PCRI’s Executive Director, Mark Scholz, MD, talks about stereotactic body radiation therapy (SBRT) as a treatment for men with the Teal stage of prostate cancer. He compares it with other forms of external beam radiation like IMRT and PBRT.
0:16 External beam radiation therapy involves going to a radiation facility and sitting in front of a radiation machine for a brief period of time, daily (Monday-Friday) until the treatment course is complete. Standard radiation treatment takes anywhere from 5-9 weeks. SBRT is different because radiation is given in larger doses each visit. So treatment can be completed in as short as one week. This is considerably more convenient.
1:21 SBRT has been studied for the past 10 years. There were concerns about delivering higher doses. Cure rates appear to be similar to other forms of external beam radiation. Serious side effects, just as with any other form of radiation include impotence or erectile dysfunction, which is equivalent between SBRT and standard radiation. Radiation therapy poses a small but significant risk of proctitis, a non-healing burn to the rectum. Instances of this appear to be higher with SBRT. But a new product called SpaceOAR can help alleviate this by creating space between the prostate and the rectum. So, since the cure rates are equal and the side effects are similar, the convenience compared to other external beam radiation therapy options makes it a favorable choice.
3:09 Will SBRT replace IMRT or IMPT? The treatment is moving in the direction where it could be used as a focal therapy. All current forms of external beam radiation, including SBRT target the entire prostate. In the future, it may be possible to use SBRT to target the tumor within the prostate, but this is still a new concept and is not yet widely available. But treating the prostate is not the only use for IMRT or IMPT. These forms of radiation are often used to target the pelvic lymph nodes as well, and currently, it has not been determined whether or not SBRT should be used in this context. Further unanswered questions are whether it should be used in combination with brachytherapy, or if it can be a replacement for brachytherapy.
4:35 When performed by an expert, SBRT can be an attractive and effective treatment option.
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