Focal Cryoablation, Stereotactic Body Radiotherapy for Prostate Cancer

There was no significant difference in failure-free survival rates between patients with unilateral localized prostate cancer who underwent focal cryoablation and patients who received stereotactic body radiotherapy, according to a recent study. However, patients who received stereotactic body radiotherapy had significantly worse sexual function than patients who underwent focal cryoablation.

The study was led by Ashley Monaco, BS, a medical student at the New York Institute of Technology College of Osteopathic Medicine, and principal investigator, Aaron Katz, MD, of the New York University Long Island School of Medicine. The results were published in International Urology and Nephrology.

The study included patients with prostate cancer who underwent focal cryoablation (n = 68) or received stereotactic body radiotherapy (n = 51) and were eligible for both treatments. Patients who had prior prostate cancer treatment were excluded. The median patient age was 68 years. The median follow-up was 84 months. The study’s primary outcome was treatment failure, defined as salvage treatment, or a Gleason group score of ≥2 on post-treatment biopsy.

Baseline Characteristics and Long-term Outcomes

There was no significant difference in tumor risk (P=.47), Gleason group (P=.20), or prostate-specific antigen (P=.70) between cohorts at baseline. At a seven-year follow up, there was no significant difference in failure-free survival rates between cohorts (P=.70).

Biochemical recurrence at the seven-year follow-up was reported in significantly more patients who underwent focal cryoablation than those who received stereotactic body radiotherapy (P<.001).

At a 48-month follow-up, patients who received stereotactic body radiotherapy had significantly worse sexual function than patients who underwent focal cryoablation (P=.032). There were no differences in urinary or bowel function between groups at the 48-month follow-up.

The therapies were associated with “similar oncologic and functional outcomes” seven years after treatment, which show the utility of both treatments for management of unilateral low-to-intermediate risk prostate cancer, the authors concluded.

Reference

Comparative results of focal-cryoablation and stereotactic body radiotherapy in the treatment of unilateral, low-to-intermediate-risk prostate cancer