New research: Five treatment sessions as effective as 39 for radiation therapy in prostate cancer
In mid-October, results were published from a British long-term follow-up study of 874 prostate cancer patients who received either conventional radiation therapy in 20 or 39 sessions or SBRT* – a method involving higher radiation doses in just five sessions. The results are unequivocal: Treatment outcomes are equally effective for patients treated five times compared to those who received conventional radiation therapy. SBRT is now expected to soon become an approved treatment in several countries, benefiting both patients and healthcare providers.
The study, “Phase 3 Trial of Stereotactic Body Radiotherapy in Localized Prostate Cancer,” was published on October 16 in the New England Journal of Medicine. The last of the 874 patients in the study was treated in January 2018. After more than five years of follow-up, researchers conclude that treatment outcomes are equally effective for the 433 patients treated with higher doses in five radiation sessions as for the 441 in the control group who received conventional treatment with lower radiation doses in 20 or 39 sessions. The results are expected to lead to many countries approving SBRT for treating patients with localized prostate cancer in the relatively near future.
New Technology Increas Accuracy
During the study period, the technology used in prostate cancer radiation therapy has significantly advanced. One example is the Raypilot® System, a Swedish technology designed to enable improved radiation therapy for prostate cancer through fewer, higher-dose sessions while radically reducing the risk of side effects. Both side effects and the conventional treatment’s high number of low-dose radiation sessions are explained by the prostate’s unpredictable movement, like other organs, making it difficult to precisely control which tissue is hit by radiation. The Raypilot System visualizes organ movement in real-time during ongoing radiation therapy. It displays the exact location of the prostate in relation to the radiation field with millimeter accuracy, alerting healthcare providers if radiation risks drifting outside the targeted area.
The Raypilot System has been used for prostate cancer radiation therapy in several European countries since 2020. Most clinics using the system are research-oriented, and in recent years, multiple studies** with the Raypilot System have shown that the technology increases accuracy, thereby reducing side effects and enabling treatment with stronger radiation doses.
Quality of Life and Efficiency
“With the publication of this comparative study, we now have evidence that SBRT treatment provides results equal to conventional treatment. It’s likely that SBRT will, in the foreseeable future, not only become approved but also recommended as standard treatment for localized prostate cancer in several countries, including Switzerland, Italy, and the United Kingdom,” says Thomas Lindström, Managing Director at Micropos Medical, the company behind the Raypilot System. He believes that approval would bring significant advantages for both patients and healthcare providers:
“A higher radiation dose delivered with great accuracy gives patients effective treatment with very little risk of side effects. This significantly impacts patients’ quality of life after treatment. Additionally, treatment becomes more convenient, completed in just five days instead of potentially seven weeks or more. For healthcare providers, the reduced number of treatments represents significant efficiency gains and an opportunity to shorten the long waiting lists in cancer care that in many places still persist since the pandemic.”
About Prostate Cancer
Prostate cancer is the second most common cancer in men globally. The number of detected cases has increased significantly in recent decades; from 1.1 million registered cases in 2012 to 1.4 million cases in 2020. The disease is most common in the Western world, where PSA tests are frequently used. In Europe, approximately 470,000 men are diagnosed with prostate cancer every year.
*SBRT, Stereotactic Body Radiation Therapy, is a treatment method where patients receive radiation therapy in five or fewer sessions, over five or fewer consecutive days, with significantly higher radiation doses each time compared to traditional treatment requiring 20-40 treatment sessions. SBRT uses sophisticated real-time monitoring with 3D imaging that enables precise radiation targeting while avoiding healthy tissue.
**Examples of studies demonstrating the accuracy of the Raypilot System:
- Clinical implementation of real time motion management for prostate SBRT: A radiation therapist’s perspective. Joanne Mitchell et al.
Technical Innovations & Patient Support in Radiation Oncology, 2024, Aug 5 - Ablative Radiotherapy for Unfavorable Prostate Tumors (ABRUPT): Analysis of Toxicity and Quality of Life from a Prospective Study. Stefano Arcangeli et al.
International Journal of Radiation Oncology, Biology, Physics, 2024, July 04. - Electromagnetic Transmitter-Based Prostate Gating for Dose-Escalated Linac-Based Stereotactic Body Radiation Therapy: An Evaluation of Intra fraction Motion. De Bari, B. et al.
Curr. Oncol. 2024, 31, 962-974. - Noninvasive inter- and intrafractional motion control in ultrahypofractionated radiation therapy of prostate cancer using RayPilot HypoCath™-a sub stitute for gold fiducial-based IGRT? Johannes Berchtold et al. Strahlenther Onkol, 2023 Aug 25
- Dosimetric Impact of Intrafraction Prostate Motion and Interfraction Anatomical Changes in Dose-Escalated Linac-Based SBRT. Valeria Faccenda et al.
Cancers 2023, 15(4), 1153