| 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. |
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. |
| 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. |
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. |
| 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 |
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. |
| 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. |
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. |