ArticleClinical and translational radiation oncology2026
MRI-guided adaptive stereotactic body radiotherapy for the prostate bed: a prospective study of safety, tolerability, and patient-reported quality-of-life outcomes.
Article in Clinical and translational radiation oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and objectives: Magnetic resonance-guided radiotherapy (MRgRT) applied as stereotactic body radiotherapy to the prostate bed represents an emerging post-prostatectomy treatment approach, offering superior soft-tissue visualization and the potential for daily online adaptive planning. This study reports a prospective experience with MR-guided adaptive SBRT to the prostate bed, with a primary focus on treatment-related adverse events and patient-reported quality-of-life (QoL) outcomes. Materials and methods: A prospective cohort of 31 patients with biochemical recurrence following radical prostatectomy was treated with MR-guided adaptive SBRT (32.5 Gy in 5 fractions) using a 0.35 T MR-LINAC (MRIdian®, ViewRay). Elective pelvic nodal irradiation was delivered in 42% of patients (25 Gy in 5 fractions), and a simultaneous integrated boost (SIB) to macroscopic disease (35 Gy in 5 fractions) was administered in 9.7% of cases. Concomitant androgen deprivation therapy (ADT) was administered in 77.4% of patients. Adverse events were graded according to the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0, and patient-reported outcomes were assessed using the Expanded Prostate Cancer Index Composite-26 (EPIC-26) and the International Prostate Symptom Score (IPSS). Results: With a median follow-up of 8.8 months (IQR: 6.1-16.8), no grade ≥ 3 adverse events were observed at any time point. Acute grade ≥ 2 genitourinary (GU) adverse events were Conclusions: MRgRT to the prostate bed demonstrates a favorable early safety and tolerability profile, with no grade ≥ 3 adverse events, low rates of grade ≥ 2 GU adverse events (4.3% at 6 months, 1/23), and absence of late grade ≥ 3 GI adverse events, while maintaining patient-reported QoL outcomes.
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