Dr. Horwitz on the Evolution of Radiation Therapy in Prostate Cancer

Eric M. Horwitz, MD, FABS, FASTRO, chair of radiation oncology, professor, and Gerald E. Hanks Endowed Chair in Radiation Oncology at Fox Chase Cancer Center, discusses the evolution of radiation therapy in prostate cancer.

Modern prostate cancer care includes the use of short-course radiotherapy, whereas earlier techniques included an 8- to 9-week course of radiation therapy, Horwitz says. Longer courses of radiation therapy are now rarely used, except for in patients who have a physically large prostate, and significant baseline urinary symptoms, he explains. 

The current standard of care at Fox Chase Cancer Center is 2.5 weeks of external radiation with stereotactic body radiation therapy. As Horwitz's institution is a radiation implant center, temporary high dose rate prostate implants are utilized, as well. While not new, these devices are not commonly utilized in the United States, as they call for more infrastructure, which Fox Chase Cancer Center has access to within their facility.

Implants are administered in patients who have small prostate cancer, typically consisting of 2 treatments that are 1 week apart. For men with bigger cancers, intensity-modulated radiation therapy will be combined with the implant, a strategy that is supported by data that has read out within the United States and globally, Horwitz concludes.