The following is a summary of ”Treatment outcomes of postoperative ultra-hypofractionated stereotactic body radiotherapy in prostate cancer,” published in the May 2023 issue of the Urologic Oncology by Ozyigit et al.

This investigation aimed to assess the safety and efficacy of ultra-hypofractionated stereotactic body radiation therapy (SBRT) in the prostate bed. 66 prostate cancer patients who received postoperative ultra-hypofractionated SBRT between 2018 and 2020 were reviewed retrospectively. All patients received a total dose of 35 Gy delivered in 5 fractions to the prostate bed. Assessing complete biochemical response (BCR), biochemical failure (BF), and acute and late toxicity. 

Seven patients (10.6%) developed BF after a median follow-up of 24.2 months (range: 6.4–37.2), and the 2-year freedom from BF (FFBF) rate was 88.4%. BCR was observed in 57 (86.4%) patients. Patients with pre-SBRT PSA <0.2 ng/mL had a higher 2-year FFBF than those with pre-SBRT PSA ≥0.2 ng/mL (100 vs 81.4%; P = 0.04). Patients with BCR had a 2-year FFBF considerably higher than those without BCR (94.5% vs 58.3%; P <0.001). Pre-SBRT PSA and post-SBRT PSA values were prognostic factors for FFBF in multivariate analysis (P = 0.009 and P = 0.01, respectively). 

Nine patients (13.6%) developed acute and late genitourinary (GU) toxicities of grade 2 at a late onset. There was neither acute nor chronic ≥3 GU toxicity. In 9 (13.6%) and 2 (3%) patients, acute and late grade ≥2 gastrointestinal (GI) toxicity was observed, respectively. In addition to excellent biochemical control rates, postoperative ultra-fractionated SBRT exhibited no severe acute toxicity and about 15% late toxicity rates. The pre-and post-SBRT PSA levels of patients receiving postoperative ultra-fractionated SBRT may predict BCR.

Source: sciencedirect.com/science/article/abs/pii/S1078143922004860