A new type of radiation therapy for the treatment of prostate cancer

This review explored the risks and benefits of stereotactic body radiation therapy (SBRT) as treatment for patients with early-stage prostate cancer.

Prostate cancer (PC) can now be found in the very early stages, due to screening techniques such as the prostate-specific antigen or PSA (a protein produced by the prostate gland whose levels rise in prostate disease) testing. Early stage PC is generally treated by removing the prostate entirely (radical prostatectomy or RP) or with radiation therapy. The most common radiation therapy is conventionally fractionated radiation therapy, during which a patient receives the same daily dose of radiation over 8 weeks. However, this long-term treatment schedule can be difficult for patients, since it can give cancer cells more time to multiply and can lead to toxicity for the kidneys and the healthy tissues surrounding the prostate gland. A newer radiation therapy regimen, stereotactic body radiation therapy (SBRT), increases the amount of radiation given at each session and decreases the total treatment time to 2 weeks. This review discusses the risk and benefits associated with SBRT. 

One benefit of a higher radiation dose is that there is an increase in tumor cell death, since there is less time for cancer cells to multiply. However, these higher doses of radiation can be more harmful for the healthy surrounding tissues. Previous studies have found 5-year disease-free survival (the percentage of patients who survived without any signs or symptoms of cancer) rates following SBRT to be 90%, with low levels of toxicity. 57% of SBRT patients remained free of genitourinary side effects, such as impotence or incontinence (problems in bladder control), both common side effects of RP, and 63% of patients did not experience any gastrointestinal symptoms, also a common side effect of radiation therapy. However, detailed quality of life measures for SBRT are not yet available. Also, as SBRT is a new treatment, follow-up times for clinical trials are shorter than those for treatments such as RP (a mean of 3.1 years versus 5.8 years, respectively).

In summary, SBRT is a new and effective treatment for PC that leads to fewer side effects. More research is needed to fully understand the risks and benefits associated with this treatment.

Discuss with your physician the most appropriate treatment for your situation.