Stereotactic body radiotherapy (SBRT) is established as standard therapy for organ-confined prostate cancer (PC) based on 5-yr phase 2-3 outcomes, but 10-yr data are lacking. Here, we report 10-yr results of a trial conducted at 21 centers. Patients were treated from January 2008 to April 2010. SBRT was delivered on a noncoplanar robotic platform with real-time motion management, to a total dose of 40 Gy in five fractions. Adjuvant hormone therapy was not allowed. Late toxicities (>90 d) were assessed with Common Terminology Criteria for Adverse Events version 3 (CTCAE v3). Biochemical failure is defined as nadir+2. Relapses are defined as biochemical or clinical failure or salvage/systemic PC therapy. Out of 310 evaluable patients, median age 68 yr; 172 were low-risk (LR), and 138 patients were intermediate-risk (IR). Median follow-up was 9 yr. Ten-yr cumulative grade 3 gastrointestinal (GI) or genitourinary (GU) toxicities were 1.4% and 1.5% in the LR and IR cohorts, respectively. There were no grade 4-5 events observed. Ten year grade 2+ GI and GU toxicity rates were 2.1% and 14% respectively. Overall survival in 10 yr was 84%. Overall, relapse-free survival (RFS) was 90%; 94% in the LR cohort, 86% in the IR cohort, and 92% versus 77% in the favorable vs unfavorable intermediate subgroups. In this multi-institutional trial, the 10-yr follow-up demonstrates that prostate SBRT yields minimal toxicity and favorable RFS.
European urology. 2026 May 08 [Epub ahead of print]
Robert M Meier, Nima Aghdam, Alan C Beckman, Shermian A Woodhouse, Shirnett K Williamson, Najeeb Mohideen, John J Dombrowski, Irving D Kaplan
Swedish Radiosurgery Center, Seattle, Washington, DC, USA. Electronic address: ., NYU Langone Health, New York, NY, USA., Central Baptist Hospital, Lexington, KY, USA., Community Cancer Center, Normal, IL, USA., Capital Health Medical Center, Pennington, NJ, USA., Northwest Community Hospital, Arlington Heights, IL, USA., St. Louis University Hospital, St Louis, MO, USA., Beth Israel Deaconess Medical Center, Boston, MA, USA.