On June 11, the World Prostate Cancer Day and, for this reason, the Spanish Society of Radiation Oncology has highlighted the importance of radiotherapy as a curative treatment for this type of cancer. The renovation of the national technology park in recent years has allowed implement new techniques of stereotaxic body radiation therapy or SBRT and thus reduce the number of radiotherapy sessions, maintaining the very high cure rates of this tumor, without altering the quality of life of patients. In addition, in the last year it has begun to using radiation therapy in people with metastatic disease, which has led to a significant improvement in the survival of these patients.
In Spain 35,126 new cases of prostate cancer were diagnosed in 2020. It is the most common tumor in men and the third cause of cancer mortality, with more than 5,000 deaths annually. However, survival has increased in recent years thanks to improved therapies. One of them is radiotherapy.
Radiation therapy is a well-established curative treatment for localized prostate cancer. In tumors with unfavorable or high-risk prognostic factors, the combined treatment of radiotherapy and hormonal treatment (androgen deprivation therapy) is currently the standard approach.
New scenarios for radiation oncology
Dr. Alfonso Gómez-Iturriaga, coordinator of the urological tumors group (UroncOR) of the SEOR, and radiation oncologist at the University Hospital of Cruces (Vizcaya), explains that, thanks to the renovation of the national radiotherapy technology park and promoted by the pressure of the pandemic, “they have started new treatment techniques in prostate cancer. A large number of hospitals have implemented stereotaxic body radiotherapy or SBRT techniques, which make it possible to reduce the number of radiotherapy sessions from 20-25 to only 5. In addition, the very high cure rates of this tumor are maintained, without altering the quality life of patients ”.
Another of the most notable changes that Radiation Oncology has experienced in the treatment of prostate cancer during the last year is the application of radiotherapy in patients with metastatic disease. Many of these patients, who historically had been treated exclusively with pharmacological therapies, can now be benefit from radiotherapy in local treatments on his prostate tumor, thus allowing greater local control of the disease and a significant improvement in survival.
Gómez-Iturriaga points out that “a secondary analysis of the STAMPEDE study, recently presented at the American Congress of Uro-Oncology, has shown that the patients who benefit the most from local treatment of the prostate with radiotherapy are those with 3 or fewer metastases.”
On the other hand, the situation experienced by most hospitals due to the SARS-CoV-2 pandemic has made it necessary to make important decisions that may impact the routine management of cancer patients.
Gómez-Iturriaga points out that “in prostate cancer, priority has been given to using shorter treatment schemes, also called hypofractionations, preferably based on evidence, depending on the risk group of each patient and taking into account the infrastructure of each center.” And he adds that in this situation it is “crucial to use schemes that maximize efficiency. In this sense, in prostate cancer there is great evidence on the efficacy and safety of hypofractionated schemes ”.