The Comparison of Stereotactic Body Radiation Therapy and Intensity-Modulated Radiation Therapy for Prostate Cancer...

Area of Science:

• Radiation Oncology
• Urologic Oncology
• Cancer Treatment Outcomes

Background:

• Organ-confined prostate cancer treatment involves radiation therapy.
• Stereotactic body radiation therapy (SBRT) and intensity-modulated radiation therapy (IMRT) are common modalities.
• Comparing their efficacy and toxicity is crucial for clinical decision-making.

Purpose of the Study:

• To compare freedom from biochemical failure (FFBF) between SBRT and IMRT for organ-confined prostate cancer.
• To evaluate toxicity profiles, including bowel, bladder, and sexual function, for both treatment groups.
• To assess the role of the 2015 National Comprehensive Cancer Network (NCCN) risk stratification in predicting outcomes.

Main Methods:

• Retrospective review of 270 patients treated with SBRT (n=150) or IMRT (n=120).
• Kaplan-Meier analysis for FFBF, with log-rank tests for comparisons.
• Multivariable Cox proportional hazard modeling to identify prognostic factors.
• Toxicity assessment using a modified Radiation Therapy Oncology Group (RTOG) scoring system.

Main Results:

• No significant difference in FFBF between SBRT and IMRT (6-year actuarial FFBF: 91.9% vs. 88.9%, p=0.46).
• NCCN risk stratification was the only significant predictor of FFBF in multivariable analysis (p=0.04).
• Excellent FFBF rates across risk groups, with no grade 3 GI/GU toxicities reported for either modality.

Conclusions:

• SBRT and IMRT demonstrate comparable FFBF for organ-confined prostate cancer.
• Low overall toxicity was observed for both treatment approaches.
• The 2015 NCCN risk stratification effectively predicts FFBF and should guide treatment decisions.