CyberKnife radiosurgery for prostate cancer shows 100% PSA response

6 April 2009

Accuray Incorporated (NASDAQ:ARAY) has announced publication of the results from a prospective clinical study on CyberKnife radiosurgery for prostate cancer, which was published in the March 15, 2009 issue of the International Journal of Radiation Oncology*Biology*Physics.

The study, led by Christopher King, MD at the Stanford University School of Medicine, treated 41 low-risk prostate cancer patients using CyberKnife radiosurgery. Continual image guidance was used to verify target position throughout the procedure allowing the team to precisely deliver very high doses of radiation in five short treatments.

At a median follow-up of 33 months, no patient experienced a PSA recurrence and early side effects were no worse than other prostate cancer therapies.

The authors refer to the findings as "highly encouraging," but remind readers that longer follow-up is required "to confirm durable biochemical control rates and low late toxicity profiles."

"The evidence in Dr King's study shows a lot of promise for prostate cancer patients around the world who are looking for a shorter, less invasive and more convenient course of treatment," said Eric P Lindquist, senior vice president and chief marketing officer at Accuray. "We look forward to seeing longer term results and study outcomes examining the side effect profile of CyberKnife radiosurgery. Doctor and patient experience thus far has been very positive."

Because the prostate can move unpredictably due to bowel gas or filling of the bladder, it is important that prostate motion is assessed and corrected for throughout treatment to allow for accurate radiosurgery treatment.

Recent studies have confirmed that the prostate experiences rapid and unpredictable motion of as much as five millimeters in as few as 30 seconds, meaning that radiosurgery delivery must recognize and correct for even the slightest motion to ensure the target receives adequate dose and the surrounding sensitive structures, such as the rectum, bladder, urethra and nerves, are maximally spared.

In September 2008 Accuray launched the InTempo Adaptive Imaging System, which enhances the CyberKnife System's ability to continually track and correct for motion of the prostate during treatment. With the InTempo System, CyberKnife radiation delivery automatically adapts to each individual patient's prostate motion by intelligently increasing the imaging frequency during periods of rapid and erratic prostate movement.

This continual assessment of prostate motion, combined with the CyberKnife System's automatic correction for movement in real-time, not only helps to ensure prescribed doses are delivered to the prostate; it also helps to ensure surrounding structures are avoided, minimizing associated side effects and complications. Using the InTempo System, the CyberKnife System drastically minimizes the "image age" — or time between image capture and when individual beam delivery is complete — to as few as 10 seconds.

Conventional IGRT therapies and other "rapid" radiation delivery techniques typically provide imaging limited to only pre-treatment set-up and therefore lack the ability to recognize motion that occurs during treatment delivery.

With such conventional techniques there is — at minimum — a two minute delay in the time between when the image is captured and the beam delivery is completed. With an image age of two minutes or more, potential motion that has proven to occur in as few as 30 seconds remains undetected, potentially resulting in inferior targeting accuracy and a heightened risk of surrounding tissue complications.

Another study, led by the Stanford University School of Medicine and published in International Journal of Radiation Oncology *Biology *Physics on September 1, 2008, concluded the following in regard to prostate motion during radiation delivery: "Our study shows the importance of real-time image guidance and motion-compensation techniques such as the robotic linear accelerator used in CyberKnife during hypofractionated prostate radiation treatment.

"Given the magnitude and random nature of prostate motion as well as recent technical advancements in various related fields, real-time monitoring of prostate position to compensate for the motion should be part of future prostate radiation therapy to ensure adequate dose coverage of the target while maintaining adequate sparing of adjacent structures."

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Your browser does not support inline frames or is currently configured not to display inline frames.	Your browser does not support inline frames or is currently configured not to display inline frames. CyberKnife radiosurgery for prostate cancer shows 100% PSA response 6 April 2009 Accuray Incorporated (NASDAQ:ARAY) has announced publication of the results from a prospective clinical study on CyberKnife radiosurgery for prostate cancer, which was published in the March 15, 2009 issue of the International Journal of Radiation OncologyBiologyPhysics. The study, led by Christopher King, MD at the Stanford University School of Medicine, treated 41 low-risk prostate cancer patients using CyberKnife radiosurgery. Continual image guidance was used to verify target position throughout the procedure allowing the team to precisely deliver very high doses of radiation in five short treatments. At a median follow-up of 33 months, no patient experienced a PSA recurrence and early side effects were no worse than other prostate cancer therapies. The authors refer to the findings as "highly encouraging," but remind readers that longer follow-up is required "to confirm durable biochemical control rates and low late toxicity profiles." "The evidence in Dr King's study shows a lot of promise for prostate cancer patients around the world who are looking for a shorter, less invasive and more convenient course of treatment," said Eric P Lindquist, senior vice president and chief marketing officer at Accuray. "We look forward to seeing longer term results and study outcomes examining the side effect profile of CyberKnife radiosurgery. Doctor and patient experience thus far has been very positive." Because the prostate can move unpredictably due to bowel gas or filling of the bladder, it is important that prostate motion is assessed and corrected for throughout treatment to allow for accurate radiosurgery treatment. Recent studies have confirmed that the prostate experiences rapid and unpredictable motion of as much as five millimeters in as few as 30 seconds, meaning that radiosurgery delivery must recognize and correct for even the slightest motion to ensure the target receives adequate dose and the surrounding sensitive structures, such as the rectum, bladder, urethra and nerves, are maximally spared. In September 2008 Accuray launched the InTempo Adaptive Imaging System, which enhances the CyberKnife System's ability to continually track and correct for motion of the prostate during treatment. With the InTempo System, CyberKnife radiation delivery automatically adapts to each individual patient's prostate motion by intelligently increasing the imaging frequency during periods of rapid and erratic prostate movement. This continual assessment of prostate motion, combined with the CyberKnife System's automatic correction for movement in real-time, not only helps to ensure prescribed doses are delivered to the prostate; it also helps to ensure surrounding structures are avoided, minimizing associated side effects and complications. Using the InTempo System, the CyberKnife System drastically minimizes the "image age" — or time between image capture and when individual beam delivery is complete — to as few as 10 seconds. Conventional IGRT therapies and other "rapid" radiation delivery techniques typically provide imaging limited to only pre-treatment set-up and therefore lack the ability to recognize motion that occurs during treatment delivery. With such conventional techniques there is — at minimum — a two minute delay in the time between when the image is captured and the beam delivery is completed. With an image age of two minutes or more, potential motion that has proven to occur in as few as 30 seconds remains undetected, potentially resulting in inferior targeting accuracy and a heightened risk of surrounding tissue complications. Another study, led by the Stanford University School of Medicine and published in International Journal of Radiation Oncology Biology Physics on September 1, 2008, concluded the following in regard to prostate motion during radiation delivery: "Our study shows the importance of real-time image guidance and motion-compensation techniques such as the robotic linear accelerator used in CyberKnife during hypofractionated prostate radiation treatment. "Given the magnitude and random nature of prostate motion as well as recent technical advancements in various related fields, real-time monitoring of prostate position to compensate for the motion should be part of future prostate radiation therapy to ensure adequate dose coverage of the target while maintaining adequate sparing of adjacent structures." Bookmark this page Your browser does not support inline frames or is currently configured not to display inline frames. To top	Your browser does not support inline frames or is currently configured not to display inline frames.