Prostate cancer is a prevalent disease that affects numerous men in the United States each year. According to the American Cancer Society (ACS), approximately one in eight men will be diagnosed with prostate cancer during their lifetime. While many men respond well to available cancer treatments, prostate cancer remains the second leading cause of cancer-related death in men. One treatment option for prostate cancer is radiation therapy, which typically involves delivering multiple doses of radiation over several weeks.
A recent study conducted by researchers from the Institute of Cancer Research in London, United Kingdom, called Prostate Advances in Comparative Evidence (PACE-B), aimed to investigate whether the length of radiation therapy treatment could be shortened by administering higher doses of multibeam radiotherapy. The researchers presented their findings at the American Society for Radiation Oncology (ASTRO) conference on October 2, 2023.
Prostate cancer can be treated through various methods, including surgery, cryotherapy, immunotherapy, and radiation therapy. Radiation therapy is often the initial treatment choice for low-grade prostate cancer that is confined to the prostate gland and has not spread. Previous studies have shown that radiation therapy can be up to 90% effective in early-stage patients. However, the researchers in this study wanted to investigate the possibility of reducing the treatment duration.
Typically, radiation therapy for prostate cancer involves multiple sessions over several weeks, delivering a total of 20 or more doses of radiation. The researchers in this study wanted to explore the use of stereotactic body radiotherapy (SBRT), a technique that allows for precise delivery of higher radiation doses to the target area. They recruited 874 men with low to medium-risk prostate cancer and randomly assigned them to receive either SBRT or standard radiotherapy.
After completing the treatments, the researchers followed up with the participants for six years, specifically checking the cancer-free rates at the five-year mark. The study authors noted that the five-year biochemical and/or clinical failure (BCF) free rates were high in both groups. However, the participants who received radiation therapy over a shorter period had a slightly higher cancer-free rate. Five years after treatment, 95.7% of the patients in the SBRT group were cancer-free, compared to 94.6% in the traditional therapy group.
Based on their findings, the study authors suggested that the five-dose SBRT treatment should become the new standard of care for prostate cancer that has not spread beyond the prostate gland. This research indicates that SBRT is an effective treatment option for individuals with low to medium-risk prostate cancer, significantly reducing the treatment time required. Dr. Asif Harsolia, a board-certified radiation oncologist, commented that this treatment could be a game-changer for low-risk and favorable intermediate-risk patients, as it is not only more cost-effective but also more convenient.
Dr. Robert Wollman, a radiation oncologist not involved in the study, also shared his perspective on this and similar research. He mentioned that there is considerable data supporting the use of a five-treatment SBRT regimen with similar cure rates. While some patients may experience short-term urinary irritation, it typically subsides within a few weeks. However, Dr. Wollman cautioned against using this regimen for patients with existing urinary issues, as they may prefer a longer course of radiation to minimize worsening of their symptoms.
In conclusion, the PACE-B study suggests that SBRT is an effective treatment option for individuals with low to medium-risk prostate cancer. By delivering higher radiation doses over a shorter treatment period, SBRT can significantly reduce the time required for radiation therapy, making it more convenient for patients. However, further research and consideration of individual patient factors are necessary to determine the most suitable treatment approach for each case.