Image-Guided Adaptive Radiation Treatments Reduces Short-Term Side Effects in Patients With Prostate Cancer

Researchers of a recent systematic review and meta-analysis have found that image-guided adaptive radiation treatment for prostate cancer is associated with a reduced risk of short-term urinary and bowel side effects.

Stereotactic body radiotherapy (SBRT) is a non-invasive treatment for prostate cancer that, the authors note, is gaining wider acceptance for use. However, there are uncertainties about the treatment's toxicity risk. Magnetic resonance imaging-guided daily adaptive prostate SBRT (MRg-A-SBRT) offers “technological advantages in [the] precision of radiation dose delivery,” according to the study’s authors. In their study, the researchers compared the toxicity rates of MRg-A-SBRT and computed tomography-guided non-adaptive prostate SBRT (CT-SBRT).

In their study, the researchers compared the effects of MRg-A-SBRT and CT-SBRT in acute grade 2 or higher (G2+) genitourinary (GU) and gastrointestinal (GI) toxicity in patients. The researchers identified 29 prospective clinical trials for a total of 2547 patients.

The results showed that MRg-A-SBRT reduced short-term urinary and bowel side effects by 44% and 60%, respectively, when compared to CT-SBRT. Further, on meta-regression, the researchers found that the odds ratio for acute G2+ GU and GI toxicities when comparing MRg-A-SBRT and CT-SBRT were 0.56 and 0.40, respectively.

“MRg-A-SBRT is associated with a significantly reduced risk of acute G2+ GU or GI toxicity compared to CT-SBRT,” the researchers concluded. “Longer follow-up will be needed to evaluate late toxicity and disease control outcomes.”

Reference:

Leeman JE, Shin KY, Chen YH, et al. Acute toxicity comparison of magnetic resonance-guided adaptive versus fiducial or computed tomography-guided non-adaptive prostate stereotactic body radiotherapy: a systematic review and meta-analysis. Cancer. 2023;129(19):3044-3052. doi:10.1002/cncr.34836