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Over the last decade, Stereotactic Body Radiation Therapy (SBRT) has emerged as a standard-of-care treatment option for men with localized prostate cancer. Some of the initial literature and rationale was based on the radiobiology of prostate cancer supporting a lower α/β ratio, indicating a high degree of ...

Over the last decade, Stereotactic Body Radiation Therapy (SBRT) has emerged as a standard-of-care treatment option for men with localized prostate cancer. Some of the initial literature and rationale was based on the radiobiology of prostate cancer supporting a lower α/β ratio, indicating a high degree of sensitivity to dose per fraction, as opposed to most other epithelial tumors. To date, several retrospective and prospective randomized studies have validated the use of hypofractionated regimens for the management of localized prostate cancer. More “extreme” hypofractionation, involving SBRT, was based on HDR brachytherapy regimens. The first study on the use of SBRT to deliver HDR-like hypofractionated treatments in the modern era was published in 2007.

Since then, there has been a growing body of literature exploring the effect of SBRT dosing, scheduling schemas, and dose distribution regimens on PSA nadir and kinetics, quality of life parameters, and cost-effectiveness. These studies were primarily retrospective and phase II prospective studies, with randomized data emerging, and with data being reported in high impact publications. A recent longitudinal analysis of accepted prostate cancer presentations at the annual ASTRO meetings from 2000 to 2017 demonstrated that SBRT became the most common treatment technique represented in prostate cancer abstracts. A consensus statement involving ASTRO, ASCO, and AUA updated their Evidence-Based Guidelines regarding hypofractionated radiation therapy to indicate that SBRT for prostate cancer is an alternative option to conventional fractionation. Concordant with its topicality in clinical guidelines involving local disease, the use of prostate SBRT for metastatic disease and of SBRT to sites of oligometastatic disease is also emerging, with favorable prospective publications.

The goal of this Research Topic is to provide a compendium of manuscripts that address this exciting landscape and highlight explored and future directions involving the use of SBRT for managing prostate cancer. We welcome Original Research and Review articles focused, but not limited to, the following areas:

1) Prostate SBRT dose and techniques associated with biochemical outcomes;
2) Quality of Life topics involving Prostate SBRT;
3) Comparative outcomes involving prostate SBRT with conventional and hypofractionated radiation regimens;
4) Dose escalation trials involving prostate SBRT;
5) SBRT in the management of unfavorable and metastatic prostate cancer.

Keywords: Prostate cancer, SBRT, Stereotactic radiotherapy, Radiosurgery, hypofractionation


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