MRI-Guided Radiation Therapy Shown to Reduce Long-Term Side Effects for Prostate Cancer Patients

Researchers at UCLA Health report that MRI-guided radiation therapy for prostate cancer reduces long-term side effects, enhancing patients’ quality of life in areas such as bowel and sexual health.

A new study by the UCLA Health Jonsson Comprehensive Cancer Center reveals that MRI-guided stereotactic body radiotherapy (SBRT) substantially lowers long-term side effects for prostate cancer patients compared to the standard CT-guided approach.

After an extensive two-year follow-up, the researchers found that patients receiving MRI-guided SBRT experienced significantly fewer urinary and bowel issues. Notably, only 27% of these patients reported moderate or severe urinary problems, such as incontinence and irritation, versus 51% in the CT-guided group.

Additionally, gastrointestinal toxicity was reported by merely 1.4% of patients undergoing MRI-guided treatment, a stark contrast to the 9.5% reported by those receiving CT-guided therapy.

“The MIRAGE trial is the only randomized trial to date comparing these state-of-the-art technologies in radiation oncology. It was designed to see whether MRI-guided SBRT led to less toxicity than CT-guided SBRT,” senior author Michael Steinberg, a professor and chair of radiation oncology at the David Geffen School of Medicine at UCLA and a director of Clinical Affairs at the UCLA Health Jonsson Comprehensive Cancer Center, said in a news release.

The research centered on a secondary analysis of the phase 3 clinical trial, MIRAGE, which evaluated the effects of using MRI guidance for delivering high-precision radiation therapy. Standard radiation treatments can cause severe and lasting side effects impacting urinary, bowel and sexual functions. MRI guidance allows for more targeted treatment, reducing exposure to surrounding healthy tissues by requiring smaller planning margins around the prostate.

“This study adds strong evidence that the enhanced precision and accuracy afforded by MRI-guided SBRT leads to significantly fewer urinary, bowel and sexual side effects for men receiving prostate SBRT,” first author Amar Kishan, an executive vice chair of radiation oncology at the David Geffen School of Medicine at UCLA , said in the news release.

“The MRI-guided approach, which includes real-time tracking of the prostate itself and the use of a built-in MRI to help deliver the radiation, allows us to use significantly narrower planning margins when delivering radiation, leading to less radiation to normal tissues. This in turn reduces the risk of enduring side effects that can impact a patient’s quality of life,” he added.

The findings have been published in the journal European Urology and were presented earlier this year at the American Society for Radiation Oncology (ASTRO) meeting in Washington, D.C.

This research could mark a significant evolution in prostate cancer treatment practices, highlighting the potential of MRI-guided radiation therapy to enhance patient outcomes and reduce the incidence of debilitating side effects, thus resonating a hopeful future for many battling the disease.