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    Korean J Urol. 2009 Nov;50(11):1066-1072. Korean.
    Published online Nov 19, 2009.
    https://doi.org/10.4111/kju.2009.50.11.1066
    Copyright © The Korean Urological Association, 2009
    Original Article

    Early Experience of Prostate Cancer Treated with CyberKnife™ Radiotherapy

    Jae-Ho Hyun, Byoung-Hun Park, Dae-Yong Koo,2 Kang-sup Kim,2 Ki-Hak Song,2 Won-Kyu Jeong,1 Dong-Seok Han, Jin-Bum Kim and Young-Seop Chang
      • Department of Urology, College of Medicine, Konyang University, Daejeon, Korea.
      • 1Department of Radiation Oncology, College of Medicine, Konyang University, Daejeon, Korea.
      • 2Department of Urology, Chungnam University School of Medicine, Daejeon, Korea.
    • Correspondence to: Young-Seop Chang. Department of Urology, College of Medicine, Konyang Universtiy, 685, Gasuwon-dong, Seo-gu, Daejeon 302-718, Korea. TEL: 042-600-9225, FAX: 042-542-3790, Email: ovalboy@hanmail.net
    Received June 02, 2009; Accepted October 09, 2009.

    Abstract

    Purpose

    We investigated the outcome in patients with prostatic cancer treated by means of CyberKnife™ radiotherapy.

    Materials and Methods

    Between July 2007 and April 2009, 16 patients with prostate cancer underwent CyberKnife™ radiotherapy. The histologic diagnosis was established by transrectal ultrasonography-guided biopsy. Radiotherapy was performed for a dose of 34 Gy at 8.5 Gy per day over 4 to 18 days. Nine patients were treated with hormone therapy. After treatment, prostate-specific antigen (PSA) relapse was evaluated with periodic PSA follow-up.

    Results

    The numbers of patients in clinical stages T2 and T3 were 13 and 3, respectively. Two patients had lymph node metastasis with no distant metastasis. The numbers of patients with a Gleason grade of 5, 6, 7, 8, and 9 were 1, 5, 4, 3, and 2, respectively. The mean time to PSA nadir and the mean PSA at nadir were 7 months and 0.43 ng/ml, respectively. To date, there has been no biochemical failure or clinical recurrence. No severe complications were observed in any patients; observed minor complications [n (%)] were perianal pain [2 (12.5%)] and defecation discomfort [2 (12.5%)].

    Conclusions

    Generally good responses were observed in patients treated with CyberKnife™ radiotherapy for prostate cancer. No severe complications were observed. More patients and a longer follow-up are required for further conclusions.

    Keywords
    Prostatic neoplasms; Prostate-specific antigen

    Figures

    Fig. 1
    Post-implant AP pelvis radiograph showing the distribution of the implanted seeds (arrow).

    Fig. 2
    Prostate-specific antigen (PSA) curves of the 16 patients treated with G4 cyberknife radiation. In most patients, the PSA nadir was reached within 7 months after the start of treatment.

    Fig. 3
    Prostate magnetic resonance imaging (MRI) before and after cyberknife radiation showing the markedly improving state of the heterogeneous T2 low SI lesion in the left peripheral zone (arrow).

    Tables

    Table 1
    Clinical characteristics of the 16 patients

    Table 2
    Post-treatment complications

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    MeSH Terms
    Biopsy
    Defecation
    Follow-Up Studies
    Humans
    Lymph Nodes
    Neoplasm Metastasis
    Prostate
    Prostate-Specific Antigen
    Prostatic Neoplasms
    Recurrence
    Metrics
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