PACE A and PACE B trial – What a radiation oncologist needs to know
Shounak J Kamat, Trinanjan Basu, Jay P Sahu, Rohith R Menon, Ajinkya Gadekar, Ghazala K Roshan, Durva A Kurkure, Rohit Kabre and Riddhijyoti Talukdar
Localised prostate cancer as a disease has seen the treatment paradigm evolve significantly over the years. Multiple treatment options including surgery, radiotherapy, systemic therapy including androgen deprivation therapy and active surveillance are applicable. Studies such as The Prostate Testing for Cancer and Treatment (ProtecT) trial recruited a study population of over 1600 men having localised prostate cancer and randomised them across active monitoring, prostatectomy and external beam radiotherapy. It demonstrated prostate cancer specific mortality of 2.7% at 15 years median follow up without any significant difference between the three treatment arms and no significant difference in metastasis free survival between the surgery and radiotherapy arms. (1) Hence there is an equipoise between surgery and radiotherapy and the choice involves the benefits and harms associated with each treatment and making an informed decision.
Keywords: prostate cancer, SBRT, fractionation, outcome
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