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Current use of stereotactic body radiation therapy for low and intermediate risk prostate cancer: A National Cancer Database Analysis

Prostate Cancer and Prostatic Diseases volume 23, pages 349–355 (2020)Cite this article

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Abstract

Background

Recent studies have demonstrated both safety and efficacy of stereotactic body radiation therapy (SBRT) as monotherapy in the treatment of low and intermediate risk prostate cancer. Our study aims to provide an update analyzing the use of SBRT compared with conventional and hypofractionated regimens in the United States from 2004 to 2015.

Methods

This retrospective review was conducted using the National Cancer Database. We identified 114,931 patients with sufficient diagnostic and treatment information treated with definitive radiation therapy in the United States from 2004 to 2015. The relative utilization of conventional fractionation (defined as 180–200 cGy per fraction and >5 fractions), moderate hypofractionation (defined as >200 cGy per fraction and >5 fractions), and SBRT (defined as >200 cGy per fraction and 5 fractions or less) were compared over the same time period. Logistic regression models were used to estimate trends. Demographic factors were collected and analyzed using chi-squared tests and independent t-tests.

Results

The proportion of prostate cancer patients receiving SBRT increased substantially from 0.9% in 2004 to 19.5% in 2015. Moderate hypofractionation exhibited some growth, increasing from 2.7% of patients to 4.7% in 2015. Conventional fractionation use declined significantly from 96.3% in 2004 to 75.8% in 2015. Notably, there was a sharp decline in the absolute number of patients receiving conventional fractionation in 2011, from 14,699 patients treated in 2009 to 1492 in 2011. Patients treated with SBRT were more likely to be treated in academic centers, younger, and have higher income than other fractionation groups. The most frequently used fractionation schedule was 3625 cGy in five fractions.

Conclusions

The use of SBRT for low and intermediate risk prostate cancer has increased significantly from 2004 to 2015, coinciding with recently published data supporting the efficacy and favorable toxicity profile of this technique.

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Authors and Affiliations

  1. Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL, USA

    Timothy D. Malouff, William C. Stross, Danushka S. Seneviratne, Mark R. Waddle, Byron C. May, Steven J. Buskirk & Katherine S. Tzou

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  1. Timothy D. Malouff
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Correspondence to Timothy D. Malouff.

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Malouff, T.D., Stross, W.C., Seneviratne, D.S. et al. Current use of stereotactic body radiation therapy for low and intermediate risk prostate cancer: A National Cancer Database Analysis. Prostate Cancer Prostatic Dis 23, 349–355 (2020). https://doi.org/10.1038/s41391-019-0191-9

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