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Stereotactic Magnetic Resonance-Guided Daily Adaptive Radiation Therapy for Localized Prostate Cancer: Acute and Late
Killian Nugent1,2, Prantik Das1, Dan Ford1
1GenesisCare UK, Oxford, United Kingdom.
Advances in Radiation Oncology
|September 3, 2024
Summary
Stereotactic magnetic resonance-guided adaptive radiation therapy (SMART) for prostate cancer shows acceptable toxicity. Most patients reported no new bowel or urinary issues, though sexual dysfunction persisted in some long-term.
Area of Science:
- Radiation Oncology
- Urology
- Patient-Reported Outcomes
Background:
- Prostate cancer treatment often involves radiation therapy, which can lead to acute and late side effects.
- Stereotactic magnetic resonance-guided adaptive radiation therapy (SMART) is an advanced technique for localized prostate cancer.
- Understanding patient-reported outcomes is crucial for evaluating treatment efficacy and quality of life.
Purpose of the Study:
- To evaluate patient-reported outcomes regarding bowel, urinary, and sexual dysfunction after stereotactic magnetic resonance-guided daily adaptive radiation therapy (SMART) for localized prostate cancer.
- To assess acute and late toxicity profiles associated with prostate SMART.
Main Methods:
- A cohort of 69 patients with localized prostate cancer treated with SMART (36.25 Gy in 5 fractions) was prospectively followed.
- Patient-reported outcomes were collected using the 12-item Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events questionnaire at baseline and follow-up time points.
- Toxicity levels for bowel, urinary, and sexual dysfunction were calculated as percentages of patients reporting new or worsening symptoms.
Main Results:
- Over a median follow-up of 27 months, >80% of patients reported no change in bowel toxicity from baseline; 9% experienced new frequent diarrhea.
- Urinary urgency was the most common complaint (39%), with 20% reporting new frequent urgency, both peaking at 1 month and resolving by >33 months.
- New severe sexual dysfunction was reported in 26% of patients and persisted beyond 33 months.
Conclusions:
- Prostate SMART demonstrates acceptable toxicity levels, with most patients experiencing no significant long-term bowel or urinary issues.
- Sexual dysfunction remains a persistent side effect for a notable percentage of patients treated with prostate SMART.
- This study represents one of the largest patient-reported outcomes analyses following prostate SMART, supporting its use in localized disease.
