Main Session
Sep
29
PQA 06 - Genitourinary Cancer, Gynecological Cancer, and Health Care Access and Engagement
3350 - Real World Experience of Stereotactic Body Radiotherapy for Carcinoma Prostate in a Tertiary Care Cancer Center in North India
Presenter(s)
Lincoln Pujari, MD, MBBS, DNB - Mahamana Pandit Madan Mohan Malaviya Cancer Centre, VARANASI, UTTAR PRADESH
L. Pujari1,2, P. Giridhar1,2, A. R. Kapoor1,2, N. Gupta3, T. Singla1,2, A. Datta1,2, A. Shinghal1,2, S. Saini1,2, A. Kapoor1,2, and S. Pradhan1,2; 1Mahamana Pandit Madan Mohan Malaviya Cancer Centre, Varanasi, India, 2Homi Bhabha National Institute, Mumbai, India, 3Apex Super Specialty Hospital & Post Graduate Institute, VARANASI, Uttar Pradesh, India
Purpose/Objective(s):
Stereotactic Body Radiotherapy (SBRT) has been shown to provide similar biochemical control with very low Gastro-Intestinal (GI) and Genito-Urinary (GU) toxicity rates in low and intermediate-risk prostate cancer. PACE C trial has shown comparable acute toxicity in patients with intermediate or high-risk prostate cancer who received SBRT as compared to the moderately hypofractionated radiotherapy (MHRT). The present study attempts to analyze the real-world outcome and safety of SBRT in intermediate and high-risk prostate cancer in a tertiary care cancer center in North India.Materials/Methods:
The present study involves an analysis of 43 patients of Carcinoma Prostate treated with SBRT between 1st January, 2021 to 31st March, 2025, with data extracted from a prospectively maintained database at our center. The demographic and clinical details were collected from the electronic medical records, with the treatment and toxicity details being collected from the Radiation Oncology Information System (ROIS) and Eclipse V18.1 planning system. As per institutional protocol, only patients without gross pelvic nodes were treated with SBRT. Target volume included prostate+1 cm or Prostate+whole of seminal vesicle in intermediate risk and high risk prostate cancer, respectively. Pelvic nodes were not treated electively. A total dose of 36.25Gy in 5 fractions was delivered to the target volume every alternate day using dynamic arc therapy with daily online image guidance involving cone beam computed tomography. Patients with intermediate risk and high risk prostate cancer received 6 months and 2 years of androgen deprivation therapy (ADT), respectively. Toxicity was analyzed using RTOG criteria. Survival analysis was done using Kaplan-Meier curves. SPSS V.30 was used to analyze the data.Results:
The median age of the patients was 71years. Median PSA level was 13.4 ng/ml (1.9 - 150 ng/ml). 15 patients (34.1%) had prior Transurethal Resection of Prostate(TURP). As per risk categorization, 15(34.8%) and 28 (65.1%) patients were intermediate risk and high risk, respectively. Acute Grade 2 GU and GI toxicity was documented in 9 (20.9%) and 3(6.9%) patients, respectively. At a median follow-up of 34 months (range: 4-59 months), whereas all 43 patients were alive, only 3(6.9%) patients had progressed. Late Grade 2 GI and GU toxicity was seen in 3 (6.9%) and 2(4.6%) patients, respectively. One patient had Grade 3 late GU toxicity. The predicted 4-year disease-free survival was 91.2%.Conclusion:
Even in real-world clinical settings outside trials, SBRT in intermediate and high-risk patients of prostate cancer appears to be an effective radiotherapy technique. with excellent safety profile. Possible positive results from ongoing prospective randomized controlled trials will further cement the role of SBRT in intermediate and high-risk prostate cancer.