Stereotactic body radiation therapy (SBRT) is a safe and effective treatment for men with low- and intermediate-risk prostate cancer, according to a long-term, multi-institutional study. The study clears the way for patients who may wish to shorten their course of treatment without fear of increasing their risk for severe, adverse side effects. Findings will be presented today at the 60th Annual Meeting of the American Society for Radiation Oncology (ASTRO).
Stereotactic radiation is a form of external beam radiation therapy (EBRT) that delivers substantially larger doses of radiation per treatment session over a much shorter time period than traditional EBRT. It is also known as extreme hypofractionation, because it delivers higher levels of radiation per fraction, or dose.
The treatment has been studied since 2000 but has not been widely adopted because of concerns over long-term safety and efficacy. Guidelines issued by ASTRO and by the National Comprehensive Cancer Network (NCCN) have called for longer follow-up studies of stereotactic radiation for prostate cancer, including multi-institutional data, to address concerns about potentially worse late toxicities occurring from higher-dose treatments.
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“This study should meet those criteria and put patients at ease when considering treatment options,” said lead author Amar U. Kishan, MD, an assistant professor in the department of radiation oncology at the David Geffen School of Medicine at the University of California, Los Angeles (UCLA).
“Radiation therapy is typically delivered in small daily doses over a multi-week period,” explained Dr. Kishan. “However, because prostate cancer cells appear to be unusually sensitive to higher daily doses of radiation, you can reduce the duration of treatment from as many as 8-9 weeks with 39-45 treatments down to about 1.5 weeks with 4-5 treatments. This study should allay the fears of those who prefer to undertake a shorter treatment course that they can do so safely and with the same, positive outcomes they would receive from a longer course of treatment.”
This multi-institutional consortium study — to date the largest analysis of long-term outcomes following SBRT for this patient population — includes data from 10 institutional trials and two large multi-institutional studies. It examines the long-term safety and efficacy of SBRT for low- and intermediate-risk prostate cancer in a cohort of 2,142 men enrolled in institutional phase II trials of SBRT from 2000 to 2012.
