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Shorter-Course Radiation Therapy for Prostate Cancer

Xinglei Shen, MD

October 07, 2019

Typically, image-guided radiation therapy (IGRT) and intensity-modulated radiation therapy (IMRT) for prostate cancer takes 8 to 9 weeks to complete the standard 40 to 45 treatments. Each treatment in this protocol is a relatively small dose of radiation.

An alternative is to give fewer treatments at higher doses. This is the idea behind a shorter-course radiation therapy called hypo-fractionated radiation. In hypo-fractionated treatment, slightly higher doses of radiation are given during each treatment, but fewer treatments are necessary. In this approach patients receive 20 to 28 treatments over a period of four to six weeks.

Benefits of shorter-course radiation therapy

Building upon this idea, a new type of radiation therapy protocol at The University of Kansas Cancer Center is making prostate cancer treatment shorter and more manageable, with less exposure to radiation. Furthermore, it has comparable side effects and outcomes to longer treatment schedules.

SBRT, or stereotactic body radiation therapy, takes the approach of less total radiation to a new level. With SBRT, prostate cancer patients receive a much larger dose of radiation for each visit, but a lower overall dose than even our current shorter courses of radiation deliver.

That means patients can complete SBRT treatment in just 5 visits. We usually administer SBRT treatments every other day so our patients are done in a little less than 2 weeks — not the 5 1/2 of our current IGRT and IMRT courses (or up to 9 weeks under the old method).

SBRT allows for radiation treatments that are much more convenient for men’s work and home lives. It’s less disruptive to deal with appointments for a couple of weeks than it is for more than a month. Men can get in, get their treatments and get back to their regular routines much faster. Not every man is a candidate for this type of procedure, but we screen patients to see if they may be good candidates.

SBRT has been used to treat prostate cancer for 10 to 15 years. Researchers are still collecting data about the treatment’s long-term results compared to other forms of radiation therapy, but outcomes so far have been promising. Patients who have had SBRT have similar results for cancer control, and side effects 5 and 10 years after treatment compared to those who have had standard radiation therapy.

Prostate cancer patients always have choices. Our top priority as a radiation oncologist is to help our patients find the choice that best fits their lives and goals. As treatments and technology for radiation therapy continue to develop, we are hopeful that we’ll be able to help more men overcome prostate cancer faster and get back to their normal lives.

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