Carcinoma PROSTATE
• CyberKnife robotic surgery – non invasive, precise, short treatment time, automatically tracks
prostate, quick recovery, minimum possible side effects
• No age limitation
• No limitation due to other co‐existing diseases
• No prostate size limitation
• Possible even with prior TURP
CyberKnife alone (CK monotherapy)*
• Low Gleason ‐ 7 or less
• PSA <20
• Lower volume
Artiste IGRT (23 ‐ 25 sittings) with CyberKnife (2 ‐3 sittings)
add on
(Artiste to treat prostate and invisible lymphnodal disease
initially & CyberKnife to focus only on prostate)
• Higher Gleason Score ‐ 8 and greater
• PSA >20
CyberKnife for Quality of Life
• Local disease control
• Recurrence after surgery or radiotherapy
• Symptomatic sites anywhere in the body
Requirement: Gold markers inserted under ultrasound guidance into the prostate (a
procedure similar to doing biopsy of prostate) to track the tumour during CyberKnife
treatment
Facts:
• There is solid biologic rationale for treating prostate cancer patients in 5 fractions
• Various studies demonstrate a consistent, significant early PSA response with a median 18‐
month PSA result of 0.22 ng/ml.
• Treatment related toxicity to date has included grade I ‐ II urinary symptoms that normally
resolve in 4 – 6 weeks, and grade 0 ‐ I rectal symptoms that normally resolve in 2 – 3 weeks.
• Results of a 3 year study in 41 patients undergoing CyberKnife therapy alone by King CR et al,
from Stanford University (March 2009):
o There were minimal bladder and rectal side effects responding over a period of time.
o A benign PSA bounce (median, 0.4 ng/mL) was observed in 12 patients (29%) occurring
at 18 months (median) after treatment.
o Of 32 patients with 12 months minimum follow‐up, 25 patients (78%) achieved a PSA
nadir </=0.4 ng/mL. A PSA decline to progressively lower nadirs up to 3 years after
treatment was observed.
* The very long‐term curative potential of CyberKnife monotherapy radiosurgery remains to be defined.
HCG CyberKnife Center, HCG Tower, #8 P Kalingarao Road, Sampangiram Nagar, Bangalore 560 027
www.cyberknifeindia.com
Call +91.80.4020.6000 or toll free 1800 102 6626