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Sandy Srinivas, MD
Sandy Srinivas, MD
Posted: Wednesday, February 1, 2023
Stereotactic body radiotherapy (SBRT) may be a safe treatment alternative to intensity-modulated radiotherapy for many patients with prostate cancer, according to an article published in The Lancet Oncology. “Localized prostate cancer is commonly treated with external-beam radiotherapy, and moderate hypofractionation is noninferior to longer schedules,” said Alison C. Tree, MDRes, of The Royal Marsden Hospital, London, and colleagues. “Stereotactic body radiotherapy allows shorter treatment courses without impacting acute toxicity.”
The phase III PACE trial, an open-label, randomized, controlled study conducted at 35 hospitals in the United Kingdom, Ireland, and Canada, enrolled 874 men. All men had low- to intermediate-risk, histologically confirmed prostate cancer. Patients were randomly assigned into two treatment arms: 441 patients received control radiotherapy consisting of 78 Gy in 39 fractions over 7 to 8 weeks or 62 Gy in 20 fractions over 4 weeks, and 433 patients received SBRT consisting of 36.25 Gy in five fractions over 1 to 2 weeks.
The authors reported that at 24 months, 2% of patients who received control radiotherapy and 3% of patients who received SBRT had Radiation Therapy Oncology Group (RTOG) grade 2 or worse genitourinary toxicity. Furthermore, RTOG grade 2 or greater gastrointestinal toxicity was observed in 3% of patients who received control radiotherapy and in 6% of patients who received SBRT at 24 months. The investigators noted that at the time, no grade 4 adverse events or treatment-related deaths had occurred in either arm of the study. Similarities between treatment groups led the authors to conclude that SBRT may prove to be a safe alternative to control radiotherapy, with lower rates of treatment-related side effects.
Disclosure: For full disclosures of the study authors, visit www.thelancet.com.
