Genitourinary Cancer

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SU_29_2297 - Trends in Utilization of Stereotactic Body Radiation Therapy for Definitive Treatment of Prostate Cancer

Sunday, October 21
1:15 PM - 2:45 PM
Location: Innovation Hub, Exhibit Hall 3

Trends in Utilization of Stereotactic Body Radiation Therapy for Definitive Treatment of Prostate Cancer
S. S. Mahase, D. D'Angelo, J. Kang, J. C. Hu, and H. Nagar; NewYork-Presbyterian/Weill Cornell Medical Center, New York, NY

Purpose/Objective(s): Stereotactic body radiotherapy (SBRT) is an extremely hypofractionated regimen utilized in the treatment of prostate cancer. Numerous clinical trials demonstrate favorable outcomes with SBRT compared to other definitive radiotherapy (RT) modalities, culminating in National Comprehensive Cancer Network guidelines supporting its’ use. This study aims to characterize recent trends in SBRT use.

Materials/Methods: The National Cancer Data Base (NCDB) was queried to identify 107,107 patients diagnosed with localized prostate cancer from 2010-2015 who underwent definitive RT. SBRT was defined as patients undergoing 5 fractions of RT. The Cochran-Armitage trend test was used to identify significant temporal trends. Univariate and multivariable logistic regression adjusted for clinical and socio-demographic factors ascertained independent determinants of SBRT utilization.

Results: Among patients treated with RT, the proportion undergoing SBRT increased from 3.23% in 2010 to 7.42% in 2015 (p<0.0001). This trend persisted across all risk groups, with significantly more low risk (3.93% to 12.64%; p<0.0001), favorable intermediate risk (3.66% to 9.52%; p<0.0001), unfavorable intermediate risk (3.14% to 7.86%; p<0.0001), and high risk (1.75% to 2.04%; p<0.05) patients undergoing SBRT. The cohort as a whole, and upon stratification by risk group, received a median dose of 36.25 Gy. Factors associated with SBRT include treatment at an academic center, metropolitan area, private insurance, higher incomes, lower comorbidity index, and low risk disease (all p<0.0001). Among all patients receiving RT, hormonal therapy (HT) use was associated with higher risk groups (low risk = 9.47%; favorable intermediate = 28.61%; unfavorable intermediate = 45.74%; high risk = 76.52%). HT use was also associated with higher risk groups among patients receiving SBRT (low risk = 4.08%; favorable intermediate = 12.45%; unfavorable intermediate = 19.33%; high risk = 33.28%). Among all patients receiving RT, 39.06% received HT, while 13.16% of patients undergoing SBRT received HT.

Conclusion: The use of SBRT as a definitive treatment modality in prostate cancer has more than doubled from 2010-2015. Patients who were treated at an academic center, lived in an metropolitan environment, had higher incomes, were healthier, and diagnosed with lower risk prostate cancer were more likely to receive SBRT. While use of HT increased with risk classification among all patients treated with RT, those treated with SBRT were significantly less likely to receive HT.

Author Disclosure: S.S. Mahase: None. J. Kang: None. H. Nagar: None.

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