Accuray Incorporated has announced that The Lancet Oncology, a high impact and leading global peer-reviewed oncology journal, has published patient- and clinician-reported outcomes data from the PACE — Prostate Advances in Comparative Evidence — trial in its most recent issue. While further investigation is planned, data reported in the journal indicate that the level of grade 2 or higher acute genitourinary toxicity in the stereotactic body radiation therapy (SBRT) arm of the trial is lower for patients treated with the Accuray CyberKnife® System than it is for patients treated on a conventional linear accelerator.
SBRT involves the delivery of very high doses of externally-administered radiation over a small number of treatment sessions, offering convenience for patients, compared to conventional radiation therapy which requires a substantially longer course of treatment. SBRT is cost-effective for healthcare providers and payers, and also increases patient satisfaction by reducing scheduling inconvenience versus conventional radiation treatments.
In the PACE trial, SBRT was delivered in five sessions while conventional radiation therapy was delivered in 20 or 39 sessions. Both the patient- and clinician-reported toxicity data demonstrate that despite the high dose delivered to the prostate, use of SBRT and conventional radiation therapy resulted in comparable rates of acute gastrointestinal and genitourinary toxicity.
Chief Investigator Dr Nicholas van As, Consultant Clinical Oncologist at The Royal Marsden NHS Foundation Trust, and Reader at The Institute of Cancer Research, London, said: "At The Royal Marsden and the ICR we are focused on developing smarter, better and kinder treatments for patients across the UK and internationally. Developments in radiotherapy such as SBRT mean we can target tumors much more effectively. It is reassuring to see from this trial that SBRT does not significantly impact patients' quality of life in the short term, compared with the current standard of care. Using SBRT to deliver this treatment would mean that patients could be spared numerous visits to hospital, allowing them to get back to their lives sooner."
The prostate gland can move unpredictably — as much as 10 mm in as little as 30 seconds — throughout the course of treatment because of normal patient bodily functions. This makes it critically important to be able to track, detect and correct for all types of motion. The CyberKnife Treatment Delivery System, designed to deliver SBRT, is the only radiotherapy device that can maintain sub-millimetric accuracy with continual imaging and automatic beam delivery corrections, including rotation, throughout treatment delivery, making it easier for clinicians to effectively treat patients while minimizing dose to healthy tissue.
"The patient-reported outcomes, when viewed alongside those of the participating clinicians, provide compelling rationale for treating prostate cancer patients with SBRT, an effective and much more convenient option for patients," said Birgit Fleurent, Chief Marketing Officer of Accuray. "With more than 15 years of expertise and more than 100 peer-reviewed articles, there is robust clinical data supporting the safety and efficacy of CyberKnife SBRT for the treatment of patients with low- and intermediate-risk prostate cancer. And now, with the Accuray Precision® Treatment Planning System and the CyberKnife VOLO™ Optimizer, clinicians are able to significantly reduce both the time to create high quality treatment plans and the time to deliver patient treatments."
About the PACE-B Trial
PACE-B, an international phase 3 randomized controlled trial comparing stereotactic body radiotherapy to conventionally fractionated or moderately hypofractionated external beam radiotherapy (CFMHRT) for localized prostate cancer, represents one arm of a two-part trial. Further data on this arm, as well as the second arm comparing hypofractionated SBRT to prostatectomy, will be shared when available. Out of the 874 patients enrolled by 38 institutions, 845 patients were analyzed; 431 receiving SBRT and 414 CFMHRT. Men who were unsuitable for surgery or preferred treatment with external beam radiation therapy were eligible to participate. The trial evaluated the treatment regimens across multiple effectiveness and safety metrics.
Study in Lancet: CyberKnife prostate patients had lower acute GI toxicity vs those treated on conventional linac. Appl Rad Oncol.