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- Title
Stereotactic radiotherapy of the prostate: fractionation and utilization in the United States.
- Authors
Weiner, Joseph P.; Schwartz, David; Meng Shao; Osborn, Virginia; Kwang Choi; Schreiber, David
- 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 x 5 fractions (49.6%) followed by 700 cGy x 5 fractions (21.3%). Conclusions: Extreme hypofractionation via SBRT is slowly increasing acceptance. Currently 700-725 cGy x 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.
- Subjects
UNITED States; STEREOTACTIC radiotherapy; PROSTATE cancer treatment; DATABASES; DISEASE risk factors; DOSE fractionation; UTILIZATION review (Medical care); MEDICAL care
- Publication
Radiation Oncology Journal, 2017, Vol 35, Issue 2, p137
- ISSN
2234-1900
- Publication type
Article
- DOI
10.3857/roj.2017.02026