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Precision Radiation Technique for Prostate Cancer May Reduce Short-Term Toxicity

By: Amanda E. Ruffino, BA
Posted: Friday, September 15, 2023

Jonathan E. Leeman, MD, of Dana‐Farber Cancer Institute/Brigham and Women’s Hospital, Harvard Medical School, Boston, and colleagues have shed light on the potential benefits of MR-guided daily adaptive stereotactic body radiotherapy (SBRT), a high-tech solution with precision dose-delivery capabilities. In a comprehensive meta-analysis, the investigators compared the acute toxicity rates of MR-guided daily adaptive SBRT with conventional CT-guided SBRT for prostate cancer. Their findings, published in the journal Cancer, indicate that patients undergoing MR-guided daily adaptive SBRT may potentially experience fewer debilitating adverse effects, leading to an improved quality of life during and after treatment.

“The study is the first to directly evaluate the benefits of MR-guided adaptive prostate radiation in comparison to another more standard and conventional form of radiation, and it provides support for use of this treatment in the management of prostate cancer,” said Dr. Leeman in a press release.

After analyzing 29 prospective trials encompassing 2,547 patients, the investigators revealed that MR-guided daily adaptive SBRT significantly reduced the risk of acute genitourinary and gastrointestinal toxicities compared with CT-SBRT. Specifically, the risk of severe urinary side effects was reduced by 44%, and the incidence of bowel-related complications dropped by 60%.

In addition, the investigators noted that MR-guided daily adaptive SBRT may enable more accurate and adaptive radiation delivery, thus possibly mitigating the negative impacts on surrounding tissues. The meta-analysis employed both random-effects and fixed-effects models to estimate pooled toxicity rates, with meta-regression further affirming the superior safety profile of MR-guided daily adaptive SBRT. Odds ratios for acute genitourinary and gastrointestinal toxicities favoring MR-guided daily adaptive SBRT over CT-SBRT were 0.56 and 0.40, respectively. These findings indicate a statistically significant reduction in toxicity risk with the innovative MR-guided daily adaptive SBRT approach. Further research with extended follow-up is warranted to fully understand the scope of the advantages of this radiotherapeutic strategy.

Disclosure: For full disclosures of study authors, visit acsjournals.com.


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