Two-fraction Versus Five-fraction Stereotactic Body Radiotherapy for Intermediate-risk Prostate Cancer: The TOFFEE...

Area of Science:

• Oncology
• Radiation Oncology
• Clinical Trials

Background:

• Five-fraction stereotactic body radiotherapy (5F-SBRT) is effective for prostate cancer (PC).
• Comparative data for fewer fractions, such as two-fraction SBRT (2F-SBRT), are limited.
• This study addresses the lack of comparative evidence between 2F-SBRT and 5F-SBRT.

Purpose of the Study:

• To compare the efficacy and quality of life outcomes of 2F-SBRT and 5F-SBRT.
• To evaluate patients with intermediate-risk prostate cancer (IR-PC).
• To provide evidence for the potential of 2F-SBRT as a standard treatment option.

Main Methods:

• Meta-analysis of individual patient data from four prospective prostate SBRT trials.
• Included patients with IR-PC treated with either 2F-SBRT or 5F-SBRT.
• Primary endpoint: biochemical failure (BCF); Secondary endpoints: distant metastases (DM) and quality of life (QoL).

Main Results:

• No significant difference in 5-year cumulative incidence of BCF between 2F-SBRT (3.6%) and 5F-SBRT (6.0%).
• No significant difference in the incidence of DM between the two treatment groups.
• No differences observed in acute or late urinary or bowel QoL outcomes.

Conclusions:

• The first prospective comparison of 2F-SBRT and 5F-SBRT for IR-PC found no significant differences in efficacy or QoL.
• Results support the consideration of 2F-SBRT as a potential standard-of-care option for IR-PC.
• Further research may explore the long-term outcomes and broader applicability of 2F-SBRT.