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Shaped Beam Radiosurgery pp 287–298Cite as

Prostate SBRT

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Abstract

Prostate cancer (PC) is currently the most common male cancer in most western countries, representing 30% of malignant tumors in men (Jemal et al. 2006). The major prognostic factors in localized prostate cancer are Gleason score, initial prostate-specific antigen (iPSA) and T stage. The terms “organ confined” and “locally advanced” disease refer to T1-T2 and T3-T4 respectively. These three prognostic factors are combined in nomograms that predict the risk of microscopic extracapsular extension, seminal vesicle (SV), and nodal involvement (D’Amico et al. 1999; Partin et al. 1997). They provide a scientific basis for treatment choice (local, locoregional and/or hormonal), allow radiation oncologists to choose the clinical target volume (CTV: prostate  ±  SV  ±  iliac lymph nodes), and ultimately predict patient outcome (Kattan et al. 1998; Kattan et al. 2001; Kattan et al. 2000). Men with indolent tumors and limited life expectancy have least to gain from submitting them to the hazards of curative treatment (Albertsen et al. 2005) and are managed by watchful waiting. “Active surveillance” (AS) refers to the strict follow-up of indolent PC in young men, leaving the possibility of a curative treatment in case of evolution to an aggressive cancer. The only active treatment that has been compared to watchful waiting in a contemporary randomized trial is radical prostatectomy (RP). RP showed a significant survival benefit and is therefore considered the gold standard for the treatment of young men with organ confined PC (Bill-Axelson et al. 2005). Whether this holds true with current high dose - high precision radiotherapy (RT) techniques remains controversial. Freedom from biochemical failure (FFBF) after RP, brachytherapy (BT) and high-dose contemporary RT are comparable (Kupelian et al. 2004).

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Authors and Affiliations

  1. UZ Brussels, Laarbeeklaan 101, B-1090, Jette, Belgium

    Guy Soete

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  1. David Geffen School of Medicine at UCLA, Department of Neurosurgery and Radiation, University of California, Le Conte Ave. 10495, Los Angeles, 90095, California, USA

    Antonio A. F. De Salles

  2. UCLA Medical Center, Department of Neurosurgery, University of California, Le Conte Ave 10945, Los Angeles, 90095, California, USA

    Alessandra Gorgulho

  3. David Geffen School of Medicine, Dept. Radiation Oncology, University of California, Los Angeles, UCLA Medical Plaza 200, Los Angeles, 90095, California, USA

    Nzhde Agazaryan

  4. , Department of Radiation Oncology, VU University Medical Center, De Boelelaan 1117, Amsterdam, 1081 HV, Netherlands

    Ben Slotman

  5. David Geffen School of Medicine at UCLA, Department of Radiation Oncology, University of California, UCLA Medical Plaza 200, Los Angeles, 90095, California, USA

    Michael Selch

  6. BrainLAB, Inc., Westbrook Corporate Center 3, Westchester, 60154, Illinois, USA

    Aaaron J. Burwick

  7. Shaped-Beam Radiosurgery, Varian Medical Systems, Inc., Hansen Way 3100, Palo Alto, 94304, California, USA

    Raymond Schulz

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Soete, G. (2011). Prostate SBRT. In: De Salles, A., et al. Shaped Beam Radiosurgery. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-11151-8_26

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