Combining Therapy with SBRT and Brachytherapy
Richard G. Stock, MD, Professor of Radiation Oncology and Director of Genitourinary Radiation Oncology at the Icahn School of Medicine at Mount Sinai in New York City, discusses the efficacy of SBRT and brachytherapy for treating patients with prostate cancer. He explains that combined SBRT and brachytherapy seems to be particularly helpful for intermediate-risk cancer, with studies showing about a 90% biochemical control rate. Dr. Stock then goes over the rationale for combined SBRT and brachytherapy, noting that brachytherapy combined with external beam radiation therapy (EBRT) at standard fractionation demonstrates excellent and safe outcomes for both intermediate- and high-risk prostate cancer, and SBRT appears to be comparable or better than standard fractionation without increased toxicity. He summarizes the findings of several different studies, explaining that with low-dose-rate brachytherapy and SBRT, researchers are seeing very similar results to using standard fractionation with brachytherapy. Dr. Stock also looks at a recent trial with high-dose-rate brachytherapy with SBRT which found a favorable early toxicity profile and encouraging cancer control outcomes. He concludes that the combination of SBRT and brachytherapy is promising, and the initial clinical impression is that patients tolerate the treatment well.
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