Shorter Radiation Treatment Shows Improved Patient Experience but Similar Disease Control in Intermediate-Risk Prostate Cancer

A recent large-scale phase III trial has demonstrated that for patients with intermediate-risk, localized prostate cancer, delivering radiation therapy in just five sessions notably enhances patient comfort by reducing side effects, although it does not significantly improve disease control compared to longer treatment regimens. The study compared stereotactic body radiation therapy (SBRT), a highly precise technique involving five treatment sessions, with more traditional moderately hypofractionated radiation therapy (MH-IMRT), which spans 20 to 28 sessions.

Participants undergoing SBRT reported fewer declines in bowel, urinary, and sexual functions over two years. Specific benefits included lower instances of bowel dysfunction (34.9% vs. 43.8%) and urinary incontinence (25.9% vs. 34.7%) two years post-treatment. Sexual function improvements were observed at the one-year mark but equalized by two years. These quality-of-life advantages highlight SBRT’s potential for patients prioritizing convenience and reduced side effects.

Despite these benefits, disease progression rates were slightly higher in the SBRT group, with 7.8% experiencing biochemical failure (rising PSA levels) versus 4.2% in the longer-course group, after three years. However, local recurrence and overall survival rates were comparable, with 97% of patients remaining disease-free or alive at the three-year follow-up. Severe genitourinary complications were rare in both groups, indicating that SBRT is a safe alternative.

The trial also examined the role of rectal spacers, which appeared to lessen bowel side effects in patients from both treatment groups, enhancing quality of life.

Led by Dr. Rodney Ellis from the University of South Florida, the study underscores that while shorter radiation courses like SBRT offer significant convenience and quality-of-life improvements, they may require longer follow-up periods to evaluate their full impact on long-term cancer control. Future research will explore SBRT's effectiveness for higher-risk prostate cancers and methods to further minimize side effects.

These findings provide critical insights for patients and clinicians, enabling personalized treatment choices that balance convenience, side effects, and potential disease control. Given the high cure rates and evolving treatment options, patients can now make more informed decisions based on their individual priorities and circumstances.

Source: https://medicalxpress.com/news/2025-09-shorter-patient-disease-intermediate-prostate.html