State of the art and future challenges of urethra-sparing stereotactic body radiotherapy for prostate cancer: a systematic review of literature

Purpose Doses delivered to the urethra have been associated with an increased risk to develop long-term urinary toxicity in patients undergoing stereotactic body radiotherapy (SBRT) for prostate cancer (PCa). Aim of the present systematic review is to report on the role of urethra-sparing SBRT (US-S...

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Bibliographic Details
Published in:World journal of urology 2023-11, Vol.41 (11), p.3287-3299
Main Authors: Le Guevelou, Jennifer, Bosetti, Davide Giovanni, Castronovo, Francesco, Angrisani, Antonio, de Crevoisier, Renaud, Zilli, Thomas
Format: Article
Language:English
Subjects:
Humans
Literature reviews
Male
Medicine
Medicine & Public Health
Neoplasm Recurrence, Local - etiology
Nephrology
Oncology
Prostate cancer
Prostatic Neoplasms - etiology
Prostatic Neoplasms - radiotherapy
Prostatic Neoplasms - surgery
Radiation therapy
Radiosurgery - adverse effects
Radiosurgery - methods
Systematic review
Topic Paper
Toxicity
Urethra
Urogenital System
Urology
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Summary:Purpose Doses delivered to the urethra have been associated with an increased risk to develop long-term urinary toxicity in patients undergoing stereotactic body radiotherapy (SBRT) for prostate cancer (PCa). Aim of the present systematic review is to report on the role of urethra-sparing SBRT (US-SBRT) techniques for prostate cancer, with a focus on outcome and urinary toxicity. Method A systematic review of the literature was performed on the PubMed database on May 2023. Based on the urethra-sparing technique, 13 studies were selected for the analysis and classified in the two following categories: “urethra-steering” SBRT (restriction of hotspots to the urethra) and “urethra dose-reduction” SBRT (dose reduction to urethra below the prescribed dose). Results By limiting the urethra D max to 90GyEQD2 (α/β = 3 Gy) with urethra-steering SBRT techniques, late genitourinary (GU) grade 2 toxicity remains mild, ranging between 12.1% and 14%. With dose-reduction strategies decreasing the urethral dose below 70 GyEQD2, the risk of late GU toxicity was further reduced (
ISSN:1433-8726
0724-4983
1433-8726
DOI:10.1007/s00345-023-04579-6