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Stereotactic Body Radiation Therapy (SBRT) is a standard therapeutic option for men with prostate adenocarcinoma. The median age of prostate cancer in the US is 66 but patients as young as 35 have been reported. Many younger patients will have surgery rather than SBRT for localized prostate cancer but some will be treated with SBRT. There is a paucity of data on the outcomes of this younger subset. This study reports updated outcomes on patients younger than 50 treated with SBRT at a single institution and compares outcomes to older patients. Between April 2006 and December 2022, 6,130 patients with prostate cancer were treated with inhomogeneous-dosed SBRT using a robotic linear accelerator. Information was available for 4,143 patients. 3568 (86.12%) of patients were treated with a median dose of 3500cGY (3500-3625) delivered over 5 consecutive fractions prescribed to the 83-85% isodose line, and the remaining 575 (13.88%) other patients receiving a median dose of 4500cGY (4500-5400) to the pelvis in conventional fractionation followed by a 3 fraction SBRT boost of 2100 cGY (1950-2100) over 3 consecutive fractions. Androgen deprivation Therapy (ADT) was prescribed in 1,035 (24.98%) of these cases. The mean age was 67.4 years old. 48 patients were younger than 50 years old (mean age 46.6). 4,095 patients were 50 or older. Patients were divided into prognostic D'Amico risk groups with 43.75%, 50.00%, 6.25% of patients falling in the low, intermediate, and high-risk stratifications in the younger cohort and 23.88%, 57.05%, 19.07% in the older cohort respectively. Pretreatment PSA was 1.72 - 43.2 (median: 5.4) in the younger group and 0.3 - 661 (median: 6.5) in the older group. In the younger group, Gleason scores were 6 in 47.92%, 7 in 47.92%, and 8-10 in 4.16%. 44 younger patients were treated with SBRT alone. 4 patients also received supplemental external beam radiation (median dose 4500cGY) and 5 patients (10.42%) received Androgen Deprivation Therapy (ADT) as part of their treatment regimen. In the older group, Gleason scores were 6 in 29.84%, 7 in 54.14%, and 8-10 in 16.02%. 3522 were treated with SBRT alone. 573 patients also received supplemental external beam radiation (median dose 4500cGY) and 1030 patients (25.15%) received Androgen Deprivation Therapy (ADT) as part of their treatment. At 75 months the 6-year biochemical relapse free survival was 95.83% in younger patients compared to 98.41% in older patients using the Phoenix definition of biochemical failure. The 6-year median post treatment PSA was 0.3 in younger patients and 0.2 in the older patients. There were no significant differences in the risk stratification between the 2 groups. This represents the largest series evaluating outcomes in very young patients treated with definitive SBRT for prostate cancer. With updated 6-year follow up, SBRT remains an effective treatment for this younger subset of patients. Continued follow up will be required to see if these results remain durable. [ABSTRACT FROM AUTHOR]

There have been substantial and growing concerns about conflicts of interest (COI) involving clinical research. Using data from the American Society of Radiation Oncology (ASTRO) 2021 annual meeting, we assessed the frequency and type of COI and evaluated associations between COI and opportunity for oral presentation. A web scraping program was used to capture all abstracts, authors, and COI disclosures from ASTRO's 63rd Annual Meeting issue of the Red Journal (11/1/21). COI disclosures were categorized into monetary (advisory board, consulting, honorarium, industry employment, patent, research funding, royalties, stock) or non-monetary (leadership role at professional society) disclosures. Abstracts were stratified based on acceptance as poster, quick pitch oral, or oral scientific presentation. Pearson's X2 and independent t-test were used to determine differences across abstract categories. Binary logistic regression was used to determine factors that portended for monetary disclosures. Univariate and multivariate analysis was used to determine the impact of various disclosures on acceptance category. 1548 abstracts with 7529 authors were analyzed. Oral scientific sessions, quick pitch oral sessions, and poster sessions composed 148 (9.6%), 108 (7.0%), and 1292 (83.5%) abstracts, respectively. The median number of authors per abstract was 8 (range:1-44). 612 (39.5%) abstracts had no disclosures amongst listed authors, and 936 (60.5%) abstracts had at least one author noting a relevant disclosure. The most common types of disclosures were Research Funding, Consulting, and Honoraria (42.1%, 33.4%, and 28.7% of abstracts, respectively). 165 (10.7%) abstracts involved authors disclosing leadership at a professional society. There were 898 (58.0%) monetary disclosures and 165 (10.7%) non-monetary disclosures. Disclosure rates were significantly different (p=.001) between abstracts awarded posters 58.5%, quick pitch oral (67.6%), and oral scientific abstracts (72.3%). Oral scientific and quick pitch oral abstracts had higher rates of monetary disclosures relative to poster abstracts (70.3% and 65.7%, vs. 56.0%, respectively; p=.001). Abstracts that involved professional society leadership were more likely to report a monetary disclosure (91.5% vs. 54.0%; p<.001). On multivariate analysis, monetary disclosures were associated with abstracts written by authors with leadership at professional societies (OR: 7.763, CI 4.421-13.631; p<.0001), abstracts containing ≥5 authors (OR 3.589, CI 2.668-4.827; p<.0001), and abstracts awarded oral presentations (OR 1.306, CI 1.086-1.567; p=.005). Most abstracts at the 2021 ASTRO annual meeting had COI disclosures, and most disclosures were monetary. Rates of disclosure increased as abstract prestige increased, and monetary disclosures were associated with oral presentations and abstracts written by authors with leadership roles in professional societies. [ABSTRACT FROM AUTHOR]