After comprehensive research over a two-year period, scientists have discovered that MRI-guided stereotactic body radiotherapy (SBRT) for prostate cancer notably decreases long-term side effects and enhances quality of life, especially regarding bowel and sexual health, in comparison to traditional CT-guided treatment.
Researchers from the UCLA Health Jonsson Comprehensive Cancer Center have conducted a thorough two-year follow-up and found that MRI-guided stereotactic body radiotherapy (SBRT) for prostate cancer greatly reduces long-term side effects and enhances quality of life, particularly in the areas of bowel and sexual health, when compared to standard CT-guided treatment.
According to Dr. Michael Steinberg, a professor and chair of Radiation Oncology at the David Geffen School of Medicine at UCLA, as well as the director of Clinical Affairs at the UCLA Health Jonsson Comprehensive Cancer Center and the senior author of this study, “The MIRAGE trial is currently the only randomized trial comparing advanced technologies in radiation oncology. The intent was to determine if MRI-guided SBRT results in lower toxicity compared to CT-guided SBRT.”
The research group performed a secondary analysis of the phase 3 clinical trial known as MIRAGE, aiming to assess how MRI guidance impacts the delivery of high-precision radiation therapy for prostate cancer. Radiation therapy is a conventional treatment for localized prostate cancer, but it can lead to serious and prolonged side effects that affect urinary, bowel, and sexual functions. Using MRI guidance allows for more accurate targeting of the tumor, leading to smaller planning margins around the prostate and minimizing damage to nearby healthy tissues. This method was juxtaposed with the traditional CT-guided SBRT, which generally necessitates larger treatment margins.
The findings revealed that participants who underwent MRI-guided SBRT reported significantly fewer urinary and bowel side effects. Specifically, only 27% of MRI-guided patients experienced moderate to severe urinary problems, like incontinence and irritation, compared to 51% in the CT-guided group. Additionally, gastrointestinal issues occurred in just 1.4% of MRI-guided patients versus 9.5% in those treated with CT guidance. Furthermore, MRI guidance corresponded with improved scores on various quality-of-life assessments, particularly concerning bowel function and sexual health.
These results signify a promising development in the treatment of prostate cancer, indicating the potential for MRI-guided radiation therapy to enhance patient outcomes.
“This research provides compelling evidence that the increased precision and accuracy of MRI-guided SBRT significantly reduces urinary, bowel, and sexual side effects for men undergoing this treatment,” emphasized Dr. Amar Kishan, the executive vice chair of radiation oncology at the David Geffen School of Medicine at UCLA and the study’s first author. “With the MRI-guided technique, we can track the prostate in real time and utilize an integrated MRI during radiation delivery, allowing us to use much narrower planning margins, resulting in less exposure of normal tissues to radiation. Consequently, this approach decreases the likelihood of long-lasting side effects that could negatively affect a patient’s quality of life.”
