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Topics:
Radiation Oncology • Genitourinary Cancers
Can SBRT be considered for high risk prostate cancer?
Prospective single arm studies with short term follow-up were recently presented in abstract form (Kishan et al, IJROBP, Oct 2017; Mallick et al, IJROBP, Oct 2017) and Katz and Kang previously published 6 year follow-up from ~100 patients with high-risk prostate cancer treated with SBRT as part of a larger prospective trial, although it could be argued that 6-year bPFS was suboptimal (69%) (Katz and Kang, Radiation Oncology, 2014). Is there enough data to offer this approach outside of a clinical trial?
Answer from: Radiation Oncologist at Community Practice
There are many ways to address this question:1. The academic "letter of the law" purist: "If a patient population was included within a clinical trial then the trial results apply to them. Subset analyses are hypothesis-generating."By this logic: HYPO-RT PC enrolled about 11% high-risk disease and s...
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Answer from: Radiation Oncologist at Academic Institution
As someone who does actively enroll patients on a trial investigating SBRT for high risk prostate cancer, I do not think there are enough data available to support treating high risk prostate cancer with SBRT outside of a clinical trial. Patients with high risk prostate cancer have multiple, potenti...
Answer from: Radiation Oncologist at Community Practice
I agree 100% with Dr. @Amar U. Kishan. We shouldn't substitute an investigational option off-trial when we already have multiple effective, safe options. My hope is that SBRT will become a standard for high-risk localized prostate cancer maybe in the near future, but for now we're not there yet, and...