Treatment Intensification in High-Risk Prostate Cancer: Lessons From the TROG 03.04 RADAR Trial

Thousands of men across the world have participated in randomized clinical trials testing the role of hormone therapy in the curative treatment of localized, high-risk prostate cancer. Over several decades, we have established that long-term hormone therapy improves survival, even in the setting of dose-escalated external beam radiation therapy (EBRT).1 Recently reported clinical trials suggest that for some men 18 months of hormone therapy may be a suitable duration that balances treatment efficacy with quality-of-life preservation.
Source: International Journal of Radiation Oncology * Biology * Physics - Category: Radiology Authors: Tags: Editorial Source Type: research

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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]
Source: Journal of Contemporary Brachytherapy - Category: Cancer & Oncology Tags: J Contemp Brachytherapy Source Type: research
Conclusions The recent, first randomized clinical trial demonstrated overall and progression free survival benefits after SBRT to oligometastatic disease which supports prior retrospective case series (6). The spine is a common site of metastatic bone disease, and as high quality data continue to mature, along with completion of additional randomized clinical trials, it is expected that utility of SBRT to the spine will increase in the future. Spine SBRT is unique due to the requirement of sharp dose falloff to prevent serious neurologic morbidity. With recent advances in radiotherapy planning, robotic patient positionin...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
ConclusionsThe current RCT comparing ADT to ADT with EBRT to the prostate in patients with primary bone mPCa did not show a significant difference in overall survival, although the CI cannot exclude a substantial survival benefit. Further research is needed to confirm our findings.Patient summaryThis study investigated the effect of adding radiation therapy to the prostate to hormonal therapy in prostate cancer patients with metastasis to the bone at diagnosis. In our patient group, additional radiotherapy did not improve overall survival. Further research is needed to confirm our findings.Twitter summaryAdding radiotherap...
Source: European Urology - Category: Urology & Nephrology Source Type: research
For men diagnosed with aggressive cancer that’s confined to the prostate and nearby tissues, the overarching goal of treatment is to keep the disease from spreading (or metastasizing) in the body. Doctors can treat these men with localized therapies, such as surgery and different types of radiation that target the prostate directly. And they can also give systemic treatments that kill off rogue cancer cells in the bloodstream. Hormonal therapy, for instance, is a systemic treatment that kills prostate cancer cells by depriving them of testosterone, which fuels their growth. Now a new study shows that a mix of differe...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Cancer Men's Health Prostate Health Source Type: blogs
Abstract The aim of the present study was to determine whether oncologic outcomes and adverse events associated with active on/off intermittent antiandrogen monotherapy (daily bicalutamide, 50 mg per day) are comparable with those of standard external beam radiation therapy (EBRT) or combined androgen blockade (CAB) therapy in prostate cancers with positive surgical margins after radical prostatectomy. Two hundred twenty-three patients with positive surgical margins post-radical prostatectomy who underwent active surveillance (AS, n = 32), EBRT without hormone therapy (n = 55), intermittent antiandrogen monotherap...
Source: Asian Journal of Andrology - Category: Urology & Nephrology Authors: Tags: Asian J Androl Source Type: research
nge G Abstract Brachytherapy as sole treatment is standard of care for D'Amico classification low-risk prostate cancer. For intermediate and high-risk patients, brachytherapy can be associated to external beam radiation therapy to better take into account the risk of extracapsular effraction and/or seminal vesicle involvement. Three randomized studies have shown that this association increases freedom from relapse survival compared to exclusive external beam radiation therapy. This benefit is not shown for overall survival. The addition of a hormonal therapy to this association is most likely mandatory for high-ri...
Source: Cancer Radiotherapie - Category: Cancer & Oncology Authors: Tags: Cancer Radiother Source Type: research
Conclusions Although CFxn remains the most common radiation therapy schedule for localized PCa, use of HFxn appears to be increasing in the United States as a result of increased extreme HFxn use. Financial and logistical factors may accelerate adoption of shorter schedules. Considering the multiple demographic and prognostic differences identified between these groups, randomized outcome data comparing extreme HFxn to alternatives are desirable.
Source: Practical Radiation Oncology - Category: Cancer & Oncology Source Type: research
AbstractPurpose of ReviewAndrogen deprivation therapy (ADT) is an important adjunctive therapy to external beam radiation therapy (RT) for the definitive management of prostate cancer. The role of ADT is well-established for locally advanced or high-risk disease in conjunction with standard doses of RT, but less defined for intermediate-risk disease or with dose-escalated RT. The goal of this review is to summarize evidence evaluating the combination of ADT/RT, focusing on recent trials and current controversies as they pertain to the practicing clinician.Recent FindingsThe benefit of ADT on biochemical control is maintain...
Source: Current Urology Reports - Category: Urology & Nephrology Source Type: research
The purpose of this study was to analyze the prognostic significance of sociodemographic factors and comorbidities on biochemical control (bNED) and overall survival (OS) in patients with prostate cancer treated with EBRT +/- hormonal therapy after being evaluated in a multidisciplinary prostate cancer clinic.
Source: International Journal of Radiation Oncology * Biology * Physics - Category: Radiology Authors: Tags: Poster Source Type: research
ConclusionAggressive treatment with short-term androgen deprivation for locally advanced prostate cancer could be beneficial and not harmful when suitable candidates are selected. Delayed androgen deprivation was effective for no adjuvant patients after PSA relapse.
Source: Japanese Journal of Clinical Oncology - Category: Cancer & Oncology Source Type: research
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