Here are Radiosurgery Society-endorsed practical guidelines to prostate SBRT including challenging case examples. Pearls include considering ADT (when indicated as you would with conventional fractionation) 2-3 months prior to SBRT for for cytoreduction in those with larger prostates, escalating dose to 40 Gy in 5 fractions to at least gross disease when feasible to improve biochemical control, treating every other day as the ideal compromise between convenience and reduced toxicity, generally favor treating high risk disease and men with inflammatory bowel disease if no active flare within the last year, and Table 3 that provides comprehensive dose constraints. | Ma, Pract Radiat Oncol 2023
