- 作者：Alexander Muacevic ; M.D.a ; alexander.muacevic@cyber-knife.net ; Markus Kufeld ; M.D.a ; Carsten Rist ; M.D.b ; Berndt Wowra ; M.D.a ; Christian Stief ; M.D.c ; Michael Staehler ; M.D.c
- 关键词：Bone metastases ; Cyberknife ; Prostate cancer ; Radiosurgery ; Stereotactic radiosurgery
- 刊名：Urologic Oncology: Seminars and Original Investigations
- 出版年：2013
- 出版时间：May, 2013
- 年：2013
- 卷：31
- 期：4
- 页码：455-460
- 全文大小：244 K
Objective
To determine the safety and feasibility after image-guided single fraction robotic stereotactic radiosurgery (SRS) in patients with bone metastases of prostate cancer.Materials and methods
Forty patients with 64 bone metastases of prostate cancer were prospectively enrolled in a single center study and underwent 54 consecutive outpatient single session SRS procedures during a 4-year period. F-18 choline PET/CT in addition to standard CT imaging was done prior to SRS in all patients. Nineteen patients were under anti-androgen therapy, 8 patients had undergone chemotherapy before SRS. Overall survival and freedom from local tumor recurrence was analyzed with the Kaplan-Meier method.
Results
Mean follow-up was 14 months (3-48 months). Seventy-five percent of patients had a single bone metastasis. The median tumor volume was 13 cc. The mean prescribed tumor dose was 20.2 Gy (16.5-22 Gy). Eight patients had died at the time point of the data analysis. The actuarial 6-months, 12-months, and 24-months local tumor control rate was 95.5 % (95 % CI: 83.0-98.8) as measured by MRI and PET CT imaging. The median initial PSA before SRS was 5.4 ng/dl (CI: 1.4-8.2) and dropped to 2.7 ng/dl (CI: 0.14-10) after 3 months. One case of progressive neurological deficits was documented.
Conclusions
This first report on single session, image-guided robotic SRS documents a safe, feasible, and patient-friendly treatment option in selected patients with bone metastases of prostate cancer.