Shorter radiotherapy course effective for prostate cancer: JAMA

A new study has reported that men having a low-intermediate risk of prostate cancer can safely undergo stereotactic body radiotherapy, a form of external beam radiation therapy that would significantly reduce the treatment duration to only 4-5 days. The study was conducted by a research team of the University of California with Dr. Amar Kishan, assistant professor of radiation oncology at the David Geffen School of Medicine, as the lead author backed by researchers of the UCLA Jonsson Comprehensive Cancer Center. The study was published in JAMA open networks.

Conventional radiation therapy low-intermediate risk of prostrate cancer requires patients to come daily for the treatment and takes an average of nine weeks to complete, That can be very burdensome on a patient and be a huge interruption in their life. With the improvements being made to modern technology, we’ve found that using stereotactic body radiotherapy, which has a higher dose of radiation, can safely and effectively be done in a much shorter timeframe without additional toxicity or compromising any chance of a cure.”- said lead author Dr. Amar Kishan.

The UCLA research team analyzed data from 2,142 men with low- or intermediate-risk prostate cancer across multiple institutions who were treated with stereotactic body radiotherapy for prostate cancer between 2000 and 2012. The men were followed for a median of 6.9 years. Just over half of the men had a low-risk disease (53 per cent), 32 per cent had a less aggressive intermediate-risk disease and 12 per cent had a more aggressive form of the intermediate-risk disease.

The recurrence rate for men with the low-risk disease was 4.5 per cent, the recurrence rate for the less aggressive intermediate-risk was 8.6 per cent, and the recurrence rate for the more aggressive intermediate-risk group was 14.9 per cent. Overall, the recurrence rate for the intermediate-risk disease was 10.2 per cent. These are essentially identical to rates following more conventional forms of radiation, which are about 4 per cent to 5 per cent for low-risk disease and 10 per cent to 15 per cent for the intermediate-risk disease.

“What is remarkable about this very large study is how favourably stereotactic body radiotherapy compares to all other forms of radiation treatments, both in terms of effectiveness and side effects,” said senior author Dr. Christopher King, professor of radiation oncology and scientist at the UCLA cancer centre. “With such long-term follow-up data, we can now offer this approach to patients with full confidence.”

The research team at UCLA had previously found that stereotactic body radiation therapy was more cost-effective because of the fewer treatments involved. Other research has also suggested psychological benefits such as less regret about undergoing treatment. The current study now provides long-term data regarding the safety and clinical efficacy of this approach.

Dr. Kishan said- " the data show that the majority of the men followed are free of prostate cancer seven years after treatment. He added- "there was no evidence that this therapy caused worse toxicity in the long term. “In fact,” Kishan said, “we not only confirm that this method is both safe and effective, but we provide significant evidence that this could be a viable treatment option for men with low- and intermediate-risk of prostate cancer.”