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Erschienen in:
14.05.2016 | Original Research
A phase II experience evaluating quality of life and survival in linac-based SBRT for prostate cancer
Erschienen in: Journal of Radiation Oncology | Ausgabe 4/2016
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Objective
This study aims to evaluate SBRT with volumetric modulated arc therapy (VMAT) and toxicity using five validated quality of life (QOL) instruments.
Methods
An approved prospective NCI-designated phase II study (NCT01581749) was conducted. The inclusion criteria are the following: histologically proven prostate adenocarcinoma, Gleason score 6–7, clinical stage T1b-T2b, PSA ≤20 ng/ml, prostate volume ≤100 cm3, and no prior prostate radiotherapy. SBRT was delivered as 36.25 Gy in five fractions to PTV via VMAT. Patients self-reported on validated QOL measures including the American Urological Association (AUA) Index, Sexual Health Inventory for Men (SHIM), Utilization of Sexual Medications/Devices (USMD), and Expanded Prostate Cancer Index Composite Short Form (EPIC-26). In addition, PSA response and survival were evaluated.
Results
A total of 33 patients were entered into the study. Median time from treatment to last follow up was 30 months. Mean age was 67.5 years. Mean PSA was 6.1 and Gleason scores ranged from 6 to 7. Mean PSA declined by 42 % was observed at 1 month post-treatment and continued to decrease. Three patients (9.7 %) had PSA bounce, with one patient having disease progression (3.0 %). There were no transient side effects or sequelae noted on their QOL questionnaires over the follow-up period of 36 months. Some adverse effects to sexual health were noticed with the majority of these incidences occurring within 1 month after treatment and resolved within 3 months of symptom onset.
Conclusion
SBRT with VMAT for low-intermediate risk prostate cancer is well tolerated. Acute toxicities showed no apparent impact on patient general sense of well-being. No adverse effects were observed over the 36 month period.