A new prostate cancer protocol?

MANHASSET, N.Y.—Louis Potters, M.D., deputy physician-in-chief and chairman of radiation medicine at the Northwell Health Cancer Institute, professor at the Feinstein Institute for Medical Research, recently demonstrated the safety and improved efficacy of increased dosage of radiation when treating prostate cancer, according to a new study published in the February issue of The International Journal of Radiation Oncology, Biology, Physics. Potters and his co-researchers aimed to solve the unanswered question of the optimal radiation dose that should be given to low and intermediate-risk prostate cancer patients.

The investigators from Northwell Health’s Cancer Institute and department of Radiation Medicine focused specifically on stereotactic body radiation therapy (SBRT), a form of radiation therapy that delivers precise amounts of radiation to cancer cells while attempting to minimize damage to healthy tissue. The researchers and clinicians emphasized that with few long-term studies, the cure rate with this technique – as compared to other prostate cancer treatments – remains questionable.

“It is recognized that stereotactic radiation is effective for treating many cancers, such as lung and brain tumors. However, for prostate cancer, we are still searching for the most effective dose of radiation that is both healing and safe. Our study shows that we can be using higher doses than the current standard to achieve greater chances of cure,” said Potters, who collaborated with clinician-researchers Zaker Rana, M.D., Lucille Lee, M.D., and Brett W. Cox, M.D., from the department of Radiation Medicine.

The study prospectively looked at using several different radiation doses. Before using higher quantities, each subgroup of patients was assessed to make sure that the treatment was tolerated. SBRT uses five treatments of radiation — as compared to conventional radiation that may require up to 45 treatments — or seed implant, which is limited to men with medium-to-small prostate glands. The investigators were able to reach the highest dose level safely, with little to no difference in toxicity as compared to lower doses, and a dramatic difference was shown as a result of PSA value, the ultimate marker for treatment success.

“This study has the potential to be game-changer for men and will serve as the foundation for future studies that will impact the current standard of care,” noted Richard Barakat, M.D., physician-in-chief and director of the Cancer Institute and Feinstein Institute professor. “We are excited to see what Dr. Potters’ next chapter of research will bring in the battle against prostate cancer.”

While the researchers note that additional study is necessary to validate their data, they say that this step serves as a foundation for future work looking at higher than standard radiation volume used today.

“With continued, leading-edge research, Dr. Potters’ discoveries may alter how clinicians use stereotactic radiation and treat prostate cancer,” added Kevin J. Tracey, M.D., president and CEO of the Feinstein Institute.