In a nutshell
This study evaluated whether fewer sessions of radiotherapy at a higher dose was more effective than conventional radiotherapy for patients with prostate cancer. The authors found that fewer radiation sessions at a higher dose did not increase side effects.
Radiation therapy is an effective treatment for prostate cancer. To be effective, the total dose of radiation needs to be high enough. Higher doses may be associated with greater side effects. However, lower doses may decrease effectiveness. Balancing treatment doses with the risk of side effects is crucial.
Stereotactic radiation (SR) involves using higher doses of radiation across fewer treatment sessions. This makes treatment more convenient and potentially more effective. However, there is a risk of more side effects. Whether stereotactic radiation is more effective than conventional radiotherapy (CR) for patients with prostate cancer is unclear.
Methods & findings
This study had 874 patients with prostate cancer that did not spread. 441 patients received CR, with lower doses over more sessions. 433 patients received SR, with higher doses over fewer sessions. Patients were followed for an average of 12 weeks.
Overall, 53 patients (12%) in the CR group had mild gut-related side effects compared to 43 patients (10%) in the SR group. Serious side effects were reported in a few patients in both groups (4 patients vs. 1 patient). Slightly more patients in the SR group had diarrhea compared to the CR group (8% vs. 15%).
118 patients (27%) in the CR group had mild urinary tract-related side effects compared to 96 patients (23%) in the SR group. Serious side effects were reported in a few patients in both groups (7 patients vs. 10 patients).
The bottom line
The authors found that fewer radiation sessions at a higher dose did not increase side effects compared to conventional radiotherapy.
The fine print
This study had patients with low to intermediate-risk disease, so these results may not apply to higher-risk patients. Also, patients were followed-up for different lengths of time because the length of treatment was different for each group. More studies are needed to confirm these results.
Published By :
The Lancet. Oncology
Sep 17, 2019
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