Prostate cancer is a very good model to study the effect of radiation with novel technology. It has always been that way. Since we had the major transition from classical radiation therapy to 3D conformal radiotherapy prostate cancer was at the forefront of research. When we had, again, in the ‘90s the transition from 3D conformal to intensity modulated radiotherapy, IMRT, prostate cancer was again a fantastic model for us to understand the efficacy of the treatment as well as the benefits of the treatment. It enabled with more sophisticated technology a dose escalation to the tumour while sparing normal tissues.

Stereotactic body radiotherapy is now beginning to show, after several years of intense and very well-performed research in many research institutes, that it can replace fractionated radiotherapy, at least for low and intermediate risk prostate cancer very effectively with a lot more convenience for the patient because it can be delivered in five sessions. We are looking at the possibility of even further reducing the number of sessions ultimately to a single event, potentially, but this is still in the investigational realm. It can be done safely as long as we have the technology that enables us to reproduce the anatomy of the patient very carefully on a day to day basis as we deliver the treatment with excellent dose distribution of the radiation, sparing normal tissues adjacent to the target, that is the prostate, and potentially dose escalating the dose so that we can achieve better outcomes compared to fractionated radiotherapy. This is, of course, part of currently ongoing investigation.

The technology is finally available. We are experiencing a transition in the medical community, in the radiation oncology community, so that the availability of stereotactic body radiotherapy in prostate cancer, as well as in many other clinical settings, becomes an established modality with benefits for the patients, of course, because of its convenience, with benefits for society at large because of our savings attached to the fact that we reduce the use of the machine time to a few events only, in other words cost-effectiveness for the healthcare systems. I think that there is enough evidence coming from many highly qualified institutions around the world that this is the way forward and we will see in the next few years a significant increase in the number of patients treated with this modality.