New risk classification system proposed for prostate cancer
US researchers have put forward a risk stratification system for patients with intermediate-risk prostate cancer undergoing dose-escalated external-beam radiation therapy.
CONCLUSION: A nomogram tuned to the detection of non-localized disease on PSMA/PET in HR-PCa patients is significantly prognostic of important clinical endpoints, with performance comparable to STAR-CAP and superior to other tools. These data strongly suggest that upstaging based on PSMA PET/CT provides clinically relevant information and warrant prospective validation.PMID:34700573 | DOI:10.1016/j.ijrobp.2021.07.135
The use of brachytherapy for the definitive treatment of localized prostate cancer has been established for over four decades (1). Therapy may be delivered using either permanent seed low dose rate (LDR) or high dose rate (HDR) technique. Both techniques are recommended in the ASCO/CCO joint guidelines (2), and data suggests comparable oncologic outcomes. Brachytherapy may be used as monotherapy for low risk and selected intermediate risk patients or in conjunction with external beam radiation therapy (EBRT) for unfavorable intermediate and high risk patients.
CONCLUSION: In this work we introduce direct incorporation of probabilistic target definition into treatment planning. This treatment planning approach can produce both uniform dose plans and plans with integrated dose boosts that are comparable to ones created using classical dose planning. PTP is a flexible way to optimize external beam radiotherapy, as it is not limited by the use of margins. PTP can produce dose plans equivalent to classical planning, while also allows for greater versatility in dose prescription and direct incorporation of patient target definition uncertainty into treatment planning.PMID:34644696 | D...
ConclusionThe two approaches used in this study showed similar patterns of alterations regarding general and disease specific HRQL with mild superiority for IMRT for the first 6 months after radiation therapy. Comparison of results between the 3DCRT and the IMRT groups revealed no substantial degrees of impairment in rectal toxicity and sexual function despite the dose escalation in the IMRT protocol. Thus, IMRT seems to offer a good treatment delivery approach with favorable HRQL outcomes.
ConclusionIn patients with baseline anticoagulant usage, moderate dose prostate SBRT was well tolerated without rectal spacing. High grade bleeding toxicities were uncommon and resolved with time. Baseline anticoagulation usage should not be considered a contraindication to prostate SBRT.
ConclusionsSalvage reirradiation of radiorecurrent prostate cancer using HDR-BT or SBRT provides similar biochemical control and acceptable late toxicity. Salvage LDR-BT is associated with higher late GU/GI toxicity. Challenges exist in comparing BT and SBRT from inconsistencies in reporting with missing data, and prospective randomised trials are needed.
CONCLUSION: Our review of the literature revealed that salvage Hifu is effective in the treatment of radiorecurrent clinically localized prostate cancer, with an overall survival of 85.2% at 5 years.PMID:34487074 | DOI:10.23750/abm.v92i3.11475
In conclusion, salvage re-irradiation for recurrent prostate cancer in the prostate bed may generate significant toxicity rates, and a prospective study with appropriate patient selection is needed to evaluate its effectiveness.
Addition of a brachytherapy boost to external beam radiation therapy (EBRT) reduces prostate cancer (PCa) recurrence at the expense of genitourinary (GU) toxicity. Whether brachytherapy boost technique, specifically low-dose-rate (LDR-BT) versus high-dose-rate (HDR-BT), impacts treatment-related toxicity is unclear.
CONCLUSIONS: After matching for T-stage and other clinical variables, history of pelvic XRT for prostate cancer in patients who later required RC for bladder cancer, was not associated with an increased rate of perioperative complications or an independent predictor of RFS or OS.PMID:34400070 | DOI:10.1016/j.urolonc.2021.06.017