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NewsA phase 3 trial shows SBRT is a strong alternative to surgery for prostate cancer. The PACE-A trial found that men who received five-fraction stereotactic body radiation therapy had 40% lower urinary pad use and significantly better sexual function than those who had surgery — with no meaningful difference in cancer control at 8 years.
For men with low- or intermediate-risk prostate cancer, a new phase 3 trial suggests radiation may be the kinder option. The PACE-A trial, presented at the ASTRO Annual Meeting, randomly assigned 123 men to either prostatectomy or five-fraction stereotactic body radiation therapy (SBRT) and followed them for a median of 8 years. The results? SBRT came out ahead on nearly every quality-of-life measure.
Cancer control was essentially a draw — biochemical/clinical failure-free rates at 5 years were 94.8% for SBRT vs. 94.1% for surgery, and no patient in either arm died of prostate cancer. But where SBRT really shone was in side effects: urinary pad use was dramatically lower, and sexual function scores were significantly better compared to the surgical group.
Key Takeaways:
Why it matters: With over 333,000 new prostate cancer diagnoses expected in the U.S. in 2026 and very low mortality for localized disease, quality of life is the deciding factor for most patients. These findings support SBRT as a standard-of-care option — and give clinicians solid data to help patients make truly informed choices.
