Stereotactic body radiotherapy viable alternative for localized prostate cancer

Stereotactic body radiotherapy (SBRT) is noninferior to conventional or moderately fractionated radiotherapy for localized prostate cancer (PC), according to a study published online Oct. 16 in the New England Journal of Medicine.

Nicholas van As, from the Royal Marsden Hospital in London, and colleagues assessed whether SBRT is noninferior to conventionally or moderately hypofractionated regimens in patients with localized PC. The analysis included patients randomly assigned to SBRT (36.25 Gy in five fractions over one or two weeks) or control radiotherapy (78 Gy in 39 fractions over 7.5 weeks or 62 Gy in 20 fractions over four weeks).

The researchers found that at a median follow-up of 74.0 months, the five-year incidence of freedom from biochemical or clinical failure was 95.8% in the SBRT group and 94.6% in the control radiotherapy group (unadjusted hazard ratio for biochemical or clinical failure, 0.73; 90% confidence interval, 0.48 to 1.12; P = 0.004 for noninferiority).

The cumulative incidence of late Radiation Therapy Oncology Group (RTOG) grade ≥2 genitourinary toxic effects at five years was 26.9% with SBRT and 18.3% with control radiotherapy (P < 0.001). For RTOG grade ≥2 gastrointestinal toxic effects, the cumulative incidence was 10.7% and 10.2%, respectively (P = 0.94).

“Five-fraction SBRT is a robust and viable alternative to moderately fractionated radiotherapy for prostate cancer, offering equivalent efficacy with enhanced convenience for patients,” the authors write.

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