Gothenburg – November 04, 2026 -- Radiotherapy is applied in as few as 12–22% of radically treated prostate cancer patients in some European national registries, even though nearly all men with non-metastatic disease requiring active treatment are candidates for it under European Association of Urology (EAU) guidelines. Clinicians and Swedish medtech firm Micropos Medical are now pushing to raise awareness of high-precision radiotherapy as an alternative to surgery.
PACE-A follow-up favors radiotherapy on long-term side effects
Professor Filippo Alongi of the University of Brescia pointed to the eight-year follow-up of the British-Canadian PACE-A trial. The study compared robotic surgery with high-precision radiotherapy delivered in five sessions, and radiotherapy showed advantages in the long-term side-effect profile, particularly urinary continence and sexual function. Alongi said the earlier ProtecT trial had already established long-term oncological effectiveness of radiotherapy relative to surgery.
Dr Berardino de Bari of Réseau Hospitalier Neuchâtelois cited ProtecT 15-year data showing only 3% of patients die of prostate cancer. He argued the key question is therefore which treatment least affects quality of life. He added that preliminary PACE-A and PACE-B results show stereotactic body radiotherapy (SBRT) can minimize side effects without compromising outcomes for appropriately selected patients.
Fewer fractions drive trials and NHS England guidance
Professor Stefano Arcangeli of the University of Milan Bicocca leads ABRUPT, a study of single-fraction prostate treatment. He said recently published research shows single-dose radiotherapy, combined with intrafraction motion control from technologies such as Micropos' Raypilot System, can deliver high doses with very low side effects.
Professor Duncan McLaren of Edinburgh Cancer Centre heads PRECISION, an ongoing three-fraction study using real-time tumor tracking. He welcomed recent NHS England guidelines expanding access to efficient treatment for localized prostate cancer. Fewer fractions, he said, improve radiotherapy capacity and help reduce waiting times.
Professor Thomas Zilli of Bellinzona Regional Hospital highlighted urethra sparing, which lowers the radiation dose to the urethra without compromising tumor treatment and reduces urinary side effects.
ESTRO and ASTRO 2026 put patient communication on the agenda
The awareness gap was discussed at ESTRO 2026 in Stockholm in May and at ASTRO 2026 in Boston. ESTRO President Professor Barbara Jereczek-Fossa stressed that clear, patient-centered terminology reduces unnecessary anxiety. Professor Piet Ost of GZA Ziekenhuizen said clinicians should stop leading with machines and techniques, noting that the surgeon's message is simple: "I'll remove it."
Hanna Syrén, COO and QA/RA Director at Micropos Medical, said the company welcomes the growing awareness and closer collaboration across the radiation oncology community. ESTRO President-Elect Dr Carmen Rubio Rodriguez of HM Hospitales, Madrid, said every eligible patient should be informed of the option to make a truly informed choice.