Eric Shinohara, MD, MSCI, associate professor and interim chair, Vanderbilt University Medical Center, discusses the potential to combine stereotactic body radiotherapy (SBRT) with immunotherapy in prostate cancer.

Austin Kirschner, MD, PhD, a physician scientist at Vanderbilt University Medical Center, is examining the combination of SBRT with immunotherapy, says Shinohara. Although this approach has been investigated in other types of tumors, Kirschner and his team are specifically evaluating the combination in prostate cancer.

One of the focuses of this research is to treat lesions with high doses of radiation and determine whether an immune response can be augmented and impact other tumors in the body that were not treated with the radiation, explains Shinohara. This is an interesting paradigm where radiation may possess the potential to boost the effects of immunotherapy, concludes Shinohara.

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Eric Shinohara, MD, MSCI, discusses the potential to combine stereotactic body radiotherapy with immunotherapy in prostate cancer.

Dr. Shinohara on Pairing SBRT With Immunotherapy in Prostate Cancer

Eric Shinohara, MD, MSCI, associate professor and interim chair, Vanderbilt University Medical Center, discusses radiation therapy considerations for patients with prostate cancer.

When considering the types of radiation therapy options available for patients with prostate cancer, other health conditions and urinary function are often considered. Often times, other forms of radiation can be longer, taking 5 weeks or 9 weeks, and sometimes that can affect a patient's urination function a bit more. When speaking with a patient about the different types of radiation they could potentially receive, comorbidities and urinary function are factored into the decision, as well as the size of their prostate gland, concludes Shinohara.

Eric Shinohara, MD, MSCI, discusses radiation therapy considerations for patients with prostate cancer.

Dr. Shinohara on Radiation Therapy Considerations in Prostate Cancer

Eric Shinohara, MD, MSCI, associate professor and interim chair, Vanderbilt University Medical Center, discusses the toxicities associated with stereotactic body radiotherapy (SBRT) in prostate cancer.

A majority of research in this space has been done in patients with low- and intermediate-risk prostate cancer as SBRT is typically offered to these men, says Shinohara.

SBRT is associated with similar toxicities that are common to other forms of radiation. These toxicities tend to affect the urinary system and include frequent urination, nocturia, and burning.

These adverse events may occur directly after treatment or 1 to 1.5 years following SBRT, says Shinohara. Generally, they resolve on their own and do not require additional intervention.

Eric Shinohara, MD, MSCI, discusses the toxicities associated with stereotactic body radiotherapy in prostate cancer.

Dr. Shinohara on Toxicities of Stereotactic Body Radiotherapy in Prostate Cancer

Eric Shinohara, MD, MSCI, associate professor and interim chair, Vanderbilt University Medical Center, discusses the future of stereotactic body radiation (SBRT) and surgery in prostate cancer.

For men with limited metastatic disease, radiation therapy can be given beyond the prostate to treat other sites of disease.

However, the role of radiation or surgery may shift according to emerging data exploring these modalities in combination with immunotherapy, explains Shinohara.

Going forward, radiation and surgery may become more widely used for men with a low volume of metastatic disease, concludes Shinohara.

Eric Shinohara, MD, MSCI, discusses the future of stereotactic body radiation and surgery in prostate cancer.

Dr. Shinohara on the Future of Radiation and Surgery in Prostate Cancer

Eric Shinohara, MD, MSCI, associate professor and interim chair, Vanderbilt University Medical Center, discusses the emergence of stereotactic body radiotherapy (SBRT) to treat patients with prostate cancer.

As the technology required for SBRT has become more affordable, the technique has become more widespread, explains Shinohara. Additionally, having the proper clinical and physics expertise to deliver the treatment is expanding. SBRT is now more commonly offered and, according to Shinohara, more data are needed to support this as a safe and effective treatment.

Devices to protect normal tissues from radiation-related injury are also becoming more common. One such device is a hydrogel spacer, which is a compound that is injected between the prostate and the rectum to push the prostate away from the rectum, says Shinohara. By physically separating the rectum from the prostate, the radiation dose received by the rectum can be greatly reduced, decreasing or potentially eliminating serious adverse events from radiation therapy to the rectum. The widespread use of hydrogel spacers has helped protect normal tissues to a greater degree, concludes Shinohara.

Eric Shinohara, MD, MSCI, discusses the emergence of stereotactic body radiotherapy to treat patients with prostate cancer.

Eric Shinohara, MD, MSCI

Articles

Dr. Shinohara on Pairing SBRT With Immunotherapy in Prostate Cancer

Dr. Shinohara on Radiation Therapy Considerations in Prostate Cancer

Dr. Shinohara on Toxicities of Stereotactic Body Radiotherapy in Prostate Cancer

Dr. Shinohara on the Future of Radiation and Surgery in Prostate Cancer

Dr. Shinohara on Stereotactic Body Radiotherapy to Treat Prostate Cancer