Background: Bony metastases from prostate cancer are often associated with severe pain. Standard palliative radiotherapy does not provide full analgesic effect in most patients. CyberKnife radiosurgery allows for the precise treatment of small lesions, such as prostate cancer metastases, located in bones or near critical organs. object. Pilot study of the effectiveness of CyberKnife radiosurgery in the treatment of patients with bony oligometastases from prostate cancer.
Material And Methods: CyberKnife radiosurgery was used in 48 cases of prostate cancer bone metastases (32 patients). Patients were treated with fraction doses of 6 to 15 Gy, delivered in 1-3 fractions, to a total dose of 6 to 45 Gy. PSA before the treatment varied from 0.01 to 387 ng/ml (mean 28.67; median 3.12). Lesions were located in the spine (31), pelvis (8), ribs (5) and cranium (4). Statistical analysis was performed for 12-months of follow-up using hierarchical linear modeling.
Results: PSA concentration decreased to 0.0-22.4 ng/ml (mean 5.8; median 4.4) during the first month of follow-up. Linear correlations were found between total dose delivered and PSA concentration and pain relief. At the end of the follow-up period, an analgesic effect was observed, with complete pain relief in 28 patients and partial in 16.
Conclusion: CyberKnife radiosurgery may be an effective method for the local treatment of patients with prostate cancer bone oligometastases, leading to a reduction of pain, reduced PSA concentration and a high rate of locoregional control.
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