Shorter courses of radiotherapy can reduce prostate cancer treatment burden while maintaining cancer control

Prostate cancer can often be cured with radiotherapy if detected at an early stage, but this can involve 20 or more treatment sessions over several weeks.  

Researchers at The Ottawa Hospital are playing a lead role internationally in investigating a newer high-precision approach called stereotactic body radiotherapy (SBRT), which can be delivered in just five treatment sessions – using a somewhat larger dose per session – over one to two weeks.

A new guideline from the American Society for Radiation Oncology recommends this kind of shorter-course radiotherapy for many prostate cancer patients, as evidence shows it can maintain cancer control while reducing overall treatment burden for patients. 

“SBRT has moved from a promising alternative to a standard treatment option for many patients with localized prostate cancer,” said guideline task force chair Dr. Scott Morgan, a radiation oncologist and clinician investigator at The Ottawa Hospital and professor at the University of Ottawa. “These recommendations give clinicians clear direction on using shorter-course treatment safely while preserving the excellent outcomes patients expect from definitive radiotherapy.”

The updated guideline reflects new evidence from large international clinical trials, including the NRG-GU005 trial recently published in JAMA and the PACE-B trial published in NEJM in 2024. Many patients at The Ottawa Hospital participated in these trials, which are now improving care for patients both locally and around the world.  

Patients at The Ottawa Hospital with prostate cancers suitable for SBRT are now often offered treatment using the MR-Linac, which combines an MRI scanner and linear accelerator, allowing custom daily treatment plans and live motion tracking, with the potential for reduced side effects.

Approximately one in eight men will be diagnosed with prostate cancer during their lifetime. When caught early, outcomes are generally excellent, and patients often have several effective approaches to consider based on their individual priorities.