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2025 ; 20
(1
): 157
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Correlations of biochemical and clinical outcomes with 10-year results after
robotic stereotactic body radiotherapy for localized prostate cancer
#MMPMID41131547
Kim JS
; Park Y
; Park HJ
; Jang WI
; Jeong BK
; Kim HJ
; Chang AR
Radiat Oncol
2025[Oct]; 20
(1
): 157
PMID41131547
show ga
BACKGROUND: Long-term data on the efficacy of robotic stereotactic body
radiotherapy (SBRT) for localized prostate cancer (LPC) remain limited. This
study aimed to evaluate the 10-year treatment outcomes of SBRT in LPC patients
and identify key prognostic factors. METHODS: A total of 82 patients with LPC who
underwent five-fraction SBRT (doses of 35-37.5 Gy) were included. The median
follow-up duration was 11.0 years (range, 3.3-15.9 years). Clinical outcomes,
including the biochemical failure-free survival (BCFFS), clinical failure-free
survival (CFFS), and prostate-specific antigen (PSA) kinetics, were analyzed to
evaluate the impact of various clinical and treatment factors on prognosis.
RESULTS: The 10-year BCFFS and CFFS rates were 86.3% (95% confidence interval
[CI], 78.6-94.8) and 86.7% (95% CI, 78.8-95.4), respectively. Nine cases of
biochemical failure were observed, alongside local (n?=?1), regional (n?=?2), and
distant (n?=?5) metastases. The cancer-specific survival rate was 100%. The
median PSA nadir was 0.09 ng/ml (range, 0.0-3.12 ng/ml) and the median interval
to PSA nadir was 52.8 months (range, 0.4-170.2 months). There was a negative
correlation between the time to the PSA nadir and the PSA nadir value
(r?=?-0.233, p?=?0.035). Daily SBRT was associated with improved BCFFS compared
to every-other-day treatment (hazard ratio [HR], 0.220; 95% CI, 0.067-0.720;
p?=?0.012), while a longer interval to PSA nadir (??5 years) was associated with
better CFFS (HR, 0.120; 95% CI, 0.015-0.944; p?=?0.044). CONCLUSIONS: Robotic
SBRT for LPC demonstrates durable long-term efficacy. Daily treatment schedules
and interval to PSA nadir were identified as crucial prognostic indicators. These
findings highlight the importance of PSA kinetics in predicting treatment success
following robotic SBRT.