A Validated Alternative to Surgery that Preserves Quality of Life.
What if prostate cancer could be treated effectively with radiotherapy in a single week? Two major clinical trials have shown that it can. The Raypilot® System provides the real-time precision needed, while protecting bladder, bowel and sexual function.
Understanding the Options
When prostate cancer is localised, there are several treatment options: surgery, conventional radiotherapy, active surveillance. Each involves trade-offs between cancer control, side effects, and impact on daily life. For many patients, the choice comes down to how much disruption they are willing to accept. Hypofractionated SBRT introduces something new to that conversation: a radiation-based treatment delivered in days, with outcomes now directly compared to surgery. The evidence below shows where SBRT stands relative to other treatments and what it means for patients weighing their options.
How Does SBRT Compare to Surgery?
In the PACE-A trial, published in European Urology in 2024, patients with localised prostate cancer were randomised to either SBRT or radical prostatectomy, making it the first head-to-head comparison of these two treatment approaches. Here is how they compare.
Stereotactic Body Radiation Therapy, SBRT
- 1–5 treatment sessions over one week
- No general anaesthesia
- No hospital stay
- Temporary urinary catheter during treatment (1–5 days)
- Return to daily life between sessions
Radical Prostatectomy
- Single procedure under general anaesthesia
- 1–2 nights in hospital
- Catheter for 7–10 days
- 4–6 weeks recovery
Oncological outcomes: comparable (PACE-A, European Urology 2024).
Quality-of-life differences favour SBRT for urinary continence and sexual function.
Life After Treatment: What the Data Shows
When comparing options, the question patients ask is not only “will it work?” but “what will my life be like afterwards?” The PACE-A trial measured patient-reported outcomes across the domains that matter most.
| SBRT | Radical prostatectomy | |
|---|---|---|
| Urinary continence | Favourable | Higher incidence of incontinence |
| Sexual function | Favourable | Higher incidence of erectile dysfunction |
| Bowel function | Some early irritation, typically resolving | Generally unaffected |
| Cancer control | Comparable | Comparable |
Source: PACE-A (van As et al., European Urology 2024).
Why Geometric Precision During SBRT Delivery is Crucial
SBRT delivers high radiation dose in fewer fractions. That means each fraction carries a higher dose, and a higher consequence if the dose lands in the wrong place. Especially since the prostate can move during treatment. Without real-time tracking, clinics compensate with wider margins. Wider margins mean more healthy tissue irradiated: urethra, rectum, bladder neck. That is where the side effects that have historically made radiation a less attractive option come from. The Raypilot® System tracks the prostate 30 times per second and visualises the urethra throughout delivery, enabling tighter margins and that dose plans can spares the urethra and other organs at risk. The geometric uncertainty that has been a weak spot in prostate SBRT, thus, is addressed directly.
30 position updates/second
The position of the prostate is monitored during the entire treatment session.
3D-tracking
Continuous tracking of prostate position and urethra location.
Low imaging dose
The treatment adds no additional imaging dose to the patient from tracking.
The Role of the First Consultation
The first clinical conversation after diagnosis shapes the patient’s understanding of their options. If SBRT, with real-time position control, is presented as a defined, evidence-based pathway, not as a last resort alternative, it becomes a genuine choice. The Raypilot® System supports the accuracy and precision needed to make SBRT a defined first-line pathway: 1-5 consecutive days of treatment, with favourable quality-of-life outcomes and an ever growing body of evidence behind it.
Interested in Bringing SBRT to Your Clinic?
The Raypilot® System is in clinical use at centres across Europe. Get in touch to discuss implementation, visit a reference clinic, or learn more about integrating SBRT into your treatment offering.
Frequently Asked Questions
View all FAQs-
Can patients return to normal activities between sessions?
Yes they can, no hospital stays.
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How does SBRT compare to radical prostatectomy?
Both surgery and radiotherapy cure the cancer itself equally good. What sets them apart is the side effect pattern after treatment.
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What are the most common side effects of prostate SBRT?
Mild urinary and bowel side effects and mild erectile dysfunction.
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Which patients are eligible for SBRT?
SBRT is used for low, intermediate and selected high risk patients. It is up to the doctor to decide which treatment is suitable.
Ready to Explore the SBRT Pathway?
Clinics across Europe are treating patients with The Raypilot® System today. Get in touch to find a clinic near you, learn more about the treatment pathway, or discuss the benefits of short-course SBRT with the Raypilot® System for your practice.