Photo Credit: Dr Microbe

The following is a summary of “Stereotactic Body Radiation Adoption Impacts Prostate Cancer Treatment Patterns,” published in the August 2024 issue of Urology by Stencel et al.

This study aimed to assess the adoption of stereotactic body radiation therapy (SBRT) for prostate cancer and its impact on treatment patterns. As evidence supporting SBRT’s effectiveness continues to grow, its integration into clinical practice and its influence compared to other prostate cancer treatments remain unclear.

Data was extracted from the SEER-Medicare database, focusing on patients diagnosed with localized prostate cancer between 2008 and 2017. The study identified physician networks by tracking the primary treating physician for each patient and linking them to their respective practices. Trends in prostate cancer treatment were analyzed within networks that either adopted or did not adopt SBRT, utilizing chi-squared tests and logistic regression models.

The analysis included 35,972 patients treated for prostate cancer across 234 physician networks. Of these, 30,635 patients were treated in non-SBRT networks (n=190), while 5,337 received treatment in SBRT networks (n=44). Patients in SBRT networks were more likely to reside in metropolitan areas with populations of 1 million or more (70% vs. 46%, p<0.001), have a higher median income exceeding $60,000 (62% vs. 42%, p<0.001), and be located in the Northeast (35% vs. 12%) or West (40% vs. 38%, p<0.001) compared to those in non-SBRT networks. Within SBRT networks, a higher proportion of patients received intensity-modulated radiation therapy (IMRT) (31% vs. 23%), while fewer underwent prostatectomy (16% vs. 23%) or active surveillance (15% vs. 19%) compared to non-SBRT networks. Notably, Black men were found to be 45% less likely to receive SBRT (OR=0.55, CI: 0.36-0.85) compared to White men.

The utilization of SBRT is on the rise in the treatment of prostate cancer, with significant variations in treatment patterns observed between networks offering SBRT and those that do not. The study also highlighted potential disparities, as SBRT appears to be less accessible to certain patient groups, particularly Black men, raising concerns about emerging inequities in the availability of this novel treatment option.

Source: sciencedirect.com/science/article/abs/pii/S0090429524006393