Dr Spratt on Metastasis-Directed Therapy and Hypofractionation in Prostate Cancer

Daniel Spratt, MD, professor, Department of Radiation Oncology, School of Medicine, member, Developmental Therapeutics Program, Case Comprehensive Cancer Center, Case Western Reserve University, highlights two significant shifts in prostate cancer: the integration of radiation therapy for metastatic sites and the trend toward hypofractionation in treatment sessions.

Regarding metastasis-directed therapy, technological advancements have enabled the treatment of multiple metastatic sites concurrently, Spratt begins. Historically, technical limitations have restricted the ability to address numerous lesions effectively; however, with modern technology, such as stereotactic body radiation therapy (SBRT), clinicians can now treat a higher number of metastases within shorter treatment courses. Ongoing trials are exploring the feasibility and efficacy of treating multiple metastatic sites, potentially revolutionizing the approach to metastasis-directed therapy, Spratt explains.

Additionally, there is a growing trend toward hypofractionation in radiation therapy, particularly in the management of localized prostate cancer and the post-operative setting, he continues. Clinical trials are investigating protocols involving lower numbers of treatment sessions, offering patients a more convenient and accessible treatment option. This reduction in treatment sessions not only improves patient convenience but also addresses potential barriers to treatment, particularly for patients who face logistical challenges or live at a distance from treatment centers, Spratt notes.

Furthermore, the adoption of hypofractionated regimens may enhance the acceptance of radiation therapy among referring providers and patients alike, Spratt says. The potential for reduced adverse effects associated with newer treatment modalities may help overcome historical biases and encourage greater utilization of radiation therapy as a primary or adjunctive treatment modality, he explains.

The integration of radiation therapy for metastatic sites and the adoption of hypofractionated treatment regimens represent significant advancements in radiation oncology practice, Spratt continues. These shifts hold promise for improving treatment outcomes, enhancing patient accessibility, and expanding the acceptance of radiation therapy as a viable therapeutic option across various clinical scenarios. Continued research and clinical trials will be essential to further refine and validate these evolving treatment approaches, Spratt concludes.