Stereotactic body radiation therapy (SBRT) has become a viable treatment option for the many patients who receive a diagnosis of localized prostate cancer each year. Technological advancements have led to tight target conformality, allowing for high-dose-per-fraction delivery without untoward normal tissue toxicity. Biochemical control, now reported up to 5 years, appears to compare favorably with dose-escalated conventionally fractionated radiotherapy. Moreover, toxicity and quality of life follow-up data indicate genitourinary and gastrointestinal toxicities are likewise comparable to conventional radiation therapy. Nevertheless, because of the long natural history of prostate cancer, extended follow-up will be necessary to confirm these impressive initial results. Within this prostate SBRT review, we explore the detailed rationale for SBRT treatment, the diverse SBRT techniques utilized and their unique technical considerations, and finally data for SBRT clinical efficacy and treatment-related toxicity.
From the *Department of Radiation Medicine, Georgetown University Hospital, Washington, DC; and †Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Finard Basement, Boston, MA.
Conflicts of Interest and Source of Funding: S.P.C. is a paid speaker for Accuray Inc. The remaining authors have no competing interests. The other authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.
Reprints: Sean P. Collins, MD, PhD, Department of Radiation Medicine, LL Bles, Georgetown University Hospital, 3800 Reservoir Rd NW, Washington, DC 20007. E-mail: SPC9@gunet.georgetown.edu.