Clinical trial will test whether adaptive radiotherapy delivers better quality of life for prostate cancer patients

Dr. Rachel Glicksman will use a 2026 MOHCCN Clinician-Scientist Award to compare adaptive and standard stereotactic body radiotherapy and determine which patients benefit from more resource-intensive treatment.

People diagnosed with early-stage prostate cancer often receive a type of radiation therapy called standard stereotactic body radiotherapy (SBRT). This treatment is very effective, delivering precise, high-dose radiation in just five to seven sessions, resulting in excellent cancer control. However, it can cause side effects that impact quality of life.

To try to reduce these side effects, a new modality of radiotherapy has emerged in recent years called adaptive SBRT, which adjusts treatment delivery based on daily anatomical changes. However, this additional tailoring is more resource intensive and expensive, and its benefits on the overall well-being of cancer patients are not well measured. This makes it hard for doctors to determine which therapy they should give their patient, and health systems unsure of what they should fund.

Determining whether adaptive SBRT should be adopted as standard of care is the main goal of a new clinical trial called ASPIRE, which is led by Dr. Rachel Glicksman, a clinical investigator at UHN’s Princess Margaret Cancer Centre and funded through a 2026 Marathon of Hope Cancer Centres Network (MOHCCN) Clinician-Scientist Award.

“Our study aims to determine whether adaptive SBRT meaningfully improves patients’ quality of life by reducing both short- and long-term treatment-related side effects compared with standard SBRT,” explains Dr. Glicksman. “The study will also clarify whether the added complexity of adaptive treatment translates into tangible patient benefits, and will assess whether adaptive SBRT is cost-effective overall by reducing downstream healthcare use.”

The team will additionally explore different forms of advanced adaptive platforms such as MR-guided versus CT-guided adaptive radiotherapy, and whether one offers further quality-of-life and treatment-planning advantages. Together, these findings could help cancer centres make evidence-based decisions about which, when and how adaptive radiotherapy technologies should be used.

“As a clinician at a centre where both adaptive and non-adaptive SBRT are available, I have observed that treatment selection is variable and often influenced by physician or patient preference rather than evidence,” she says. “This highlights a critical gap in knowledge regarding whether adaptive SBRT truly improves patient outcomes. This project is therefore directly informed by the need to establish evidence-based criteria to guide treatment selection and ensure patients receive the most effective and appropriate care.”

The work will be funded through an MOHCCN Clinician-Scientist Award. A total of $525,000 will support Dr. Glicksman’s project over three years, with $262,500 coming from the MOHCCN and matching funds from The Princess Margaret Cancer Foundation.

“This award is an honour and a meaningful validation of the importance of this work,” says Dr. Glicksman. “It reinforces the potential impact of our research and provides valuable support to advance a study that can directly improve patient care.”