Validation of different PSMA-PET/CT-based contouring techniques for intraprostatic tumor definition using histopathology as standard of reference
The identification and accurate contouring of the intraprostatic tumor volume is a crucial step for diagnostic and therapeutic approaches in patients with primary prostate cancer (PCa). In the last decade the concept of focal radiation therapy (RT) has gained interest for patients with PCa and boosting the RT dose to the visible tumor areas within the prostate may improve treatment outcome [1,2]. Moreover, recurrent PCa after conventional RT often occurs at the site of the primary tumor [3,4]. Currently, several phase III trials (e.g.
High-dose, precision radiation therapy extends progression-free survival in recurrent prostate cancer with limited metastatic spread and prevents the development of new lesions at 6 months.Medscape Medical News
Authors: Morgentaler A, Caliber M Abstract Introduction: The use of testosterone therapy (TTh) in men with prostate cancer (PCa) is relatively new, and controversial, due to the longstanding maxim that TTh is contraindicated in men with PCa. Scientific advances have prompted a reevaluation of the potential role for TTh in men with PCa, particularly as TTh has been shown to provide important symptomatic and general health benefits to men with testosterone deficiency (TD), including many men with PCa who may expect to live 30-50 years after diagnosis. Areas covered: This review outlines the historical underpinnings o...
This report demonstrates a patient with high PSA levels (856 ng/mL) at time of biochemical recurrence that showed only 1 metastasis on PSMA PET/CT. Combined androgen deprivation therapy and radiation therapy resulted in a complete biochemical response.
Abstract PURPOSE: Systemic androgen-signaling inhibition added to ongoing androgen-deprivation therapy (ADT) improved clinical outcomes in patients with nonmetastatic castration-resistant prostate cancer without detectable metastases by conventional imaging (nmCRPC). Prostate-specific membrane antigen ligand positron-emission tomography (PSMA-PET) detects prostate cancer with superior sensitivity to conventional imaging, but its performance in nmCRPC remains largely unknown. We characterized cancer burden in high-risk nmCRPC patients using PSMA-PET. EXPERIMENTAL DESIGN: We retrospectively included 200 patient...
CONCLUSION: There is increasing variation among group practices in the use of conservative management for prostate cancer. This underscores the need for a better understanding of practice-level factors that influence prostate cancer management. PMID: 31509481 [PubMed - as supplied by publisher]
CONCLUSIONS: These findings suggest that moderate hypofractionation (up to a fraction size of 3.4 Gy) results in similar oncologic outcomes in terms of disease-specific, metastasis-free and overall survival. There appears to be little to no increase in both acute and late toxicity. PMID: 31476800 [PubMed - as supplied by publisher]
CONCLUSIONS: Prostate cancer patients experience significant declines in HRQoL after primary therapy. Additional secondary therapy after RP, in the form of EBRT and/or ADT, appears to be responsible for further deterioration in HRQoL outcomes. PMID: 31469635 [PubMed - in process]
Conclusions: Fluoroscopy and 3D CT image-guided interstitial brachytherapy is feasible and appears to be a suitable treatment technique for patients with clinically localized prostate cancer after previous rectal resection and external beam radiation therapy. PMID: 31435432 [PubMed]
Medical device companies attempting to market a new treatment in the U.S. often make the erroneous assumption that winning FDA approvalÂ is the final destination, and success is theirs. In fact, going through the regulatory process is only the halfway point. The grueling path from FDA approval to reimbursement is like a treacherous walk through Death Valley and many companies donât make it through. In this case study, I discussÂ the trials and triumphs of bringing robotic high intensity focused ultrasound (HIFU), a non-invasive procedure for localized prostate cancer, to the U.S.&Aci...
ConclusionA decision tree based on the JDH metrics that can quickly determine the necessity of online replanning based on the image of the day without segmentation has been determined using a machine learning process. The process can be automated and completed within a minute, allowing users to quickly decide which fractions require OLAR.