NEJM Study Confirms Five-Session Radiation Matches Conventional Therapy for Localized Prostate Cancer

Accuray Incorporated has recently announced the publication of the PACE-B trial results in the New England Journal of Medicine, highlighting significant advancements in the treatment of prostate cancer. The PACE-B trial, which stands for Prostate Advances in Comparative Evidence, compared the effectiveness of stereotactic body radiation therapy (SBRT) to conventional radiotherapy (CRT) over a five-year period. The findings indicate that SBRT offers comparable cancer control rates and side effect profiles while drastically reducing the treatment duration from up to 39 days to just five days. This trial employed the Accuray CyberKnife System for the SBRT-treated group, demonstrating excellent disease control with minimal toxicity for men diagnosed with prostate cancer.

Prostate cancer is a prevalent condition in men, with nearly 1.5 million new cases globally in 2022. Despite its generally slow progression and manageable nature, access to effective treatment options like SBRT is crucial. SBRT, using advanced targeting techniques, delivers high doses of radiation over a few days, demanding precise accuracy. The PACE-B trial included men with low to intermediate-risk prostate cancer, who received either SBRT in five sessions or CRT in 20 to 39 sessions.

Professor Nicholas van As, the Chief Investigator of the study, emphasized the significance of the findings. He noted that the ability to deliver radiation treatment effectively in just five days, rather than four weeks, is a major advancement for both healthcare systems and patients. This reduction in treatment time without compromising effectiveness is a significant step forward, providing patients with a more convenient and less burdensome treatment option.

The trial results showed high cancer control rates at five years, with 94.6 percent for CRT and 95.8 percent for SBRT, both without the use of androgen deprivation therapy (ADT). Additionally, SBRT was well-tolerated, and the treatment-related impairments, including urinary, bowel, and sexual functions, were comparable to those observed with CRT. Approximately 29.1 percent of men treated with CRT and 26.4 percent of those receiving SBRT reported erectile dysfunction five years post-treatment, with stable urinary and bowel symptoms in both groups.

Dr. Seth Blacksburg, Chief Medical Officer at Accuray, highlighted the importance of the PACE-B trial results, describing them as a game-changer. He emphasized that the data strongly support the use of SBRT for early-stage prostate cancer, offering a highly effective treatment option that minimizes disruptions to patients' lives. The trial’s findings are expected to influence the standard of care, empowering men to choose SBRT as an alternative to traditional radiation or surgery.

The CyberKnife System, supported by over 30 years of clinical data, plays a crucial role in treating prostate cancer with great confidence. Its ability to track and adjust for tumor motion in real-time ensures precise radiation delivery, reducing potential side effects and increasing the likelihood of successful outcomes. The system's capability to maintain sub-millimeter accuracy throughout treatment is unique and instrumental in providing optimal care.

The PACE-B trial, a prospective, randomized study conducted across multiple centers in the UK, Canada, and Ireland, compared five-fraction SBRT to conventional or moderately hypofractionated external beam radiotherapy for localized prostate cancer. Sponsored by The Royal Marsden and coordinated by the Clinical Trials and Statistics Unit at The Institute of Cancer Research, the trial enrolled 874 patients, with 433 receiving SBRT and 441 undergoing standard radiotherapy. Of those treated with SBRT, 41 percent received treatment using the CyberKnife platform.

Accuray is dedicated to advancing radiation therapy to improve patient outcomes, continuously innovating in the field to address complex and common cases alike. The company remains committed to helping patients return to their lives more quickly by partnering with clinicians and administrators worldwide.