Journal List > Korean J Urol > v.47(11) > 1069784

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Kim, Park, Jo, Lee, Yang, and Cho: CyberKnife for the Treatment of Nonmetastatic Prostate Cancer: Preliminary Results
Original Article
Korean Journal of Urology

Korean Journal of Urology 2006; 47(11): 1172-1177.

Published online: 30 November 2006

DOI: https://doi.org/10.4111/kju.2006.47.11.1172

CyberKnife for the Treatment of Nonmetastatic Prostate Cancer: Preliminary Results

Geon Hun Kim, Kwanjin Park, Moon Ki Jo, Chong Wook Lee, Kwang Mo Yang1, Chul Gu Cho1

Department of Urology, Korea Cancer Center Hospital, Seoul, Korea.

1Department of Radiation Oncology, Korea Cancer Center Hospital, Seoul, Korea.

Corresponding author (urodori@yahoo.co.kr)

Received 5 June 2006       Accepted 1 September 2006

Copyright © 2006 The Korean Urological Association

Abstract

Purpose

Herein is reported our initial experience of the CyberKnife to show its safety and feasibility as a treatment modality for non-metastatic prostate cancer.

Materials and Methods

Twenty patients, with biopsy-proven prostate cancers, were recruited into a phase I clinical trial using the CyberKnife. The distribution of clinical risks, as assessed using the ASTRO criteria, was as follows: low (4), intermediate (5) and high (11). The mean age and follow up of the patients were 71.4 years and 15 months, respectively. The patients received 7.5-9Gy of radiation in a single fraction for 4-5 days. The total radiation dose to the prostate was 34-37.5Gy, which approximates to 86.4Gy in 2Gy fractions. The rectal and bladder acute toxicities were graded using the criteria of the Radiation Therapy Oncology Group (RTOG). The results of acute toxicities were compared to those of the historical control, which had been treated with conventional four field box techniques (received median dose 70.2Gy). The prostate-specific antigen (PSA)-based short-term efficacy was described.

Results

The acute rectal toxicity scores were 0, 1 and 2 in 13, 5, and 2 patients, respectively. The acute bladder toxicity scores were 0, 1 and 2 in 16, 3 and 1 patient, respectively. No grade 3 or 4 acute toxicity was noted. These figures contrast sharply with those found for the historical control. All toxicities spontaneously subsided within 3 months after treatment. Continuous PSA reduction was noted in all patients, and no PSA failure was noted during the follow up period.

Conclusions

Our data show the feasibility of the CyberKnife in terms of its efficacy and acute toxicity. Moreover, the capability of using a hypo-fractionation schedule lead to marked improvement in patient convenience, with substantial resource savings.

Keywords: CyberKnife, Prostate cancer, Radiation

Figures and Tables

Fig. 1
CyberKnife component orientation.
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Table 1
Clinical characteristics of the 20 consecutive prostate cancer patients treated with the CyberKnife™
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*low-risk: stage T1c, T2a and PSA level ≤10ng/ml and Gleason score ≤6, intermediate-risk: stage T2b or Gleason score of 7 or PSA level >10 and ≤20ng/ml, high-risk: stage T2c or PSA level >20ng/ml or Gleason score ≥8. PSA: prostate-specific antigen

Table 2
Comparison of the acute toxicity with that of the historical control
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