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KMID : 1038620170350020137
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Radiation Oncology Journal
2017 Volume.35 No. 2 p.137 ~ p.143
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Stereotactic radiotherapy of the prostate: fractionation and utilization in the United States
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Weiner Joseph P.
Schwartz David
Shao Meng
Osborn Virginia
Choi Kwang
Schreiber David
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Abstract
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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.
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KEYWORD
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Prostate cancer, Stereotactic body radiation therapy, Fractionation, Utilization, National Cancer Database
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