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Can't have brachytherapy? SABR may be the solution.

3/12/2016

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By Dr. Andrew Loblaw, Chair, PCF
 
Based on a consensus agreement of Canadian prostate radiation specialists, “seed” brachytherapy (or internal radiation) should be offered to patients with intermediate and high-risk prostate cancer. Brachytherapy is a highly effective, outpatient, minimally invasive procedure that can be given as a stand-alone treatment or in combination with external beam radiation (Morris J et al, 2013; Morris J et al, 2015; Smith GD et al, 2015).
 
Not all men are candidates for brachytherapy, due to pre-existing medical conditions, enlarged prostates, and/or poor urinary function. Stereotactic Ablative Body Radiotherapy (SABR) is a non-invasive pinpoint radiotherapy technique that appears to be as effective as brachytherapy (Loblaw A et al, 2014) but with better quality of life (Helou J et al 2015). SABR can also be given to many men who can’t have brachytherapy.

SABR is more precise, more convenient and appears to be more effective than standard external beam radiation (Loblaw A et al, 2014). Patients only need five high-precision, non-invasive treatments, compared to the usual 20-39 treatment course.
 
An international clinical trial called PACE (Prostate Advances in Comparative Evidence) opened on February 16, 2016 at Sunnybrook Health Sciences Centre. Dr. William Chu is the Canadian Lead for the study. Patients will be randomly assigned to standard radiation or SABR. Already, two patients have been recruited to the study and six more are lined up.
 
The PACE trial is taking place at 12 cancer centres across Canada. Other centres include: Tom Baker Cancer Centre, Calgary; Juravinski Cancer Centre, Hamilton; London Regional Cancer Centre, London; Jewish General, Rosemount  and Central Sud Hospitals, Montreal; Ottawa Regional Cancer Centre, Ottawa; Northeast Cancer Centre, Sudbury; Odette Cancer Centre and Princess Margaret Cancer Centre, Toronto; Windsor Regional Cancer Centre, Windsor; and CancerCare Manitoba, Winnipeg.
 
The Prostate Cure Foundation and Ride For Dad are co-sponsoring the trial in Canada, helped by generous donations from Astellas, Janssen and Astra Zeneca.
 
Men with favorable-risk prostate cancer who are interested in participating in the SABR Prostate Cancer Trial should contact their oncologist to see if they might qualify for the trial. 

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