Last week, the American Urological Association (AUA), the American Society for Radiation Oncology (ASTRO), and the Society of Urologic Oncology (SUO) released collaborative clinical guidelines for managing localized prostate cancer which offers a framework for shared decision-making between physicians and patients. Through this collaboration, the committee provided guidance on active surveillance and on which treatments are appropriate for cancers warranting intervention. The guidelines also include specifics for implementing care options, managing side effects, and administering post-treatment follow-up.
The guidelines are comprised of 68 statements grouped into six categories and include topics such as shared decision making, care options by cancer severity/risk group, recommended approaches/details on specific care options, outcome expectation and management, and future directions.
While the guidelines are inclusive of all treatment options, they contain several positive statements on radiation therapy and are supportive of the use of stereotactic body radiation therapy (SBRT) for low- and favorable intermediate-risk prostate cancer.
The guideline position on single modality external beam radiation for low- to favorable intermediate-risk prostate cancer, which includes IMRT and SBRT, reads: Clinicians may offer single modality external beam radiotherapy or brachytherapy for patients who elect radiotherapy for low-risk localized prostate cancer. Clinicians may offer external beam radiotherapy or brachytherapy alone or in combination for favorable intermediate-risk localized prostate cancer.
The committee deemed these statements as clinical principles, which are statements about a component of clinical care that is widely agreed upon by urologists or other clinicians for which there may or may not be evidence in the medical literature.
At Austin CyberKnife, men diagnosed with prostate cancer are treated with SBRT with the CyberKnife® Robotic Radiosurgery System. CyberKnife is a painless, non-invasive prostate cancer treatment technology in which high-dose radiation is delivered to the tumor from a linear accelerator mounted on a highly maneuverable robotic arm. Hundreds of different angles enable the radiation to be contoured to the shape of the prostate, resulting in treatment aimed directly to the prostate gland, avoiding nearby critical anatomy. This precision reduces treatment time to just five outpatient visits, compared to the average 45 visits conventional radiation therapy requires.