Stereotactic body radiation therapy for low and intermediate risk prostate cancer-Results from a multi-institutional clinical trial.

BACKGROUND - We report the outcome of a phase I/II clinical trial of stereotactic body radiation therapy (SBRT) for low (LR) and select intermediate risk (IR) prostate cancer (PCa) patients.

PATIENTS AND METHODS - Eligible patients included men with prostate adenocarcinoma with Gleason score 6 with PSA ≤ 20 or Gleason 7 with PSA ≤ 15 and clinical stage ≤ T2b.

For the phase I portion of the study patients in cohorts of 15 received 45, 47.5, or 50 Gray (Gy) in five fractions. Since the maximally tolerated dose was not met in the phase I study, an additional 47 patients received 50 Gy in five fractions in the phase II study. Toxicity using Common Toxicity Criteria for Adverse Events v. 3.0, quality of life, and outcome data was collected.

RESULTS - A total of 91 patients are included for analysis; 63.7% had NCCN IR and 36.3% had LR PCa. At a median follow up of 54 months the actuarial freedom from biochemical failure was 100% at 3 years and 98.6% at 5 years. Actuarial distant metastasis free survival was 100% at 3 and 5 years. Overall survival was 94% at 3 years and 89.7% at 5 years with no deaths attributed to PCa. Acute and late urinary grade ≥ III toxicity occurred in 0% and 5.5% of patients, respectively. Gastrointestinal (GI) acute and late toxicity of grade ≥ III occurred in 2% and 7% of patients, respectively. A total of four men experienced grade IV toxicity (three GI, one genitourinary).

CONCLUSIONS - SBRT treatment results in excellent biochemical control rates at 5 years for LR and IR PCa patients although doses greater than 47.5 Gy in five fractions led to increased severe late toxicity.

European journal of cancer (Oxford, England : 1990). 2016 Mar 29 [Epub ahead of print]

Raquibul Hannan, Vasu Tumati, Xian-Jin Xie, L Chinsoo Cho, Brian D Kavanagh, Jeffrey Brindle, David Raben, Akash Nanda, Susan Cooley, D W Nathan Kim, David Pistenmaa, Yair Lotan, Robert Timmerman

Department of Radiation Oncology, University of Texas Southwestern Medical Center, USA., Department of Radiation Oncology, University of Texas Southwestern Medical Center, USA., Department of Clinical Sciences, University of Texas Southwestern Medical Center, USA., Department of Radiation Oncology, University of Minnesota, USA., Department of Radiation Oncology, University of Colorado, USA., Department of Radiation Oncology, Prairie Lakes Hospital, USA., Department of Radiation Oncology, University of Colorado, USA., Department of Radiation Oncology, Orlando Health, USA., Department of Radiation Oncology, University of Texas Southwestern Medical Center, USA., Texas Oncology-Waco, USA., Radiation Research Program, NCI, USA., Department of Urology, University of Texas Southwestern Medical Center, USA., Department of Radiation Oncology, University of Texas Southwestern Medical Center, USA. 

E-Newsletters

Newsletter subscription

Free Daily and Weekly newsletters offered by content of interest

The fields of GU Oncology and Urology are rapidly advancing. Sign up today for articles, videos, conference highlights and abstracts from peer-review publications by disease and condition delivered to your inbox and read on the go.

Subscribe