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P Weiner J, Schwartz D, Shao M, et al. Stereotactic radiotherapy of the prostate: fractionation and utilization in the United States. Radiat Oncol J. 2017;35(2):137-143doi: 10.3857/roj.2017.02026.
P Weiner, J., Schwartz, D., Shao, M., Osborn, V., Choi, K., & Schreiber, D. (2017). Stereotactic radiotherapy of the prostate: fractionation and utilization in the United States. Radiation oncology journal, 35(2), 137-143. https://doi.org/10.3857/roj.2017.02026
P Weiner, Joseph, et al. "Stereotactic radiotherapy of the prostate: fractionation and utilization in the United States." Radiation oncology journal vol. 35,2 (2017): 137-143. doi: https://doi.org/10.3857/roj.2017.02026
P Weiner J, Schwartz D, Shao M, Osborn V, Choi K, Schreiber D. Stereotactic radiotherapy of the prostate: fractionation and utilization in the United States. Radiat Oncol J. 2017 Jun;35(2):137-143. doi: 10.3857/roj.2017.02026. Epub 2017 Jun 30. PMID: 28712283; PMCID: PMC5518450.
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Radiat Oncol J. 2017 Jun;35(2):137-143. doi: 10.3857/roj.2017.02026. Epub 2017 Jun 30.

Stereotactic radiotherapy of the prostate: fractionation and utilization in the United States.

Radiation oncology journal

Joseph P Weiner, David Schwartz, Meng Shao, Virginia Osborn, Kwang Choi, David Schreiber

Affiliations

  1. Department of Radiation Oncology, Veterans Affairs New York Harbor Healthcare System, Brooklyn, NY, USA.
  2. Department of Radiation Oncology, Stanford Cancer Institute, Stanford, CA, USA.
  3. Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, NY, USA.

PMID: 28712283 PMCID: PMC5518450 DOI: 10.3857/roj.2017.02026

Abstract

PURPOSE: To analyze the utilization and fractionation of extreme hypofractionation via stereotactic body radiotherapy (SBRT) in the treatment of prostate cancer.

MATERIALS AND METHODS: Data was analyzed on men diagnosed with localized prostate cancer between 2004-2012 and treated with definitive-intent radiation therapy, as captured in the National Cancer Database. This database is a hospital-based registry that collects an estimated 70% of all diagnosed malignancies in the United States.

RESULTS: There were 299,186 patients identified, of which 4,962 (1.7%) were identified as receiving SBRT as primary treatment. Of those men, 2,082 had low risk disease (42.0%), 2,201 had intermediate risk disease (44.4%), and 679 had high risk disease (13.7%). The relative utilization of SBRT increased from 0.1% in 2004 to 4.0% in 2012. Initially SBRT was more commonly used in academic programs, though as time progressed there was a shift to favor an increased absolute number of men treated in the community setting. Delivery of five separate treatments was the most commonly utilized fractionation pattern, with 4,635 patients (91.3%) receiving this number of treatments. The most common dosing pattern was 725 cGy × 5 fractions (49.6%) followed by 700 cGy × 5 fractions (21.3%).

CONCLUSIONS: Extreme hypofractionation via SBRT is slowly increasing acceptance. Currently 700-725 cGy × 5 fractions appears to be the most commonly employed scheme. As further long-term data regarding the safety and efficacy emerges, the relative utilization of this modality is expected to continue to increase.

Keywords: Fractionation; National Cancer Database; Prostate cancer; Stereotactic body radiation therapy; Utilization

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