Great question GSD! A definitive answer to your question is some years away. I'll make a few observations and what I think is likely to emerge as more data becomes available.
1. One thing to remember is that PACE-B was concluded over 5 years ago in a different county and while the protocol looks similar it may not be identical to current treatment/hardware being used here today.
2. That said, there does appear to be a small, but real increase in late GU complications with SBRT as you've noted.
3. As Ben pointed out, all SBRT isn't equal. "Regular" SBRT typically uses 5 mm margins except posteriorly where 3 mm is common. Margins in PACE-B were 4-5 mm except posteriorly where they were 3-5 mm. MR-Guided SBRT is typically uses 2 or 3 mm margins and is the most likely mechanism for any benefits over regular SBRT (i.e., not the adaptive planning or continuous monitoring).
My best guess, which I posed to the GU section chief at arguably a top U.S. cancer hospital, is that when all the data is in, we will know that SBRT (Cyberknife, Proton, etc), while more convenient, does carry a small increase in late GU complications compared to moderately hypo-fractionated treatment of 28 sessions. With MRI-guided RT (Electa or MRIdian) the complication rate is likely to be equivalent to 28 sessions while maintaining the convenience of only 5 sessions. FWIW, the "top name" radiation oncologist agreed and said that's also what he thought.
Therefore, you won't be surprised that when I'm asked for a recommendation about SBRT, my standard response is if there is a choice between 28 sessions and 5 sessions on a standard machine, AND you have the time, I'd take the 28 sessions. If you have access to a MRI-guided machine, then I'd go with the MR guided strictly for the convenience.
FYI, I had 2 mm margins on a MRIdian machine for favorable intermediate disease.
Thoughtful post midatlpatch. I came to the same conclusion, I was worried about GU effects and believe as you the 28 sessions is preferable based on data I can find. I did proton therapy with Spaceoar for 28 sessions. Agree that MRI guided trumps other treatments. Note of caution, no free lunch as proton has higher rectal complications, Spaceoar is essential to reduce risks to 5% or so.