# Single-Dose Radiation Therapy for Localized Prostate Cancer: Where Does the Evidence Lead?

## TL;DR

This paper reviews the use of single-dose radiation therapy for prostate cancer, highlighting its benefits and challenges.

## Contribution

The paper provides a comprehensive review of the evolution and current state of single-dose prostate radiotherapy.

## Key findings

- Single-dose RT offers reduced treatment time and enhanced patient convenience.
- Modern techniques like SBRT show promising efficacy and safety for low- and intermediate-risk prostate cancer.
- Challenges include managing organ motion and minimizing urethral toxicity.

## Abstract

Radiotherapy treatment using modern techniques like stereotactic body RT is a safe and effective treatment for both localized and advanced prostate cancers. The progressive decrease in number of RT sessions from 40 to 20 and finally to five or four and perhaps one single fraction has been quite impressive. This manuscript reviews the evolution and current state of primary prostate single-dose radiotherapy, focusing on its benefits and limitations. Single-dose prostate RT approaches represent an exciting and potentially revolutionary opportunity in the field of RT treatment of localized prostate cancers. Despite some cases of disappointing long-term results from single-dose interventional brachytherapy, preliminary data from studies using stereotactic EBRT are extremely encouraging, especially in terms of toxicity.

Prostate cancer (PCa) remains the most prevalent cancer among men and the second leading cause of cancer-related deaths worldwide. Early diagnosis is crucial as it opens up various treatment options with curative intent. Recent advancements confirm that radiotherapy (RT), particularly through modern techniques like stereotactic body RT (SBRT) and single-dose RT (SDRT), is a safe and effective treatment for both localized and advanced PCa. This manuscript reviews the evolution and current state of primary prostate SDRT, focusing on its benefits and limitations. SDRT offers advantages such as reduced treatment time and enhanced patient convenience, showing promising efficacy and safety, especially for low- and intermediate-risk PCa. Challenges include controlling intrafraction variability and organ motion, as well as minimizing urethral toxicity. Next-generation imaging and MR-guided RT are improving treatment accuracy. While SDRT shows potential for cost-effective PCa treatment, further research is needed to address its limitations and refine its clinical application.