Matched Cohort Study of Low-risk Prostate Cancer Treated with Standard External Beam Radiotherapy Versus Stereotactic Body Radiotherapy
CUA Online Library. Sethukavalan P. 06/22/13; 31402; UP-23
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Abstract
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Introduction and Objectives: Radiation therapy is a standard treatment option for patients with prostate cancer. The purpose of this study is to evaluate and compare biochemical control and late toxicities of low-risk prostate cancer patients treated with standard external beam radiotherapy (STND; median 76 Gy in 38 fractions) versus stereotactic body radiotherapy (SBRT: 35 Gy in 5 fractions) at the Odette Cancer Centre.
Methods: A matched cohort study of 165 low-risk prostate cancer patients was conducted. From 2006-2008, 81 patients were treated with STND and medical charts were reviewed retrospectively; during the same period 84 patients were treated with SBRT and followed prospectively. 5 and 1 patients, respectively, were treated with short-term neoadjuvant androgen deprivation therapy and excluded from biochemical analyses.
Results: At baseline, 87% of patients were T1c, 13% T2a; 100% had GS 6; median PSA 6.2 (range 0.5-10) ng/ml. There were more patients in the STND cohort who had T2a disease (21% vs. 6%, p= 0.0055); all other factors were well balanced. The median follow-up for the STND and SBRT cohorts were 62 and 57 months, respectively. Four patients, 2 in each cohort, had biochemical failure. There was no significant difference in biochemical disease-free survival between the two cohorts (96.9% vs 97.4% at 60 months, respectively, p = 0.94). There was also no significant difference in bowel or bladder toxicities experienced by patients in the two treatment groups (Table 1).
Conclusions: SBRT shows equivalent tolerability and effectiveness as STND at our centre. However, SBRT requires fewer patient visits, is more convenient and is less costly to the patient and department than STND. Further prospective studies of SBRT are ongoing.
Methods: A matched cohort study of 165 low-risk prostate cancer patients was conducted. From 2006-2008, 81 patients were treated with STND and medical charts were reviewed retrospectively; during the same period 84 patients were treated with SBRT and followed prospectively. 5 and 1 patients, respectively, were treated with short-term neoadjuvant androgen deprivation therapy and excluded from biochemical analyses.
Results: At baseline, 87% of patients were T1c, 13% T2a; 100% had GS 6; median PSA 6.2 (range 0.5-10) ng/ml. There were more patients in the STND cohort who had T2a disease (21% vs. 6%, p= 0.0055); all other factors were well balanced. The median follow-up for the STND and SBRT cohorts were 62 and 57 months, respectively. Four patients, 2 in each cohort, had biochemical failure. There was no significant difference in biochemical disease-free survival between the two cohorts (96.9% vs 97.4% at 60 months, respectively, p = 0.94). There was also no significant difference in bowel or bladder toxicities experienced by patients in the two treatment groups (Table 1).
Conclusions: SBRT shows equivalent tolerability and effectiveness as STND at our centre. However, SBRT requires fewer patient visits, is more convenient and is less costly to the patient and department than STND. Further prospective studies of SBRT are ongoing.
Introduction and Objectives: Radiation therapy is a standard treatment option for patients with prostate cancer. The purpose of this study is to evaluate and compare biochemical control and late toxicities of low-risk prostate cancer patients treated with standard external beam radiotherapy (STND; median 76 Gy in 38 fractions) versus stereotactic body radiotherapy (SBRT: 35 Gy in 5 fractions) at the Odette Cancer Centre.
Methods: A matched cohort study of 165 low-risk prostate cancer patients was conducted. From 2006-2008, 81 patients were treated with STND and medical charts were reviewed retrospectively; during the same period 84 patients were treated with SBRT and followed prospectively. 5 and 1 patients, respectively, were treated with short-term neoadjuvant androgen deprivation therapy and excluded from biochemical analyses.
Results: At baseline, 87% of patients were T1c, 13% T2a; 100% had GS 6; median PSA 6.2 (range 0.5-10) ng/ml. There were more patients in the STND cohort who had T2a disease (21% vs. 6%, p= 0.0055); all other factors were well balanced. The median follow-up for the STND and SBRT cohorts were 62 and 57 months, respectively. Four patients, 2 in each cohort, had biochemical failure. There was no significant difference in biochemical disease-free survival between the two cohorts (96.9% vs 97.4% at 60 months, respectively, p = 0.94). There was also no significant difference in bowel or bladder toxicities experienced by patients in the two treatment groups (Table 1).
Conclusions: SBRT shows equivalent tolerability and effectiveness as STND at our centre. However, SBRT requires fewer patient visits, is more convenient and is less costly to the patient and department than STND. Further prospective studies of SBRT are ongoing.
Methods: A matched cohort study of 165 low-risk prostate cancer patients was conducted. From 2006-2008, 81 patients were treated with STND and medical charts were reviewed retrospectively; during the same period 84 patients were treated with SBRT and followed prospectively. 5 and 1 patients, respectively, were treated with short-term neoadjuvant androgen deprivation therapy and excluded from biochemical analyses.
Results: At baseline, 87% of patients were T1c, 13% T2a; 100% had GS 6; median PSA 6.2 (range 0.5-10) ng/ml. There were more patients in the STND cohort who had T2a disease (21% vs. 6%, p= 0.0055); all other factors were well balanced. The median follow-up for the STND and SBRT cohorts were 62 and 57 months, respectively. Four patients, 2 in each cohort, had biochemical failure. There was no significant difference in biochemical disease-free survival between the two cohorts (96.9% vs 97.4% at 60 months, respectively, p = 0.94). There was also no significant difference in bowel or bladder toxicities experienced by patients in the two treatment groups (Table 1).
Conclusions: SBRT shows equivalent tolerability and effectiveness as STND at our centre. However, SBRT requires fewer patient visits, is more convenient and is less costly to the patient and department than STND. Further prospective studies of SBRT are ongoing.
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