Phase 3 Randomized Trial Data Shows SBRT has Similar Acute Safety Profile to Conventional Radiation Therapy in Patients with Localized Prostate Cancer
SBRT involves the delivery of very high doses of externally-administered radiation over a small number of treatment sessions, offering convenience for patients, compared to conventional radiation therapy which requires a substantially longer course of treatment. In the PACE trial, SBRT was delivered in five sessions while conventional radiation therapy was delivered in 20 or 39 sessions. The Phase 3 trial found that despite the high dose delivered to the prostate, use of SBRT and conventional radiation therapy result in comparable rates of acute gastrointestinal and genitourinary toxicity.
"There has been considerable discussion and analysis of the risks versus the benefits of different radiation treatment techniques, especially in patients with low- or intermediate-risk prostate cancer, in large part because the side effects of treatment can impact quality of life. One of the clinical trial goals was to determine whether SBRT or a more conventionally fractionated radiotherapy schedule would provide a safer treatment choice," said Nicholas van As, M.D., Medical Director and Consultant Clinical Oncologist of The Royal Marsden NHS Foundation Trust and Reader at the ICR,
The prostate gland can move unpredictably throughout the course of treatment because of normal patient bodily functions. This makes it vitally important to be able to track, detect and correct for all types of motion. The CyberKnife® System, designed to deliver SBRT, is the only radiotherapy device that can track and automatically correct for prostate motion and maintain sub-millimeter accuracy throughout treatment delivery, thereby enhancing clinicians' ability to treat effectively while preserving healthy tissue.
"The results of this randomized controlled trial add to the large body of evidence supporting the use of SBRT as a treatment option for low- and intermediate-risk prostate cancer. The data are important because they have the potential to impact clinicians' approach to the treatment of this disease," said Fabienne Hirigoyenberry-Lanson, Ph.D., Vice President Global Medical and Scientific Affairs at
About the PACE-B Trial
PACE-B, an international phase 3 randomized controlled trial comparing stereotactic body radiotherapy to conventionally fractionated or moderately hypofractionated external beam radiotherapy (CFMHRT) for localized prostate cancer, represents one arm of a two-part trial. Further data on this arm, as well as the second arm comparing hypofractionated SBRT to prostatectomy, will be shared when available. Out of the 874 patients enrolled by 38 institutions, 845 patients were analyzed; 431 receiving SBRT and 414 CFMHRT. Men who were unsuitable for surgery or preferred treatment with external beam radiation therapy were eligible to participate. The trial evaluated the treatment regimens across multiple effectiveness and safety metrics; toxicity measures were presented at ASCO GU.
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