For men with localized prostate cancer, a new study suggests improved rates of noncompletion with stereotactic body radiotherapy (SBRT), rather than conventional fractionation. The study’s results were presented as part of the American Society of Clinical Oncology 2021 Genitourinary Cancers Symposium.

In the study, men with prostate cancer who were treated using primary radiotherapy were identified from the National Cancer Database. Patients were evaluated for whether they had completed radiotherapy, with benchmarks for completion based on the total fractions received using either conventional fractionation or SBRT protocols, and overall survival was also evaluated.

A total of 157,657 patients were identified, and most (95.7%) were treated with conventional fractionation, while 4.3% were treated with SBRT. The noncompletion rate was higher with conventional fractionation, at 12.5%, whereas this rate was 1.9% with SBRT. The odds ratio (OR) for noncompletion with SBRT vs conventional fractionation was 0.21 (95% CI, 0.18-0.26; P <.001). A propensity-adjusted multivariate analysis showed that noncompletion was linked to lower survival (hazard ratio, 1.25; 95% CI, 1.22-1.29; P <.001).


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Several factors were linked to treatment noncompletion, including a racial disparity. Overall, the rate of noncompletion for African American patients was 12.8%, in comparison with a rate of 11.8% for White patients (OR, 1.14; 95% CI, 1.09-1.19; P <.001). By type of radiotherapy, a similar rate of disparity was also found for noncompletion of conventional fractionation (P <.001), but a significant racial disparity did not appear for noncompletion rates with SBRT (P =.34).

The study investigators concluded that, compared with conventional fractionation, SBRT was associated with lower rates of radiotherapy noncompletion in patients with localized prostate cancer and that SBRT did not show the racial disparity seen with conventional fractionation.

Disclosures: Multiple authors declared affiliations with or received funding from the pharmaceutical industry. Please refer to the original abstract for the full list of disclosures.

Reference

Dee EC, Muralidhar V, Arega MA, et al. Factors influencing noncompletion of radiotherapy among men with localized prostate cancer. J Clin Oncol. 2021;39(suppl 16):abstr 199. doi:10.1200/JCO.2021.39.6_suppl.199

This article originally appeared on Oncology Nurse Advisor