SBRT Shortens Tx for Prostate Cancer Without Greater Toxicity
Ultra-hypofractionated stereotactic body radiotherapy cuts treatment from two months to two weeks
FRIDAY, Sept. 27, 2019 (HealthDay News) -- A targeted radiotherapy technique can substantially cut treatment time for prostate cancer without increasing gastrointestinal or genitourinary acute toxicity, according to a phase 3 study published online Sept. 17 in The Lancet Oncology.
Douglas H. Brand, M.D., from the Royal Marsden Hospital in the United Kingdom, and colleagues performed an acute toxicity substudy using data from an international, phase 3, open-label, randomized, noninferiority trial in which 874 men with low-risk or intermediate-risk prostate adenocarcinoma were randomly assigned to either conventionally fractionated or moderately hypofractionated radiotherapy (441 patients; 78 Gy in 39 fractions over 7.8 weeks and 62 Gy in 20 fractions over four weeks, respectively), or stereotactic body radiotherapy (433 patients; 36.25 Gy in five fractions over one to two weeks).
The researchers found that worst acute Radiation Therapy Oncology Group (RTOG) gastrointestinal toxic effect (at least grade 2 severe toxic events) occurred in 12 percent of the patients in the conventionally fractionated or moderately hypofractionated radiotherapy group and in 10 percent of the patients in the stereotactic body radiotherapy group (difference, −1.9 percentage points; 95 percent confidence interval, −6.2 to 2.4; P = 0.38). Worst acute RTOG genitourinary toxicity occurred in 27 percent of patients in the conventionally fractionated or moderately hypofractionated radiotherapy group versus 23 percent of patients in the stereotactic body radiotherapy group (difference, −4.2 percentage points; 95 percent confidence interval, −10.0 to 1.7; P = 0.16). No treatment-related deaths were reported.
"Our results suggest that substantially shortening treatment courses with stereotactic body radiotherapy does not increase either gastrointestinal or genitourinary acute toxicity," the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.