Stereotactic radiotherapy for prostate cancer: A review and future directions

Not sure if this has been posted already, but I just ran across the article and thought this was worth sharing. It's generally positive, if somewhat cautious, towards SBRT.

The link is for a free full-text article. It has a lot of information, and as usual it's important to do your own research. I make no judgement, and am not vouching for any aspect of this article, just presenting it for information.

Here's the Conclusion:
Initial studies examining the use of SBRT in the treatment of prostate cancer have demonstrated impressive rates of biochemical recurrence-free survival and PSA response, while maintaining a relatively favorable acute toxicity profile. Doses of 8 Gy or less per fraction have lower reported rates of toxicity with similar biochemical control rates compared to higher doses per fraction. Though we are cautiously optimistic that SBRT has the potential to serve as an alternative to conventionally fractionated RT in the treatment of prostate cancer, long-term follow-up is needed in order to evaluate whether biochemical control, overall survival, and late toxicity are maintained, or improved, as compared to the current standard of care.

Stereotactic radiotherapy for prostate cancer: A review and future directions

What did most of the folks in your support group choose?

Back then it must have been open surgery or older RT with lower doses?

Turboz - most of the guys I'm referring to had surgery but several had "conventional" beam radiation or low-dose seeds. I think the lack of today's better imaging tools worked against them all, and the older radiation methods were not as precise as today's, and the dosage was probably less.

Progress in medical science is usually a good thing, I think.

All these technology-based treatments have and will continue to progress nearly exponentially in effectiveness and utilization.

The IMRT of today is improved over the IMRT I was treated by in 2017. The computer controls, collimator controls, imaging etc. is greatly improved and will continues to do so. Brachytherapy, both seeds and HDR are better today than in the past due to improving technology. Basically SBRT is to IMRT as HDR is to seeds. Better use of technology to deliver more efficient, effective and less damaging treatment.

Since radiation-based therapies are so technology driven, we should expect to see continued improvement and better treatments for patients. Many cancers and other conditions no longer use surgery as the radiation-based treatments and diagnostic methods have become so much better than surgery. SBRT and HDRBT are used in many cancers other than PCa to effectively treat patients. Particularly in cancers that surgery is very difficult like the brain, head and neck, gynecological and urological. Twenty five years ago it was common place to hear that someone was having exploratory surgery to see what was wrong. Today exploratory surgery is so rare you hardly ever hear of it. Go back and watch reruns of StarTrek and see how Bones never used surgery to treat the patients. Technology had taken over and he had no need to cut.

I agree with TallAllen when he says there is absolutely no reason to use traditional IMRT/IGRT for initial treatment for PCa when SBRT is available. Five fraction versus 25-40? Absolute no-brainer.