Stereotactic Ablative Radiotherapy For Prostate Cancer


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The typical radiation therapy for treatment of prostate cancer involves nearly 40 sessions. Now researchers are working on a new approach called stereotactic ablative radiotherapy for prostate cancer that reduces that number down to only 5.

Receiving only five radiation treatments for prostate cancer could be life-changing for men with the disease. Currently, men who undergo traditional external beam radiation for prostate cancer, for example, are at significant risk for many side effects, including changes in bowel habits, irritated skin, edema, rectal and urinary irritation, urinary symptoms, erectile dysfunction, and urinary bleeding. What impact could changing the method of delivery and the number of treatments have on side effects?

Stereotactic ablative radiotherapy for prostate cancer

Stereotactic ablative radiotherapy (SABR) is a highly targeted radiation technique that uses several beams of radiation simultaneously. These beams deliver a high dose of radiation to the cancer but only a very low dose to healthy tissue around the tumor. The incidence of side effects is lower when using SABR, but some still do occur, including urinary problems, bowel problems, impotence, tiredness, dry skin, and soreness or swelling at the treatment application area.

These and other side effects associated with radiation for prostate cancer can be minimized when a hydrogel is used. Use of the hydrogel, known as SpaceOAR, was the focus of a new trial of men who underwent radiation SABR for prostate cancer.

SpaceOAR is a temporary hydrogel spacer that is placed between the rectum and the prostate to minimize side effects during radiation therapy.

In the trial, the results of which were published in the British Journal of Radiology, the researchers evaluated the performance of the hydrogel in six patients. According to one of the authors, Ciaran Fairmichael, a clinical research fellow at Queen’s University in Belfast, the hydrogen “creates a greater distance between the prostate tumor and other tissues, which allows us to concentrate the radiotherapy dosage provided to the tumor and thus reducing the chance of radiation harming other tissues close to the tumor such as the bowel.”

The authors noted that use of the hydrogel reduced the probability of side effects and reduced the incidence of rectal bleeding. They concluded that “observed dose sparing of the rectum is predicted to result in meaningful clinical benefit.” Men who may need radiation for their prostate cancer should ask their doctor about the availability of SABR.

References

King RB et al. Efficacy of a rectal spacer with prostate SABR-first UK experience. British Journal of Radiology 2018 Feb; 91(1083): 20170672

Sandoiu A. New technique treats prostate cancer in just five radiotherapy sessions. MedicalNewsDaily 2018 Aug 15

Whalley D et al. SpaceOAR hydrogen in dose-escalated prostate cancer radiotherapy: rectal dosimetry and late toxicity. Clinical Oncology (Royal College of Radiologists) 2016 Oct; 28(10): e148-54