PCa: SBRT yields long-term benefit in low-/intermediate-risk disease

  • Kishan AU & et al
  • JAMA Network Open
  • 8 Feb 2019

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • In patients with low-/intermediate-risk prostate cancer (PCa), stereotactic body radiotherapy (SBRT) is associated with low rates of severe adverse events (AEs) and high rates of long-term biochemical control.

Why this matters

  • National Comprehensive Cancer Network (NCCN) recommends SBRT as an alternative to conventionally fractionated regimens, but data on long-term effects are unknown.

Study design

  • Study of individual patient data from 12 phase 2 trials including 2142 men with low-/intermediate-risk prostate cancer.
  • Funding: None reported.

Key results

  • Median follow-up, 6.9 years.
  • 55.3% had low-risk disease, 32.3% had favorable intermediate-risk disease, and 12.4% had unfavorable intermediate-risk disease.
  • 7-year cumulative rates of biochemical recurrence:
    • low-risk disease: 4.5% (95%CI, 3.2%-5.8%),
    • favorable intermediate-risk disease: 8.6% (95%CI, 6.2%-11.0%),
    • unfavorable intermediate-risk disease: 14.9% (95%CI, 9.5%-20.2%), and
    • all intermediate-risk disease: 10.2% (95% CI, 8.0%-12.5%).
  • 7-year cumulative incidence of late grade ≥3 genitourinary and gastrointestinal AEs was 2.4% and 0.4%.
  • The crude incidence of acute grade ≥3 AEs:
    • Gastrointestinal: 0.09%.
    • Genitourinary: 0.60% (urinary frequency was most common).

Limitations

  • Lack of comparator group.

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