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.
Multiple management options are available for clinically localized prostate cancer, including definitive external beam radiation therapy (EBRT), radical prostatectomy (RP), brachytherapy (BT), and, for patients with low-risk and favorable intermediate-risk disease, active surveillance.1 Given the high cure rate and long life expectancy after treatment, quality of life (QOL) often remains the paramount factor in decision-making for patients with clinically localized disease.2 Several validated patient-reported outcome (PRO) instruments exist for prostate cancer.
To compare 10-year late complications of radical prostatectomy (RP) versus external-beam-radiation-therapy (EBRT) versus brachytherapy (BT).
Conclusions: 18F-DCFPyL detected more lesions than mpMRI within the same FOV across all therapy groups with the most lesions in those who had undergone both prostatectomy and radiation (89 lesions). MRI detected more lesions than 18F-DCFPyL in the prostate bed, primarily in the surgical and radiotherapy groups (35 and 36 lesions, respectively) with the least number of lesions seen in the dual therapy group (24 lesions). Concordance rates between the two modalities was comparably modest among the treatment groups (20.8% for surgery, 33.3% for radiation and 21.2% for both.) Curative therapy method (surgery, radiation or both...
Purpose: Men with Gleason grade group 5 (GG5) prostate cancer (PCa) have particularly aggressive disease, and current guidelines recommend external beam radiation therapy (EBRT) with or without a brachytherapy (BT) boost plus androgen deprivation therapy (ADT) or radical prostatectomy (RP) with pelvic lymph node dissection. The largest retrospective cohort study to date previously demonstrated that EBRT plus a BT boost was associated with significantly better prostate-cancer specific mortality (PCSM) and lower rate of distant metastases (DM) compared with EBRT alone (Kishan, JAMA 2018).
Conclusion[18F]PSMA-1007-PET/CT showed a high positivity rate in patients with biochemically recurrent PCa. PSA value and PSA velocity were significant predictors of scan positivity as well as of the presence and number of bone and soft tissue lesions and the number of LN lesions. Our findings can guide clinicians in optimal patient selection for [18F]PSMA-1007-PET/CT and support further research leading to the development of a prediction nomogram.
CONCLUSIONS: In men with recurrent prostate cancer after radiotherapy, biopsy findings and MRI can be used to select index lesions potentially amenable for sPGA and can guide patient evaluation for inclusion in clinical trials of sPGA following radiation failure. Larger, prospective studies are required to evaluate both the role of MRI and clinical criteria in guiding focal salvage therapy and the effectiveness of this modality for radiorecurrent prostate cancer.PMID:33583697 | DOI:10.1016/j.urolonc.2021.01.011
CONCLUSIONS: In men with recurrent prostate cancer after radiotherapy, biopsy findings and MRI can be used to select index lesions potentially amenable for sPGA and can guide patient evaluation for inclusion in clinical trials of sPGA following radiation failure. Larger, prospective studies are required to evaluate both the role of MRI and clinical criteria in guiding focal salvage therapy and the effectiveness of this modality for radiorecurrent prostate cancer. PMID: 33583697 [PubMed - as supplied by publisher]
CONCLUSION: Prostate cancer treatment choices differ substantially between men diagnosed in private and public health services in Victoria. These differences are not explained by disease severity or comorbidity. PMID: 32996611 [PubMed - as supplied by publisher]
CONCLUSION: PDR salvage brachytherapy in local recurrent previously irradiated prostate cancer is efficient with low late toxicity. Salvage-brachytherapy represents a valuable therapeutic option for the treatment of previously irradiated locally recurrent prostate cancer. PMID: 32593646 [PubMed - as supplied by publisher]
1247Background: While the diagnostic performance of 18F-FACBC PET/CT imaging in the restaging of patients with biochemical recurrence (BCR) after initial prostatectomy is well documented, its clinical utility in patients with BCR following primary non-prostatectomy treatments is unknown. We aimed to determine detection rate of 18F-FACBC PET/CT scan and the patterns of prostate cancer recurrence in patients with suspected BCR after initial non-prostatectomy treatments, particularly in patients with PSA levels below the accepted Phoenix definition of PSA failure (PSA nadir + 2). Methods: In this single tertiary institution s...