title: CyberKnife stereotactic radiotherapy for isolated recurrence in the prostatic bed.
abstract: OBJECTIVE
  To report a clinical experience of stereotactic body radiation therapy (SBRT) for isolated recurrence in the prostatic bed from prostate cancer.
  
  
  METHODS
  Between November 2011 and November 2013, 16 patients were treated with SBRT for a macroscopic isolated recurrence of prostate cancer in the prostatic bed. All patients were initially treated with radical prostatectomy, and half of them also received radiotherapy. Two schedules of SBRT were used: 30 Gy in 5 fractions in previously irradiated patients, 35 Gy in five fractions in radiotherapy-naïve patients.
  
  
  RESULTS
  At a median follow-up of 10 months (range 2-21 months), a significant biochemical response was found in all but one patient. At imaging evaluation, no local progression was noted: 10 patients showed partial response while four stable disease. At the moment of analysis, all 16 patients were alive. Seven of them experienced distant relapse, while nine maintained biochemical control, with no further therapy. Median time to relapse was 9.3 months (range 3-15.2 months). The treatment was well tolerated: One patient experienced G2 acute genitourinary and gastrointestinal toxicity.
  
  
  CONCLUSIONS
  Our experience shows that SBRT with CyberKnife for isolated nodal relapse is a safe and well-tolerated treatment.
authors.affiliation: Radiotherapy Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Largo G.A. Brambilla 3, Florence, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Detti
authors.affiliation: Radiotherapy Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Largo G.A. Brambilla 3, Florence, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Bonomo
authors.affiliation: CyberKnife Center- I.F.C.A (Istituto Fiorentino di Cura ed Assistenza), University of Florence, Florence, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Masi
authors.affiliation: CyberKnife Center- I.F.C.A (Istituto Fiorentino di Cura ed Assistenza), University of Florence, Florence, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Doro
authors.affiliation: CyberKnife Center- I.F.C.A (Istituto Fiorentino di Cura ed Assistenza), University of Florence, Florence, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Cipressi
authors.affiliation: CyberKnife Center- I.F.C.A (Istituto Fiorentino di Cura ed Assistenza), University of Florence, Florence, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Iermano
authors.affiliation: CyberKnife Center- I.F.C.A (Istituto Fiorentino di Cura ed Assistenza), University of Florence, Florence, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Bonucci
authors.affiliation: Radiotherapy Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Largo G.A. Brambilla 3, Florence, Italy. davide.franceschini@unifi.it.
authors.forename: D
authors.initials: D
authors.lastname: Franceschini
authors.affiliation: Radiotherapy Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Largo G.A. Brambilla 3, Florence, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Di Brina
authors.affiliation: Radiotherapy Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Largo G.A. Brambilla 3, Florence, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Baki
authors.affiliation: Radiotherapy Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Largo G.A. Brambilla 3, Florence, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Simontacchi
authors.affiliation: Radiotherapy Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Largo G.A. Brambilla 3, Florence, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Meattini
authors.affiliation: Urology Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Carini
authors.affiliation: Urology Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Serni
authors.affiliation: Urology Unit, Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Nicita
authors.affiliation: Radiotherapy Unit, Azienda Ospedaliera Universitaria Careggi, University of Florence, Largo G.A. Brambilla 3, Florence, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Livi
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000532:radiotherapy; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011467:Prostate / Q000000981:diagnostic imaging* / Q000528:radiation effects; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis / Q000532:radiotherapy*; D016634:Radiosurgery / Q000379:methods*; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen
keywords: CyberKnife; Local control; Prostate cancer; Relapse; Stereotactic radiotherapy