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Can SBRT be considered for high risk prostate cancer?

Prospective single arm studies with short term follow-up were recently presented in abstract form (Kishan et al, IJROBP, Oct 2017; Mallick et al, IJROBP, Oct 2017) and Katz and Kang previously published 6 year follow-up from ~100 patients with high-risk prostate cancer treated with SBRT as part of a larger prospective trial, although it could be argued that 6-year bPFS was suboptimal (69%) (Katz and Kang, Radiation Oncology, 2014). Is there enough data to offer this approach outside of a clinical trial?
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Radiation Oncology · Case Western Reserve University/ University Hospitals Seidman Cancer Center
Answered on

There are many ways to address this question:

1. The academic "letter of the law" purist: "If a patient population was included within a clinical trial then the trial results apply to them. Subset analyses are hypothesis-generating."

By this logic: HYPO-RT PC enrolled about 11% high-risk disease and s...

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Radiation Oncology · David Geffen School of Medicine at UCLA
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As someone who does actively enroll patients on a trial investigating SBRT for high risk prostate cancer, I do not think there are enough data available to support treating high risk prostate cancer with SBRT outside of a clinical trial. Patients with high risk prostate cancer have multiple, potenti...

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Radiation Oncology · The Oregon Clinic-Radiation Oncology West
Answered on

I agree 100% with Dr. @Dr. First Last. We shouldn't substitute an investigational option off-trial when we already have multiple effective, safe options. My hope is that SBRT will become a standard for high-risk localized prostate cancer maybe in the near future, but for now we're not there yet, and...

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