A phase IB clinical trial of 15 Gy HDR brachytherapy followed by hypofractionated/SBRT in the management of intermediate-risk prostate cancer
High dose-rate (HDR) brachytherapy is commonly administered as a boost to external beam radiation therapy (EBRT). Our purpose was to compare toxicity with increasingly hypofractionated EBRT in combination with a single 15 Gy HDR boost for men with intermediate-risk prostate cancer.
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]
Multiple forms of definitive radiotherapy are acceptable alternatives to more prolonged radiotherapy regimens for men with intermediate-risk prostate cancer (PCa) and can be considered for men with low-risk disease who decline active surveillance. Stereotactic body radiotherapy (SBRT) is an external beam radiotherapy modality in which large radiation doses are delivered over five or fewer fractions. Two forms of brachytherapy -- permanent seed implant low dose rate brachytherapy (LDR-BT) and temporary interstitial implant high dose rate brachytherapy (HDR-BT) -- are also options.
Optimal therapy for clinically node-positive, nonmetastatic (cN1) prostate cancer (PC) patients remains controversial, ranging from aggressive local therapy to palliative systematic therapy alone. Despite guideline support, it is unclear if a brachytherapy (BT) boost should be considered for cN1 patients as these patients were excluded from randomized trials establishing its benefit. Herein, we compare definitive radiation therapy (RT) with or without a BT boost in cN1 PC.
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]
ConclusionsMaximal reduction of the rectal dose seems very important to prevent serious rectal hemorrhage. In addition, we should consider the risk of rectal toxicities in patients with abnormalities in the rectal mucosa, especially hemorrhoids.
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...
Authors: Konat-Bąska K, Chicheł A, Staszek-Szewczyk U, Maciejczyk A, Matkowski R Abstract Purpose: Prostate and colorectal cancers are the first and the third most popular malignancies in male population, in which some patients may develop these tumors metachronously or synchronously. At present, there are no standard recommendations, and oncologists need to provide an optimal management for two different cancers with an acceptable risk of possible treatment of adverse effects. Material and methods: This case report presents the treatment of a 61-year-old patient suffering from synchronous prostate and rectal...
Dose-escalated external beam radiation therapy results in improved outcomes for patients with prostate cancer, but at the cost of increased gastrointestinal toxicity [1 –3]. Indeed, the prostate is not a static organ, and nearby critical structures present a limiting factor to delivering higher doses to the target volume. Methods including image-guided radiation therapy (IGRT) and intensity modulated radiation therapy (IMRT) have been developed to help reduce tox icity rates by improving confidence in target localization and by increasing dose conformity, respectively.
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.