TOPLINE:
Aggressive margin decrease with MRI-guided stereotactic body radiotherapy (SBRT) resulted in a considerably lower occurrence of late genitourinary and intestinal toxicities at 2 years compared to CT-guided SBRT in males with localized prostate cancer, brand-new information revealed.
METHOD:
- MRI-guided SBRT is understood to decrease preparing margins in prostate cancer and result in less intense toxicity compared to basic CT-guided SBRT. The long-lasting advantages of the MRI-guided technique stay uncertain.
- To learn, scientists performed the stage 3 MIRAGE trial, in which 156 clients with localized prostate cancer were arbitrarily designated to get either MRI-guided SBRT with 2-mm margins or CT-guided SBRT with 4-mm margins.
- The MIRAGE trial at first reported the main result of intense genitourinary grade ≥ 2 toxicity within 90 days of SBRT.
- In this secondary analysis, scientists assessed physician-reported late genitourinary and intestinal toxicity, together with modifications in numerous patient-reported quality-of-life ratings over a 2-year follow-up duration.
TAKEAWAY:
- Over a duration of 2 years, MRI-guided SBRT was related to a considerably lower cumulative occurrence of grade ≥ 2 genitourinary toxicities compared to CT-guided SBRT (27% vs 51%; P =.004). Comparable results were kept in mind for grade ≥ 2 intestinal toxicities (1.4% with MRI vs 9.5% with CT; P =.025).
- Less clients who got MRI-guided SBRT reported degeneration in urinary inflammation in between 6 and 24 months after radiotherapy– 14 of 73 clients (19.2%) in the MRI group vs 24 of 68 clients (35.3%) in the CT group (P =.031).
- Clients getting MRI-guided SBRT were likewise less most likely to experience medically pertinent degeneration in bowel function (chances ratio [OR]0.444; P =.035) and sexual health rating (OR, 0.366; P =.03).
- In between 6 and 24 months after radiotherapy, 26.4% of clients (19 of 72) in the MRI group vs 42.3% (30 of 71) in the CT group reported scientifically pertinent wear and tear in bowel function.
IN PRACTICE:
“Our secondary analysis of a randomized trial exposed that aggressive preparation for margin decrease with MRI assistance vs CT assistance for prostate SBRT resulted in lower physician-scored genitourinary and intestinal toxicity and much better bowel and sexual quality-of-life metrics over 2 years of follow-up,” the authors composed.
SOURCE:
This research study, led by Amar U. Kishan, University of California Los Angeles, was released online in European Urology
CONSTRAINTS:
The lack of blinding in this research study might have affected both physician-scored toxicity evaluations and patient-reported quality-of-life results. In addition, the MIRAGE trial was not particularly created with enough analytical power to assess the secondary analyses provided in this research study.
DISCLOSURES:
This research study was supported by grants from the United States Department of Defense. Numerous authors reported getting grants or individual costs and having other ties with different sources.
This short article was produced utilizing numerous editorial tools, consisting of AI,
