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Prostate stereotactic body radiotherapy—first UK experience.

A C Tree1, P Ostler2, P Hoskin2

  • 1Royal Marsden NHS Foundation Trust, London, UK.

Clinical Oncology (Royal College of Radiologists (Great Britain))
|September 7, 2014
PubMed
Summary

Stereotactic body radiotherapy (SBRT) for prostate cancer shows promising outcomes in the first UK cohort. This advanced radiotherapy technique demonstrated manageable toxicity and favorable early results for patients with organ-confined disease.

Keywords:
ProstateSBRTstereotactic body radiotherapytoxicity

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Area of Science:

  • Oncology
  • Radiation Oncology
  • Urology

Background:

  • Stereotactic body radiotherapy (SBRT) integrates image-guided radiotherapy and hypofractionation, potentially improving patient outcomes in prostate cancer.
  • North America holds the majority of clinical experience with SBRT for prostate cancer.

Purpose of the Study:

  • To present the outcomes of the first UK cohort of patients treated with SBRT for prostate cancer.
  • To evaluate the safety and efficacy of SBRT in a UK population.

Main Methods:

  • Fifty-one prostate cancer patients (10 low, 35 intermediate, 6 high risk) received SBRT (36.25 Gy in 5 fractions over 1-2 weeks) with gold seed image guidance.
  • Prospective recording of toxicity using the International Prostate Symptom Score (IPSS) and Radiation Therapy Oncology Group (RTOG) criteria.
  • Serial prostate-specific antigen (PSA) measurements were taken 3-6 monthly during follow-up.

Main Results:

  • Median IPSS showed transient increases post-treatment, returning to near baseline by 7-12 weeks.
  • Grade 2 genitourinary and gastrointestinal toxicity occurred in 22% and 14% of patients, respectively, within 1-3 weeks post-treatment.
  • No grade 3+ toxicity was observed within 1-3 weeks; two patients experienced grade 3 urinary frequency during treatment. Median PSA at 13-18 months was 1.3 ng/ml for patients not receiving androgen deprivation therapy.

Conclusions:

  • Prostate SBRT is a promising treatment option for organ-confined prostate cancer.
  • The findings support ongoing UK-led phase III trials investigating prostate SBRT.