane JA et al. 10-year outcomes after monitoring, surgery, or radiotherapy for localized prostate cancer. N Engl J Med 2016; 375 (15): 1415–1424.
9. Brenner DJ, Hall EJ. Fractionation and protraction for radiotherapy of prostate carcinoma. Int J Radiat Oncol Biol Phys 1999; 43 (5): 1095–1101.
10. Fowler J, Chapell R, Ritter M. Is alpha/beta for prostate tumors really low? Int J Radiat Oncol Biol Phys 2001; 50 (4): 1021–1031.
11. Zaorsky N, Palmer J, Hurwitz M et al. What is the ideal radiotherapy dose to treat prostate cancer? A meta-analysis of biologically equivalent dose escalation. Radiother Oncol 2015; 115 (3): 295–300. doi: 10.1016/j.radonc.2015.05.011.
12. Katz A, Santoro M, Diblasio F et al. Stereotactic body radiotherapy for localized prostate cancer: disease control and quality of life at 6 years. Radiat Oncol 2013; 8: 118. doi: 10.1186/1748-717X-8-118.
13. King C, Freeman D, Kaplan I et al. Stereotactic body radiotherapy for localized prostate cancer: pooled analysis from a multi-institutional consortium of prospective phase II trials. Radiother Oncol 2013; 109 (2): 217–221. doi: 10.1016/j.radonc.2013.08.030.
14. Tan TJ, Siva S, Foroudi F et al. Stereotactic body radiotherapy for primary prostate cancer: a systematic review. Med Imaging Radiat Oncol 2014; 58 (5): 601–611. doi: 10.1111/1754-9485.12213.
15. Sonn GA, Sadetsky N, Presti JC et al. Differing perceptions of quality of life in patients with prostate cancer and their doctors. J Urol 2013; 189 (Suppl 1): S59–S65. doi: 10.1016/j.juro.2012.11.032.
16. Litwin MS, Havs RD, Fink A et al. The UCLA Prostate Cancer Index: development, reliability, and validity of a health-related quality of life measure. Med Care 1998; 36 (7): 1002–1012.
17. Szymanski KM, Wei JT, Dunn RL et al. Development and validation of an abbreviated version of the expanded prostate cancer index composite instrument for measuring health-related quality of life among prostate cancer survivors Urology 2010; 76 (5): 1245–1250. doi: 10.1016/j.urology.2010.01.027.
18. EPIC Expanded Prostate Cancer Index Composite. Medicine Umich [online]. Michigan: Urology, University od Michigan Health System. Available from: https: //medicine.umich.edu/dept/urology/research/ epic.
19. Roach M, Hanks G, Thames H Jr et al. Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer: recommendations of the RTOG-ASTRO Phoenix Consensus Conference. Int J Radiat Oncol Biol Phys 2006; 65 (4): 965–974.
20. King C, Collins S, Fuller D et al. Health-related quality of life after stereotactic body radiation therapy for localized prostate cancer: results from a multi-institutional consortium of prospective trials. Int J Radiat Oncol Biol Phys 2013; 87 (5): 939–945. doi: 10.1016/j.ijrobp.2013.08. 019.
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