Radiation therapy for prostate cancer used to involve repeated visits to the clinic for weeks or months for treatment. This isn't necessarily true today. Instead of giving smaller doses (called fractions) in each session until your entire plan is accomplished, radiation delivery is moving toward higher-dose fractions that could be given over a shorter time period with fewer sessions.
This “hypofractionated” strategy is more convenient for patients, and growing evidence suggests that it could actually be completed safely. With a technology called stereotactic body radiation therapy (SBRT), patients can complete their treatment plans inside every week, versus a month or more. Several devices can be found to deliver hypofractionated therapy, so patients may hear it called the CyberKnife or other brand names.
An SBRT session takes about 20 to half-hour, and the experience is analogous to receiving an X-ray. Often, doctors first insert small metal pellets in regards to the size of a grain of rice into the prostate gland. Called fiducials, the pellets act as markers that help doctors goal tumors more precisely, in order that radiation beams avoid healthy tissue. During treatment, a patient lies still while a radiation delivery machine moves around their body, administering the therapy.
How good is SBRT at controlling prostate cancer? Results from a randomized control Clinical trial show that SBRT and standard radiotherapy offer similar long-term advantages.
How was the study conducted?
The trial enrolled 874 men with localized prostate cancer, meaning cancer that continues to be confined to the prostate gland. The men were aged between 65 and 74 years, and all had prostate cancer with a low or intermediate risk of progression. The study randomized each of the lads into certainly one of two groups:
- Treatment group: The 433 men on this group each received SBRT at the identical every day dose. The treatment plan was accomplished after five visits over one to 2 weeks.
- Control group: 441 men on this group received conventional radiotherapy over a period of 4 to 7.5 weeks.
None of the lads received additional hormonal therapy, which is a treatment that forestalls prostate cancer – boosting the consequences of testosterone.
What the study showed
After a median follow-up of 74 months (about six years), the study found little difference in cancer outcomes. Of the lads within the treatment group, 26 showed apparently recurrent prostate cancer, or elevated prostate-specific antigen (PSA) levels that indicate latest tumors are present elsewhere within the body ( This is known as biochemical replication). In contrast, 36 men within the control group developed visible cancer or biochemical reoccurrence. Put one other way, 95.8% of men within the SBRT group – and 94.6% of men within the control group – were still freed from prostate cancer.
A word of caution
Preliminary results The same study published two years later showed a better rate of genitourinary unwanted effects in men treated with SBRT. Common genitourinary unwanted effects include inflammatory reactions that increase pain during urination, or that cause men to urinate more regularly. need to do Some men develop incontinence or scar tissue that makes urination harder. Overall, 12% of men within the SBRT group experienced genitourinary unwanted effects at two years, compared with 7% of control subjects.
The authors suggest that men who've existing urinary problems may consider conventional radiation as a substitute of SBRT. First Being treated for cancer. Patients with primary urinary problems “are more likely to have long-term toxicities,” the authors wrote, adding that the brand new findings “require better patient selection for SBRT, and more careful counseling.” must be allowed.”
“This elegant study will put to rest any question about the validity of SBRT as a standard of care option for many prostate cancer patients,” added Dr. Aghdam. “Importantly, in this trial, we see excellent outcomes for many patients who were treated with radiation alone. As this approach gains widespread acceptance in radiation oncology practices, it is important to Each patient should be carefully considered on the basis of their baseline characteristics, and a high level of quality assurance should be employed in delivering large doses of radiation in fewer fractions, as the overall duration of radiation therapy is reduced “The single treatment becomes far more vital.”