Prostate Cancer

Prostate cancer is the most common malignancy diagnosed in men in the United States. Prostate cancer is hypothesized to have an alpha/beta ratio of <2 offering a potential therapeutic benefit for hypofractionation. In addition to biological reasons, the frequency of prostate cancer and the high health care cost of treatment have led to significant interest in shortening radiation treatment time. For intact prostate cancer, moderate hypofractionation is now considered the standard of care supported by several large randomized trials providing level I evidence for the safety and efficacy of moderate hypofractionation. There has been a more recent interest in stereotactic body radiation therapy (SBRT) for prostate cancer with many single- and multi-institutional studies reporting safety and efficacy for low- and intermediate-risk disease, as well as a recently published phase III randomized trial. SBRT for high-risk patients is an active area of ongoing research. Post-radical-prostatectomy hypofractionation is supported by promising results from NRG GU003 but remains an area of active investigation.