The ‘SPORT trial’ (A Study Evaluating Stereotactic Prostate Radiotherapy in High-Risk Localised Prostate Cancer) is the first of its kind in the UK and was a collaborative effort involving cancer researchers from Queen’s University Belfast and the Belfast Health and Social Care Trust.

The results have been published in the world’s leading radiotherapy journal, the International Journal of Radiation Oncology Biology and Physics.

The 30 men from Northern Ireland who took part in the trial were treated with an advanced treatment called ‘SABR’ (Stereotactic Ablative Body Radiotherapy). This radical radiotherapy is highly accurate in targeting certain cancers, reducing tumours, whilst delivering large doses per treatment, allowing men to have their full course in only five hospital visits.

This reduction in the number of treatments was also found to be more efficient and cost-effective for busy radiotherapy departments within the NHS. Prostate cancer is the most commonly diagnosed cancer in men so this treatment could make a real impact on busy radiotherapy centres.

In addition, prior to the radiotherapy treatment, the patients in the study had a SpaceOAR inserted, a minimally invasive hydrogel technology. This gel was placed between the prostate and bowel before treatment and was found to reduce unwanted radiation dose to the bowel by 70%. This allowed clinicians to treat the prostate with a higher dose of radiation without increasing the risk of negative side-effects, particularly bowel problems.

The trial was led by Suneil Jain, Clinical Professor from the Patrick G Johnston Centre for Cancer Research (PGJCCR) at Queen’s University Belfast and Friends of the Cancer Centre’s Consultant Oncologist at the Belfast Health and Social Care Trust. He explains: “We are very excited by these results. The SPORT trial has proven this large reduction in treatments with advanced radiotherapy is feasible in patients with high-risk prostate cancer.

"Our hope is that in the future men with high-risk prostate cancer will require only five treatments of radiotherapy with SABR, improving their chances of disease control, whilst minimising the risk of life-altering side effects.”

In addition to proving the effectiveness of the SABR treatment, researchers from the PGJCCR also identified biomarkers that may predict which patients involved in the study were more likely to develop bowel toxicity.

Dr Orla Houlihan, Clinical Fellow from the PGJCCR at Queen’s University Belfast who was one of the researchers on the study, said: “Changes in the levels of these biomarkers suggest that we may be able to identify those patients who have an increased risk of side effects from radiotherapy.

“We hope to be able to use this information to adapt their radiotherapy plans to reduce this risk. This would improve patient outcomes and quality of life after radiotherapy for prostate cancer. Results are very encouraging for the future of personalised radiotherapy.”

One of the participants who took part in the trial, Mr John Creswell (known to his friends as Iain), was diagnosed with prostate cancer in 2018. Luckily, John's cancer was localised and had not spread, and as he had already started hormone treatment, he was a suitable candidate for the SPORT trial. Speaking about how the trial was successful for him, John said: "I have a few friends who have had prostate cancer and have gone through the hormone and radiotherapy treatments, telling me of the negative side effects they experienced. Hearing this, I was understandably worried about what lay ahead of me.

"Thankfully, due to the SPORT trial, I didn’t have any of the side effects my friends warned me about. Due to the spacer being in position, there was no blood in my urine and no blood in the bowel either. Secondly, the convenience of just one hospital visit a week for treatment was more user friendly for me and my treatment team.

"For me, the treatment has been a major success; my cancer was detected and treated before it spread to the rest of my body. I am now five years post-treatment and have no ill effects. This trial and procedure for treating prostate cancer is a success for both the medical profession and for patients like me."

The SPORT trial has been supported by Friends of the Cancer Centre, with the charity funding several of the research posts involved in the study. Ana Wilkinson, Chief Executive of Friends of the Cancer Centre, said: “For over 10 years, Friends of the Cancer Centre has been working in partnership with Queen’s University to support locally led research and the SPORT trial is a great example of the calibre of trials the charity’s funding is supporting.

“To date, Friends of the Cancer Centre has invested nearly £3 million into local research, pledging a further £1 million over the next 3 years. We are incredibly proud to help fund the vital infrastructure needed for clinical trials to take place, knowing that staff funded by the charity are involved in research studies like the SPORT trial. The results of the SPORT trial are very encouraging, with improved outcomes and quality of life for men in Northern Ireland and beyond. Most importantly, the trial has the potential to make a real difference to the future of cancer treatment and care.”

Hayley Luxton, Senior Research Impact & Intelligence Manager at Prostate Cancer UK, said: “We’re excited by these results, which show that this pioneering radiotherapy technique is safe — opening the door to much more accurate, higher dosage treatments, and fewer hospital visits for men living with prostate cancer.

“I’m proud that Prostate Cancer UK, with Movember, are supporting a larger follow-on study in order to provide the evidence needed to show this treatment is effective for men with high-risk prostate cancer.

“It’s particularly great news that this breakthrough has come from researchers in Belfast because Northern Ireland is one of the worst-affected regions in the UK for late prostate cancer referrals and diagnoses, where 1 in 5 men with the disease are diagnosed too late for a cure. In London, that figure is 1 in 8.”

A larger clinical study in men with prostate cancer across the whole of the UK is currently underway.

The research was funded by Friends of the Cancer Centre, Prostate Cancer UK, Movember, the Health and Social Care R&D Division and supported by Boston Scientific.

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Media inquiries to Sian Devlin at s.devlin@qub.ac.uk