Re: Sebastian Berg, Alexander P. Cole, Marieke J. Krimphove, et al. Comparative Effectiveness of Radical Prostatectomy Versus External Beam Radiation Therapy Plus Brachytherapy in Patients with High-risk Localized Prostate Cancer. Eur Urol 2019;75:552–5
Publication date: Available online 23 May 2019Source: European UrologyAuthor(s): Michael Froehner, Christian Thomas
Prostate cancer therapies are improving over time. But how do the long-term side effects from the various options available today compare? Results from a newly published study are providing some valuable insights. Investigators at Vanderbilt University and the University of Texas MD Anderson Cancer Center spent five years tracking the sexual, bowel, urinary, and hormonal status of nearly 2,000 men after they had been treated for prostate cancer, or monitored with active surveillance (which entails checking the tumor periodically and treating it only if it begins to grow). Cancers in all the men were still confined to the p...
The age-old question in prostate cancer is which treatment is better, radical prostatectomy (RP) or external beam radiation therapy (EBRT)? Typically, RP failed at the margins of resection, whereas EBRT failed at the site of origin, and survival rates were the same. However, with low-dose rate (LDR) brachytherapy (BT), one can deliver high, ablative doses to the prostate, while also covering the edges, thereby capturing the best of both worlds.
ConclusionEBRT + BT was associated with a significantly better prostate CSS compared with surgery or EBRT. EBRT alone was inferior to surgery by OS.
To compare 10-year oncologic treatment outcomes of radical prostatectomy (RP) vs external beam radiation therapy (EBRT) vs brachytherapy (BT) for patients with intermediate risk prostate cancer (IRPC).
In this study we evaluate the lesion detection efficacy of18F-DCFPyL PET/CT in patients with BCR and determine the detection efficacy as a function of their PSA value.MethodsA total of 248 consecutive patients were evaluated and underwent scanning with18F-DCFPyL PET/CT for BCR between November 2016 and 2018 in two hospitals in the Netherlands. Patients were examined after radical prostatectomy (52%), external-beam radiation therapy (42%) or brachytherapy (6%). Imaging was performed 120 min after injection of a median dose of 311 MBq18F-DCFPyL.ResultsIn 214 out of 248 PET/CT scans (86.3%), at least one lesion sug...
CONCLUSIONS: In this systematic review and meta-analysis, we did not observe higher rate of BCR after TRT for nonmetastatic CaP patients after definitive local therapy. Based on these data, others and we have outlined a phase I/II trial assessing the safety and benefits of TRT in select men with secondary symptomatic hypogonadism who have no active disease after definitive local CaP therapy with curative intent. PMID: 31296421 [PubMed - as supplied by publisher]
Publication date: Available online 4 June 2019Source: European UrologyAuthor(s): Sebastian Berg, Alexander Cole, Quoc-Dien Trinh
CONCLUSION: We found no statistically significant difference in survival between RP and EBRT+BT. EBRT and brachytherapy had higher mortality, respectively, compared to RP. When including only radiotherapy patients who received ADT and, in the case of EBRT, a total dose ≥ 7920 cGy, there was no statistically significant difference in survival when comparing RP to EBRT or brachytherapy. These findings should be prospectively studied. PMID: 31109836 [PubMed - as supplied by publisher]
Cancer, still presenting one of the major challenges in modern healthcare, leads to more than 8.8 million deaths annually. While the main treatment options include surgery, chemotherapy, and radiotherapy, increasing attention is given to brachytherapy in e.g. the treatment of prostate cancer. Advantages of brachytherapy, as compared to radical prostatectomy and external beam radiation therapy, lie in the much higher radiation doses which can be given to the tumour tissue whilst sparing healthy tissue.
ConclusionssRP was safe, feasible, and effective using either an open or robot-assisted approach, in experienced hands. Age, preoperative clinical stage, NS procedure, and pathological GS were linked with BCR after sRP.