Should Stereotactic Body Radiation Therapy Be Standard Option in Localized Prostate Cancer?
Posted: Monday, September 9, 2019
Stereotactic body radiation therapy (SBRT) has substantial evidence supporting its use as a standard treatment option in localized prostate cancer, including favorable disease control, patient-reported quality of life, and acute or late toxicity. William C. Jackson, MD, of the University of Michigan, and colleagues published a meta-analysis of more than 6,000 men treated with prostate SBRT in the International Journal of Radiation Oncology • Biology • Physics.
“Our findings support that SBRT could be considered a standard radiotherapeutic strategy for localized prostate cancer while ongoing trials assess its potential superiority to other treatment methods,” concluded the authors.
To determine the effectiveness of this radiotherapy, the team conducted a systematic search leveraging Medline via PubMed and EMBASE databases to find articles published between January 1990 and January 2018. Abstracts with sufficient extractable data from January 2013 to March 2018 supplemented the original search. Studies included were those that assessed curative-intent SBRT for localized prostate cancer and reported physician-related toxicity, patient-reported quality of life, and biochemical recurrence–free survival.
A total of 38 prospective studies were identified, with results from 6,116 patients with low-, intermediate-, and high-risk disease. The median follow-up was 39 months for all patients. Overall the 5-year biochemical recurrence–free survival rate was 95.3%, and the 7-year survival rate was 93.7%. Grade 3 or higher genitourinary and gastrointestinal toxicity rates were 2.0% and 1.1%, respectively. Two years after SBRT treatment, Expanded Prostate Cancer Index Composite urinary and bowel domain scores returned to baseline and remained nonsignificantly different to scores 5 years after treatment. Increasing doses of SBRT appeared to be related to improved biochemical control but worse late grade 3 or higher genitourinary toxicity.
Disclosure: The study authors’ disclosure information can be found at redjournal.org.