To assess 2-year biochemical control, radiological progression, late side effects, and survival outcomes following stereotactic body radiotherapy (SBRT) for localized prostate cancer in a multicenter Spanish cohort.
A total of 250 patients with localized prostate cancer treated with SBRT across 12 Spanish centers between January 2020 and December 2023 were analyzed. Biochemical recurrence was defined according to the Phoenix criterion (nadir PSA + 2 ng/mL). Late genitourinary (GU), gastrointestinal (GI), and sexual adverse events were assessed using the Common Terminology Criteria for Adverse Events (CTCAE) v5.0. Univariate and multivariate analyses were performed to identify factors associated with outcomes. Survival was estimated using the Kaplan-Meier method and the log-rank test (p < 0.05).
The median age was 72 years (IQR: 65-76), and the median baseline PSA was 6.7 ng/mL (5.3-8.7). According to the NCCN classification, 30% of patients were low risk, 67% intermediate (26.8% favorable, 39.6% unfavorable), and 3% high or very high risk. The median prescribed dose was 40 Gy in five fractions (36.25-40.0), administered on alternate days. At 2 years, biochemical control was 96.4%, and radiological progression occurred in 2.8% of patients, predominantly nodal. The incidence of grade ≥ 2 late adverse events was 7.6% GU, 1.2% GI, and 14.3% sexual.
SBRT for localized prostate cancer offers excellent 2-year biochemical control with low rates of late adverse events, supporting its safety and effectiveness in routine clinical practice for selected patients. A longer follow-up is warranted to fully characterize long-term outcomes.
Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico. 2026 Feb 07 [Epub ahead of print]
Sigfredo Elias Romero Zoghbi, Fernando López Campos, Abrahams Ocanto, David Sanz-Rosa, Israel John Thuissard-Vasallo, Cristina Andreu Vázquez, Cristina Laria, Jaume Fernández Ibiza, Jon Andreescu Yagüe, Evita Krumina, Maria Mateos, Maia Dzhugashvili, Luis Alberto Glaría, Daniela Gonsalves, Castalia Fernández, David Esteban, José Begara de la Fuente, José Antonio González Ferreira, Antonio Ristori, Daniel Rivas, Escarlata López, Ana Belén Bezares Alarcón, Loubna Aakki, Luis Larrea, José Ángel García Cuesta, Constantinos Zamboglou, Filippo Alongi, Rafael García García, Felipe Couñago
Department of Radiation Oncology, GenesisCare Talavera de la Reina, Talavera de la Reina, Spain. ., Department of Radiation Oncology, Hospital Universitario Ramón y Cajal, Madrid, Spain., Department of Radiation Oncology, GenesisCare Madrid, Hospital Universitario La Milagrosa, Madrid, Spain., Department of Medicine, Faculty of Medicine, Health and Sports, Universidad Europea de Madrid, Madrid, Spain., Department of Veterinary Medicine, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Madrid, Spain., Department of Radiation Oncology, GenesisCare Talavera de la Reina, Talavera de la Reina, Spain., Department of Radiation Oncology, Centro 360 de Excelencia Oncológica GCCC, Barcelona, Spain., Department of Radiation Oncology, GenesisCare Córdoba, Córdoba, Spain., Department of Radiation Oncology, GenesisCare Guadalajara, Guadalajara, Spain., Department of Radiation Oncology, GenesisCare Alcázar de San Juan, Alcázar de San Juan, Spain., Department of Radiation Oncology, GenesisCare Málaga, Málaga, Spain., Department of Radiation Oncology, GenesisCare Sevilla, Seville, Spain., Department of Radiation Oncology, GenesisCare Jerez de la Frontera, Jerez de la Frontera, Spain., Department of Radiation Oncology, GenesisCare Campo de Gibraltar, Algeciras, Spain., Department of Radiation Oncology, GenesisCare Alicante, Alicante, Spain., Department of Radiation Oncology, GenesisCare Hospital Vithas Valencia Consuelo, Valencia, Spain., Department of Medical Oncology, GenesisCare Hospital Universitario San Francisco de Asís, Madrid, Spain., Department of Radiation Oncology, University of Freiburg Faculty of Medicine and Medical Centre, Freiburg, Germany., Advanced Radiation Oncology Department, IRCCS Ospedale Sacro Cuore Don Calabria, Negrar di Valpolicella, Verona, Italy., Department of Radiation Oncology, Hospital Ruber Internacional, Madrid, Spain.
PubMed http://www.ncbi.nlm.nih.gov/pubmed/41653361