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Purpose <p>To assess 2-year biochemical control, radiological progression, late side effects, and survival outcomes following stereotactic body radiotherapy (SBRT) for localized prostate cancer in a multicenter Spanish cohort.</p> Methods <p>A total of 250 patients with localized prostate cancer treated with SBRT across 12 Spanish centers between January 2020 and December 2023 were analyzed. Biochemical recurrence was defined according to the Phoenix criterion (nadir PSA + 2&#xa0;ng/mL). Late genitourinary (GU), gastrointestinal (GI), and sexual adverse events were assessed using the Common Terminology Criteria for Adverse Events (CTCAE) v5.0. Univariate and multivariate analyses were performed to identify factors associated with outcomes. Survival was estimated using the Kaplan–Meier method and the log-rank test (<i>p</i> &lt; 0.05).</p> Results <p>The median age was 72&#xa0;years (IQR: 65–76), and the median baseline PSA was 6.7&#xa0;ng/mL (5.3–8.7). According to the NCCN classification, 30% of patients were low risk, 67% intermediate (26.8% favorable, 39.6% unfavorable), and 3% high or very high risk. The median prescribed dose was 40&#xa0;Gy in five fractions (36.25–40.0), administered on alternate days<i>.</i> At 2 years, biochemical control was 96.4%, and radiological progression occurred in 2.8% of patients, predominantly nodal. The incidence of grade ≥ 2 late adverse events was 7.6% GU, 1.2% GI, and 14.3% sexual.</p> Conclusions <p>SBRT for localized prostate cancer offers excellent 2-year biochemical control with low rates of late adverse events, supporting its safety and effectiveness in routine clinical practice for selected patients. A longer follow-up is warranted to fully characterize long-term outcomes.</p>

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Biochemical control and 2-year tolerability following stereotactic body radiotherapy for localized prostate cancer: a multicenter study in Spain

  • 期刊论文

  • 发表日期：

    2026年2月7日

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  • Sigfredo Elias Romero Zoghbi,
  • Fernando López Campos,
  • Abrahams Ocanto,
  • David Sanz-Rosa,
  • Israel John Thuissard - Vasallo,
  • Cristina Andreu Vázquez,
  • Cristina Laria,
  • Jaume Fernández Ibiza,
  • Jon Andreescu Yagüe,
  • Evita Krumina,
  • Maria Mateos,
  • Maia Dzhugashvili,
  • Luis Alberto Glaría,
  • Daniela Gonsalves,
  • Castalia Fernández,
  • David Esteban,
  • José Begara de la Fuente,
  • José Antonio González Ferreira,
  • Antonio Ristori,
  • Daniel Rivas,
  • Escarlata López,
  • Ana Belén Bezares Alarcón,
  • Loubna Aakki,
  • Luis Larrea,
  • José Ángel García Cuesta,
  • Constantinos Zamboglou,
  • Filippo Alongi,
  • Rafael García García,
  • Felipe Couñago

摘要

Purpose

To assess 2-year biochemical control, radiological progression, late side effects, and survival outcomes following stereotactic body radiotherapy (SBRT) for localized prostate cancer in a multicenter Spanish cohort.

Methods

A total of 250 patients with localized prostate cancer treated with SBRT across 12 Spanish centers between January 2020 and December 2023 were analyzed. Biochemical recurrence was defined according to the Phoenix criterion (nadir PSA + 2 ng/mL). Late genitourinary (GU), gastrointestinal (GI), and sexual adverse events were assessed using the Common Terminology Criteria for Adverse Events (CTCAE) v5.0. Univariate and multivariate analyses were performed to identify factors associated with outcomes. Survival was estimated using the Kaplan–Meier method and the log-rank test (p < 0.05).

Results

The median age was 72 years (IQR: 65–76), and the median baseline PSA was 6.7 ng/mL (5.3–8.7). According to the NCCN classification, 30% of patients were low risk, 67% intermediate (26.8% favorable, 39.6% unfavorable), and 3% high or very high risk. The median prescribed dose was 40 Gy in five fractions (36.25–40.0), administered on alternate days. At 2 years, biochemical control was 96.4%, and radiological progression occurred in 2.8% of patients, predominantly nodal. The incidence of grade ≥ 2 late adverse events was 7.6% GU, 1.2% GI, and 14.3% sexual.

Conclusions

SBRT for localized prostate cancer offers excellent 2-year biochemical control with low rates of late adverse events, supporting its safety and effectiveness in routine clinical practice for selected patients. A longer follow-up is warranted to fully characterize long-term outcomes.