Stereotactic Body Radiation Therapy (SBRT)
Stereotactic body radiation therapy (SBRT) precisely targets tumors with very high doses of radiation. It is also known as stereotactic ablative radiotherapy and stereotactic ablative body radiation (SABR).
SBRT can cure early-stage cancer by destroying the tumor. It can also shrink tumors, stop the spread of disease and even stimulate the body’s immune system to fight cancer.
It is used against smaller tumors and is often a treatment for lung cancer, prostate cancer and kidney cancer.
Doctors also use SBRT to treat other cancers that have spread, or metastasized, to different parts of the body. This includes oligometastatic disease, in which a patient has just a few metastatic growths. In these cases, SBRT may stop the disease from spreading more and extend the patient’s life.
Patients may choose SBRT instead of surgery in some cases. This lets them avoid a hospital stay, a recovery period and other aspects of surgery. The treatment also may be an option for patients who are not healthy enough for surgery.
One common side effect of SBRT is fatigue. Other side effects depend on the tumor’s location. A patient treated for an abdominal tumor may have gastrointestinal side effects. A patient with a tumor near a bone could experience bone damage.
How does SBRT work?
SBRT uses several radiation beams of different strengths that are aimed at the tumor from various angles.
This requires one or more treatment planning sessions. During these sessions, the patient will undergo a CT scan, MRI and/or other?imaging exams. Doctors use these images to map the tumor’s exact location and shape. They then create a customized treatment plan that sets the angles and intensities of the radiation beams.
If the tumor is in or near the lungs the care team will also make a video of the patient breathing. The doctor will use the video to factor motion into the treatment plan. Patients may be asked to hold their breath for short periods while the video is being created and during treatment.
The care team will also make a mold of the patient’s body near the tumor. The mold puts the patient in a position that makes treatment most effective. It also holds the patient still during treatment. This ensures the tumor gets the full dose of radiation. Damage to nearby healthy tissue is minimized.
After planning, patients undergo between one and five SBRT sessions. Sessions take place either once a day or once every other day. Most last about 30 minutes.
SBRT at MD Anderson
Radiation therapy is a pillar of cancer treatment. Some radiation oncologists treat cancers all over the body. Radiation oncologists at MD Anderson focus on specific types of cancer. This gives them incredible expertise when caring for patients.
They use this knowledge when treating patients with SBRT. This treatment can have different goals, from curing patients to stopping cancer’s spread. Knowing what is possible is key to a successful treatment.
Once a goal is set, doctors then develop a treatment plan. Our radiation oncologists are experts in the diseases they treat and SBRT itself. They design SBRT plans to limit damage to nearby healthy tissue while fighting the cancer as much as possible.
Our radiation oncologists also partner with surgeons and medical oncologists who focus on the same cancer. They work together to coordinate care and develop treatment plans tailored to each patient.
And at MD Anderson, patients are surrounded by the strength of one of the nation's top-ranked cancer centers. From support groups to physical therapy to integrative medicine care, we have all the services needed to treat the whole person – not just the disease.
Prostate cancer survivor grateful for stereotactic body radiation therapy (SBRT)
With a family history of prostate cancer, Keith Burchfield did not wait to talk to his doctor about the risks and benefits of early prostate cancer screening.
At his yearly exam, his prostate-specific antigen (PSA) levels had significantly changed since the previous year. There was a 50% chance that he had early-stage prostate cancer. PSA levels show up through a blood test that measures the amount of PSA circulating in the blood. This level is used to assess prostate cancer risk.
Knowing MD Anderson is the?top cancer hospital in the nation, he? online right away. “I live in the Dallas area and was willing to make the 4-hour drive for the expertise and top treatment options,” says Keith. “I did not want to waste any time.”
Finding expertise and reassurance at MD Anderson
Keith’s first appointment at MD Anderson was scheduled in November 2020, during the COVID-19 pandemic. He met with urologist ,?who ordered an MRI to be done in Dallas so Keith could be close to home.
After the MRI, Gregg confirmed Keith had four lesions. The previous hospital had only detected three. Keith had a biopsy at MD Anderson, then went back to Dallas to wait for his results. Shortly thereafter, Gregg called to let Keith know that the biopsy confirmed he had stage II prostate cancer.
Gregg outlined Keith’s prostate cancer treatment options: surgery,?radiation therapy or active surveillance?– also known as watchful waiting. “Dr. Gregg answered all my questions with great care. This helped me and my wife, Judy, decide what type of treatment was best for me,” says Keith.
He did not want to postpone treatment by choosing active surveillance. He also didn’t want to face the possibility of side effects from surgery. So, Keith chose radiation therapy. He knew he had a window of opportunity and did not want to wonder if the cancer would become aggressive.
“I was presented with the gift of early detection and wanted to do something as soon as possible,” he says.
Undergoing SBRT for prostate cancer treatment
In February 2021, Keith traveled to Houston to meet with radiation oncologist , and Sarah Todd, her physician assistant at the time.
“Dr. Hoffman and Sarah took the time to explain the types of radiation therapy treatments that I qualified for,” remembers Keith. Each radiation type uses a different number of treatments, either daily radiation for weeks or a short-term radiation for five sessions.
After talking it over with his wife, Keith decided to undergo a short-term radiation therapy called stereotactic body radiation therapy (SBRT). SBRT typically consists of five treatments using a high dose of radiation to treat the tumor’s exact location and shape. A customized treatment plan sets the angles and intensities of the radiation beams.
Keith decided to commute to Houston from Dallas for his five daily SBRT treatments. It happened to be the week of the February 2021 winter storm, an historic winter weather event in Houston resulting in road closures, widespread power outages, loss of heat and broken pipes across Texas.
“I am very thankful that Dr. Hoffman and Sarah are so easy and wonderful to work with. They stayed in continuous communication with me. They made sure I was able to stay on track with my treatments during the bad winter storm – even treating me on a Saturday to make up a missed appointment during the week,” he says.
Keith does not recall experiencing any significant side effects from SBRT. “While every treatment has side effects, I did not notice anything out of the norm from treatment. I had energy to drive back and forth each day,” he says. “And the staff accommodated my travel schedule and arranged my appointments for later in the morning or early afternoon.”
Cherishing every moment after successful SBRT
Three years after treatment, Keith continues to enjoy life after cancer. He meets with Todd every six months to review his PSA levels via a telehealth visit and make sure his prostate cancer stays in remission. In July, he will switch to annual visits.
“My father was diagnosed with stage IV prostate cancer many years ago when they did not have the technology and treatment options available today,” says Keith. “I’m thankful for the advances in radiation therapy.”
Keith is glad he got annual exams to keep an eye on his PSA levels. Most people with stage I or II prostate cancer do not show any?symptoms. He tells other men: If you develop prostate cancer and catch it early, you will have more?treatment options?and a better chance of getting cured.
Not doing active surveillance was an easy decision for Keith. He did not want to have regrets, and he knew the treatment would be more challenging if he was diagnosed with advanced disease.
“Know the prostate cancer warning signs and stay on top of your PSA screenings, especially if you have a family history,” he says. “Early diagnosis is the key to effective treatment.”
or call 1-877-632-6789.
Stereotactic body radiation therapy (SBRT) for prostate cancer: What to know
If you have received a prostate cancer diagnosis, you may be wondering which treatment options are available to you. Prostate cancer treatment options?can include?surgery,?different types of radiation therapy and hormone therapy. Once your doctor identifies if your localized prostate cancer has a low risk, intermediate risk or high risk of the cancer spreading, they can determine the best treatment options for you.?
Stereotactic body radiation therapy (SBRT) is a radiation treatment that uses high doses of radiation with several beams of various intensities aimed at different angles to precisely target the tumor. This limits radiation exposure to healthy tissue and offers several benefits to patients undergoing prostate cancer treatment. To better understand SBRT, we spoke with radiation oncologist?,?who specializes in caring for patients with prostate cancer.
How is stereotactic body radiation therapy for prostate cancer different from other radiation therapies??
Standard external beam radiation therapy for prostate cancer requires 20 to 28 treatments given over 4 to 6 weeks, whereas SBRT requires just five days of treatment. With fewer treatments, there is much less disruption to patients’ lives, especially for those who live far away.??
SBRT has been shown in clinical trials to be as effective in controlling prostate cancer as longer-duration radiation for patients with low- and intermediate-risk disease. Patients receiving SBRT for prostate cancer may initially experience more urinary symptoms, but long-term urinary and bowel function is similar to the function you would have after longer duration radiation treatment.?
With SBRT, we shorten the duration of treatment by giving larger amounts of radiation each day, using a more focused and precise radiation treatment.?
We are now treating patients with SBRT at several of MD Anderson’s Houston locations. This offers patients even more convenience during treatment.??
At our Texas Medical Center Campus, we treat patients with SBRT using MR-Linac radiation therapy. MR-Linac delivers precise high-dose radiation to patients inside an MRI machine. The machine constantly obtains images during treatment, providing high-resolution images of the tumor and control of the radiation beam in real time.?
This allows your care team to deliver high-dose radiation to tumors that can change shape or move during treatment. Our doctors can get information about not only the tumor but also normal surrounding tissue so they can modify and adapt your treatment plan daily if needed. This new technology keeps the radiation beam directly on target throughout treatment, providing even more precise treatment to protect normal tissues around it.?
What can prostate patients expect from a typical SBRT treatment plan??
For prostate cancer, SBRT is an effective short course of radiation that can be given in just five treatments.??
Patients first meet with one of our physicians to verify they are a candidate for SBRT. Then, we do a planning appointment, a CT scan and an MRI scan to help map out where the radiation would go. You return one week later to start a typical SBRT treatment plan, which is five days of treatments delivered every other day.??
The most common early side effect is more frequent urination. Patients may also experience discomfort while urinating. These side effects can be managed with medication and typically go away after treatment. Most patients can maintain their usual activities during treatment.??
Many patients receive SBRT by itself. However, depending on your case, you might receive testosterone suppression with the radiation. You can eat and drink normally during treatment. When you undergo treatment, we typically ask you to have a full bladder and an empty rectum.?
What new research is being done for prostate cancer patients receiving SBRT?
As a leader in treating prostate cancers, MD Anderson has?clinical trials?for patients who have newly diagnosed, recurrent or progressive diseases.?
A recent prostate cancer randomized shows that five-fraction SBRT was non-inferior to control radiation therapy?with respect to biochemical or clinical failure and is an effective treatment option for patients with low-to-intermediate-risk localized prostate cancer. Patients treated with SBRT reported more urinary side effects two years after treatment, but differences in urinary symptoms went away by five years.??
Given the convenience of SBRT for treating prostate cancer, ongoing clinical trials at MD Anderson are looking to expand patients eligible for this treatment. Hoffman is leading a national trial, the trial, which is comparing prostate SBRT to traditional multi-week radiation for patients with high-risk prostate cancer.??
The is testing SBRT for patients who need radiation treatment to the pelvic lymph nodes in addition to the prostate. The PRORAD-5 trial is led by , and is only available at MD Anderson.??
What advice do you have for prostate cancer patients?
Patients with localized prostate cancer should discuss SBRT options with their care team to determine if they are a candidate for five-treatment radiation.
Choosing the right hospital may be the most important decision you make as a prostate cancer patient. At MD Anderson you will get care and support from the nation’s top-ranked cancer center. If you experience side effects, talk to your care team. We can help you come up with strategies to cope. From?a dedicated prostate cancer support group?to?counseling?to?integrative medicine care, we have all the services needed to treat not just the disease, but the whole person.
Most importantly, look for a care team that makes you feel comfortable and is experienced to ensure you are getting the best treatment possible for the best possible outcome.?
?or by calling 1-877-632-6789.