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Prostate cancer

Post-Radical Prostatectomy Stereotactic Body Radiotherapy Shows Promise

Strategic Insights

— 1 min read

Research published in JAMA Oncology suggests that post-radical prostatectomy (post-RP) stereotactic body radiotherapy (SBRT) is a well-tolerated treatment for prostate cancer, with patient-reported outcomes (PROs) comparable to those seen after postoperative conventionally fractionated radiotherapy (CFRT). The study, led by John Nikitas, M.D., of the University of California, Los Angeles, examined the treatment's safety and effectiveness in a phase 2 trial involving 100 men with high-risk prostate cancer.

Key Takeaways:

  • Post-RP SBRT is a well-tolerated treatment for prostate cancer, with a cumulative incidence of late grade 2 and 3 genitourinary toxic effects and gastrointestinal tract toxic effects of 25 and 4 percent and 3 and 3 percent, respectively.
  • The longitudinal PROs for men receiving SBRT were comparable to those of 200 men receiving postoperative CFRT, with 38.9, 17.9, and 34.1 percent of patients experiencing decrements more than twofold the minimal clinically important difference (MCID) in PROs for urinary incontinence, urinary irritation, and bowel function, respectively.
  • The adjusted odds ratios for patients receiving SBRT experiencing decrements more than twofold the MCID were not significant when compared with the CFRT cohort for urinary incontinence, urinary irritation, and bowel function.
  • The study found no measurable decline in urinary, bowel, or sexual function through two years compared with a cohort of patients treated using CFRT.

Statistics:

  • 100 men were treated with post-RP SBRT in the phase 2 trial.
  • The patients were followed for a median of 43 months.
  • The cumulative incidence of late grade 2 and 3 genitourinary toxic effects and gastrointestinal tract toxic effects was 25 and 4 percent and 3 and 3 percent, respectively.
  • 38.9, 17.9, and 34.1 percent of patients experienced decrements more than twofold the minimal clinically important difference (MCID) in PROs for urinary incontinence, urinary irritation, and bowel function, respectively.
  • The adjusted odds ratios for patients receiving SBRT experiencing decrements more than twofold the MCID were not significant when compared with the CFRT cohort for urinary incontinence, urinary irritation, and bowel function.

Sources:

  • Nikitas, J, et al. "Patient-Reported Outcomes after Stereotactic Body Radiation Therapy for Prostate Cancer." JAMA Oncology, 2025, doi: 10.1001/jamaoncol.2025.1334.

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