Radical Prostatectomy |
- CyberKnife® Radiosurgery Advantage:
- Non-invasive outpatient treatment, with rapid recovery
- There is no hospital admission
- No post-operative recovery
- A patient may rapidly resume normal activity
- Advanced age or coexisting medical conditions that may preclude surgical treatment do not impede the ability to receive CyberKnife® treatment.
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- CyberKnife® Radiosurgery Drawback:
- Radical prostatectomy has a large body of long-term data indicating a high cure rate for localized prostate cancer (1, 2, 3).
- Radical prostatectomy is the only local treatment method proven to increase overall survival in early stage prostate cancer patients (2).
- The long-term curative potential of CyberKnife® radiosurgery remains to be defined.
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External Beam Radiotherapy |
- CyberKnife® Radiosurgery Advantage:
- Compared with external beam radiotherapy, which takes approximately two months to complete, the CyberKnife® approach takes one week to complete.
- The CyberKnife® therapeutic margin is “surgical” compared with any form of external radiotherapy, potentially reducing complications, by reducing the relative radiation dose to bladder and rectum.
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- CyberKnife® Radiosurgery Drawback:
- External beam radiotherapy, particularly dose-escalated approaches such as IMRT or proton beam therapy, have substantial data indicating a high cure rate for localized prostate cancer (10, 11, 12).
- The long-term curative potential of CyberKnife® radiosurgery remains to be defined
- The “surgical” CyberKnife® treatment margin raises the possibility of cancer relapse at the therapeutic margin, such that CyberKnife® monotherapy should be restricted to very early cases, whereas external beam or combined radiotherapeutic approaches may be applied against the full spectrum of disease presentations.
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Permanent Source Prostate Brachytherapy |
- CyberKnife® Radiosurgery Advantage:
- The CyberKnife® approach is a non-invasive treatment
- Leaves no radioactive foreign bodies in the prostate
- The CyberKnife® urologic recovery appears more rapid
- There is less potential for long-term urinary obstruction
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- CyberKnife® Radiosurgery Drawback:
- Permanent source prostate brachytherapy has a large body of long-term data indicating a high cure rate for localized prostate cancer (7, 8).
- The long-term curative potential of CyberKnife® radiosurgery remains to be defined.
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HDR Prostate Brachytherapy |
- CyberKnife® Radiosurgery Advantage:
- The CyberKnife® approach is a non-invasive treatment
- No hospital admission
- No painful plastic tubes protruding from the prostate through the skin
- It appears capable of recapitulating the HDR brachytherapy dose-sculpting feature without the tubes and hospital admission.
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- CyberKnife® Radiosurgery Drawback:
- HDR prostate brachytherapy has a body of intermediate-term data indicating a high cure rate for localized prostate cancer (9).
- The curative potential of CyberKnife® radiosurgery remains to be defined, though its interchangeability of dose sculpting compared with HDR brachytherapy predicts an identical outcome in comparably staged patients.
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