Finding Value for Protons: The Case of Prostate Cancer?

The standard radiotherapy treatment for prostate cancer is intensity-modulated radiotherapy (IMRT). An alternative option is proton beam therapy (PBT). PBT is a safe and effective treatment, but does it add value over IMRT? We explore this controversial question by examining the available dosimetric and clinical evidence.
Source: Seminars in Radiation Oncology - Category: Cancer & Oncology Authors: Source Type: research

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Authors: Gorji KE, Sadat-Mirkazemi M, Banaei A, Abedi-Firouzjah R, Afkhami-Ardekani M, Ataei G Abstract BACKGROUND: Rectum and bladder are hallow structures and considered as critical organs in prostate cancer intensity modulated radiotherapy (IMRT). Therefore, dose received by these organ walls must be considered for prediction of radiobiological effects. Contouring the real organ walls is quite difficult and time consuming in CT/MRI images, so the easy contouring artificial walls with uniform thickness could be appropriated alternatives. OBJECTIVE: To compare reconstructed artificial walls with real walls of ...
Source: Journal of X-Ray Science and Technology - Category: Radiology Tags: J Xray Sci Technol Source Type: research
Abstract AIM: To report toxicity and quality of life (QOL) outcomes from a randomised trial of prostate only versus whole pelvic radiotherapy in high risk, node negative prostate cancer. MATERIALS/METHODS: Patients with localised prostate adenocarcinoma and nodal involvement risk > 20%, were randomised to prostate only (PORT, 68 Gy/25# to prostate) and whole pelvis (WPRT, 68 Gy/25# to prostate and 50 Gy/25# to pelvis) arms with stratification for TURP, Gleason score, baseline PSA, and type of androgen deprivation therapy (ADT). Image guided intensity modulated radiotherapy (IG-IMRT...
Source: Radiotherapy and Oncology : journal of the European Society for Therapeutic Radiology and Oncology - Category: Radiology Authors: Tags: Radiother Oncol Source Type: research
AbstractObjectivesTo compare the outcomes of radical prostatectomy (RP), intensity-modulated radiation therapy (IMRT), and low-dose-rate brachytherapy (BT) using propensity score matching analysis in patients with clinically localized prostate cancer.MethodsA group of 2273 patients with clinically localized prostate cancer between January 2004 and December 2015 at the Yokohama City University hospital were identified. The records of 1817 of these patients, who were followed up for a minimum of 2  years, were reviewed; 462 were treated with RP, 319 with IMRT, and 1036 with BT. The patients were categorized according to...
Source: World Journal of Urology - Category: Urology & Nephrology Source Type: research
Conclusion: IMRT reduces significantly the risk of late GI severe complication compared with 3D-CRT using conventional fractionation with a total dose ≥ 74Gy without any differences for bRFS and OS.
Source: International Braz J Urol - Category: Urology & Nephrology Source Type: research
Conclusion: Our results were not able to show any significant correlation between increasing convenience with QUANTEC limits and lower rectal toxicity. Conclusively, new dosimetric definitions are warranted to predict acute rectal toxicity more accurately in prostate cancer patients during IMRT treatment.
Source: Reports of Practical Oncology and Radiotherapy - Category: Cancer & Oncology Source Type: research
Conditions:   Metastatic Prostate Adenocarcinoma;   Prostate Adenocarcinoma;   Recurrent Prostate Carcinoma;   Stage IV Prostate Cancer AJCC v8;   Stage IVA Prostate Cancer AJCC v8;   Stage IVB Prostate Cancer AJCC v8 Interventions:   Radiation: Intensity-Modulated Radiation Therapy;   Radiation: Proton Beam Radiation Therapy;   Other: Quality-of-Life Assessment;   Other: Questionnaire Administration Sponsors:   Mayo...
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
ConclusionsThe dosimetric parameters for the cylindrical normal tissue volumes show that using RapidArc technique gives equal or slightly better normal tissue sparing and SIB provided the same normal tissue sparing as CFRT planned with RapidArc.
Source: Reports of Practical Oncology and Radiotherapy - Category: Cancer & Oncology Source Type: research
ConclusionIMRT at a dose up to 78  Gy combined with short-term neoadjuvant ADT resulted in excellent long-term disease-free outcomes with acceptable morbidities among patients with IR PCa. In addition, the incidence of late recurrence was very low. Further investigation is warranted to confirm our findings.
Source: International Journal of Clinical Oncology - Category: Cancer & Oncology Source Type: research
This study assessed the incidence of late rectal toxicities and evaluated potential predictive factors for late proctitis in patients treated with prostate-specific intensity-modulated radiotherapy in Hong Kong. METHODS: This retrospective longitudinal observational study included patients with localised prostate cancer who were treated with intensity-modulated radiation therapy in an oncology unit in Hong Kong between January 2007 and December 2011, and who had>1 year of follow-up. Clinical, pharmacological, and radiation parameters were recorded. Toxicities were measured by Common Terminology Criteria for Adverse...
Source: Hong Kong Med J - Category: General Medicine Authors: Tags: Hong Kong Med J Source Type: research
Introduction. This contribution aims to present the analysis of a dosimetric database containing around 700 patients treated for prostate cancer between 2016 and 2018. Currently, the quality of dosimetry is determined based on clinical goals coming essentially from Recorad 1. In this work we seek to improve our validation criteria for intensity modulation (IMRT/VMAT) treatments.
Source: Physica Medica: European Journal of Medical Physics - Category: General Medicine Authors: Source Type: research
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