New Guideline for Treating Prostate Cancer Issued by 3 Top Medical Societies

by | Oct 20, 2018 | Prostate Cancer

Stronger, Shorter Courses of Radiation Therapy, like CyberKnife Should be Offered to Men Undergoing Treatment for Localized Prostate Cancer. 

This According to the American Society For Radiation Oncology (ASTRO), American Society Of Clinical Oncology (ASCO) and the American Urological Association (AUA).

CyberKnife also known as Stereotactic Body Radiation Therapy (SBRT) can be done in 5 treatment sessions over 10 days compared to 42 treatments over 3 months with other types of radiation therapy known as (EBRT) or External Beam Radiation Therapy.

“Conclusive evidence from several large, well-designed randomized trials now confirms that dose escalation can almost universally benefit men with early-stage prostate cancer who choose to manage their disease with external radiation,” Howard Sandler, MD, co-chair of the guideline panel, said in a prepared statement issued by ASTRO. 

“Significant advances in treatment planning and delivery have enabled oncologists to deliver more powerful, life-saving doses of radiation in fewer visits and without compromising quality of life.”

“This recommendation represents the acceptance of the excellent data that has now been gathered, validating the efficacy of  using CyberKnife SBRT for treatment of many early stage prostate cancers.” Says Dr. James Schwade Executive Director of the Cyberknife Center of Miami – The Beam Of Life

Below is a link to the new guideline & here’s the breakdown.


Based on high-quality evidence, strong consensus was reached for offering moderate hypofractionation across risk groups to patients choosing external beam radiation therapy. 

The task force conditionally recommends ultrahypofractionated radiation may be offered for low-and intermediate-risk Prostate Cancer but strongly encourages treatment of intermediate-risk patients on a clinical trial or multi-institutional registry. 

For high-risk patients, the task force conditionally recommends against routine use of ultrahypofractionated external beam radiation therapy. 

With any hypofractionated approach, the task force strongly recommends image guided radiation therapy and avoidance of nonmodulated 3-dimensional conformal techniques.

According to the three medical societies, hypofractionated external beam radiation therapy (EBRT) can shorten cancer treatments and provide more convenience to patients. 

The new guideline was published in Practical Radiation Oncology, Journal of Clinical Oncology and The Journal of Urology.

The guideline was developed by an expert-panel of physicians, researchers and a patient advocate. 

They reviewed 61 studies published from December 2001 to March 2017, including four large randomized clinical trials consisting of more than 6,000 patients.

These specific recommendations apply to male patients who need or prefer treatment instead of monitoring and have opted for EBRT instead of other treatment options specific to localized prostate cancer. 

Key recommendations include:

EBRT patients should be provided with the option of moderate hypofractionation as an alternative to traditional fractionation—regardless of their risk, age, anatomy or urinary function.

Physicians must counsel patients about the increased risk of short-term gastrointestinal toxicity and also communicate the limited amounts of data related to oncologic outcomes five years post treatment.

Ultrahypofractionation guidance will depend upon prostate-cancer risk. 

Low-risk patients can use hypofractionation as an alternative to traditional fractionation. Intermediate-risk patients should be treated as part of a clinical trial or multi-national registry. High-risk patients should not be offered ultrahypofractionation outside of a trial or registry.

“Hypofractionated radiation therapy provides important potential advantages in cost and convenience for patients, and these recommendations are intended to provide guidance on moderate hypofractionation and ultrahypofractionation for localized prostate cancer,” the guideline panel wrote in their guideline article. 

“The limits in the current evidentiary base—especially for ultrahypofractionation—highlight the imperative to support large-scale randomized clinical trials and underscore the importance of shared decision making between clinicians and patients.”

“Men who opt to receive hypofractionated radiation therapy will be able to receive a shorter course of treatment, which is a welcomed benefit to many men. 

When clinicians can reduce overall treatment time while maintaining outcomes, it’s to our patients’ benefit, as they can spend less time away from family and less time traveling to and from treatment,” said Scott Morgan, MD, FRCPC, co-chair of the guideline panel in the same prepared statement issued by ASTRO.

Talk to our cancer experts at CyberKnife Miami to learn more 305-279-2900