A new Canadian trial designed and led by Sunnybrook Health Sciences Center will determine whether stereotactic ablative body radiotherapy (SABR) can replace standard brachytherapy augmentation for men with unfavorable-risk prostate cancer.
The trial, called ASCENDE-SBRT, aims to see around 710 participants randomized to receive five sessions of SABR or 23 sessions of whole pelvis radiation and a brachytherapy boost.
SABR involves higher-dose treatments per day, delivered with extreme precision to target tumors. Brachytherapy is a form of targeted radiation that sees a small radioactive seed temporarily placed inside the prostate. Five SABR treatments are now the standard of care for patients with favorable-risk prostate who are not eligible for active surveillance.
This new trial will look at the benefits to patients and the healthcare system of using this course of treatment for patients with higher-risk prostate cancer. Dr. Andrew Loblaw, a radiation oncologist and scientist at Sunnybrook, will lead the work along with Drs. Wendy Parulekar and Keyue Ding of the Canadian Cancer Trials Group (CCTG).
“This could mean fewer hospital visits, less travel, less parking, less disruption to employment and other aspects of life,” Dr Loblaw said. “We suspect it could save the health care system more than $30 million annually, while increasing treatment capacity and reducing wait times.”
Previous Sunnybrook research for favorable-risk patients has also found that men who undergo five SABR treatments have better sexual and bladder function after treatment compared with brachytherapy, he added. The trial will determine whether this is also true for unfavorable risk patients.
This trial has received a $4.5 million grant from the CIHR and will be run by the CCTG at centers across Canada.