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Prostate brachytherapy

Junchao Chen, Clara Oromendia, Joshua A Halpern, Karla V Ballman
PURPOSE: Recent years have brought many changes in the management of localized prostate cancer as national screening guidelines have been updated and diagnostic practice patterns evolved. We sought to better understand how the changing landscape influenced treatment utilization in the United States. METHODS: We used the SEER database in this retrospective analysis of patients with clinically localized prostate cancer between 2004 and 2013. We evaluated utilization of primary treatment modalities over time with descriptive and trend analyses, and examined treatment utilization by cancer risk group and age at diagnosis...
March 14, 2018: Prostate
Karan Lal, Travis J Morrell, Michael Cunningham, Patrick OʼDonnell, Nikki A Levin, Kristine M Cornejo
Cutaneous mixed tumor (chondroid syringoma) is the cutaneous counterpart of pleomorphic adenoma of salivary glands, comprised of both epithelial and mesenchymal components. Malignant transformation is exceptionally rare, with only a few cases reported. We report a case of a malignant cutaneous mixed tumor in an 86-year-old white man who presented with a pink indurated plaque on his left scapula. He had a history of nonmelanoma skin cancers, a stage IB malignant melanoma of a lower extremity and Gleason 4 + 3 prostate cancer treated with brachytherapy, external beam irradiation, and bicalutamide...
March 6, 2018: American Journal of Dermatopathology
Thomas Brun, Jean-Marc Bachaud, Pierre Graff-Cailleaud, Bernard Malavaud, Daniel Portalez, Christian Popotte, Richard Aziza, Amélie Lusque, Thomas Filleron, Soléakhéna Ken
PURPOSE: To present the feasibility study of optimal dose coverage in ultra-focal brachytherapy (UFB) with multiparametric MRI for low- and intermediate-risk prostate cancer. METHODS AND MATERIALS: UFB provisional dose plans for small target volumes (<7 cc) were calculated on a prostate training phantom to optimize the seeds number and strength. Clinical UFB consisted in a contour-based nonrigid registration (MRI/Ultrasound) to implant a fiducial marker at the location of the tumor focus...
March 7, 2018: Brachytherapy
Simon P Keam, Twishi Gulati, Cristina Gamell, Franco Caramia, Cheng Huang, Ralf B Schittenhelm, Oded Kleifeld, Paul J Neeson, Ygal Haupt, Scott G Williams
INTRODUCTION: The development of radioresistance in prostate cancer (PCa) is an important clinical issue and is still largely uninformed by personalized molecular characteristics. The aim of this study was to establish a platform that describes the early oncoproteomic response of human prostate tissue to radiation therapy (RT) using a prospective human tissue cohort. METHODS: Fresh and fixed transperineal biopsies from eight men with clinically localized tumors were taken prior to and 14 days following a single fraction of high-dose-rate brachytherapy...
March 9, 2018: Prostate
Sunil W Dutta, Kristine Bauer-Nilsen, Jason C Sanders, Daniel M Trifiletti, Bruce Libby, Donna H Lash, Melody Lain, Deborah Christodoulou, Constance Hodge, Timothy N Showalter
PURPOSE: To evaluate the delivery cost of frequently used radiotherapy options offered to patients with intermediate- to high-risk prostate cancer using time-driven activity-based costing and compare the results with Medicare reimbursement and relative value units (RVUs). METHODS AND MATERIALS: Process maps were created to represent each step of prostate radiotherapy treatment at our institution. Salary data, equipment purchase costs, and consumable costs were factored into the cost analysis...
March 5, 2018: Brachytherapy
Pierre Graff, Daniel Portalez, Amélie Lusque, Thomas Brun, Richard Aziza, Jonathan Khalifa, Mathieu Roumiguié, Marie-Laure Quintyn Ranty, Thomas Filleron, Jean-Marc Bachaud, Bernard Malavaud
PURPOSE: Focal therapy of prostate cancer requires precise positioning of therapeutic agents within well-characterized index tumors (ITs). We assessed the feasibility of low-dose-rate ultrafocal brachytherapy. METHODS AND MATERIALS: The present study was an institutional review board-approved European Clinical Trials Database-registered phase II protocol. Patients referred (October 2013 to August 2016) for active surveillance (prostate-specific antigen <10 ng/mL, cT1c-cT2a, Gleason score on referring biopsy specimens ≤6 (3+3), ≤3 positive biopsy cores, ≤50% of cancer) were preselected...
February 2, 2018: International Journal of Radiation Oncology, Biology, Physics
Amar U Kishan, Ryan R Cook, Jay P Ciezki, Ashley E Ross, Mark M Pomerantz, Paul L Nguyen, Talha Shaikh, Phuoc T Tran, Kiri A Sandler, Richard G Stock, Gregory S Merrick, D Jeffrey Demanes, Daniel E Spratt, Eyad I Abu-Isa, Trude B Wedde, Wolfgang Lilleby, Daniel J Krauss, Grace K Shaw, Ridwan Alam, Chandana A Reddy, Andrew J Stephenson, Eric A Klein, Daniel Y Song, Jeffrey J Tosoian, John V Hegde, Sun Mi Yoo, Ryan Fiano, Anthony V D'Amico, Nicholas G Nickols, William J Aronson, Ahmad Sadeghi, Stephen Greco, Curtiland Deville, Todd McNutt, Theodore L DeWeese, Robert E Reiter, Johnathan W Said, Michael L Steinberg, Eric M Horwitz, Patrick A Kupelian, Christopher R King
Importance: The optimal treatment for Gleason score 9-10 prostate cancer is unknown. Objective: To compare clinical outcomes of patients with Gleason score 9-10 prostate cancer after definitive treatment. Design, Setting, and Participants: Retrospective cohort study in 12 tertiary centers (11 in the United States, 1 in Norway), with 1809 patients treated between 2000 and 2013. Exposures: Radical prostatectomy (RP), external beam radiotherapy (EBRT) with androgen deprivation therapy, or EBRT plus brachytherapy boost (EBRT+BT) with androgen deprivation therapy...
March 6, 2018: JAMA: the Journal of the American Medical Association
Myriam Laprise-Pelletier, Yunzhi Ma, Jean Lagueux, Marie-France Côté, Luc Beaulieu, Marc-André Fortin
Gold nanoparticles (Au NPs) distributed in the vicinity of low-dose rate (LDR) brachytherapy seeds, could multiply their efficacy thanks to the secondary emissions induced by the photoelectric effect. Injections of radioactive LDR gold nanoparticles (LDR Au NPs), instead of conventional millimetre-size radioactive seeds surrounded by Au NPs, could further enhance the dose by distributing the radioactivity more precisely and homogeneously in tumors. However, the potential of LDR Au NPs as an emerging strategy to treat cancer is strongly dependent on the macroscopic diffusion of the NPs in tumors, as well as on their microscopic internalization within the cells...
March 2, 2018: ACS Nano
Carla Freiberger, Vanessa Berneking, Thomas-Alexander Vögeli, Ruth Kirschner-Hermanns, Michael J Eble, Michael Pinkawa
PURPOSE: The aim of this study was to evaluate quality-of-life changes up to 10 years following three different radiotherapy concepts. METHODS AND MATERIALS: In the years 2000-2003, 295 patients were treated with external beam radiotherapy (EBRT; n = 135; 70.2 Gy in 1.8 Gy fractions), low-dose-rate brachytherapy (LDR-BT with I-125; n = 94; 145 Gy), and high-dose-rate brachytherapy (HDR-BT with Ir-192; n = 66; 18 Gy in two fractions using 4-6 needles) as a boost to EBRT (50...
February 26, 2018: Brachytherapy
Luis Gorospe Sarasúa, Nicolás Alejandro Almeida-Aróstegui, Isabel García-Gómez-Muriel
No abstract text is available yet for this article.
February 26, 2018: Archivos de Bronconeumología
Lennart Åström, Erik Grusell, Fredrik Sandin, Ingela Turesson, Lars Holmberg
BACKGROUND: High-dose-rate brachytherapy (HDR-BT) has optimal prerequisites in radiotherapy of prostate cancer (PC) with a conformal dose distribution and high doses per fraction giving a biological dose escalation. We report the outcome after HDR-BT and external beam radiotherapy (EBRT) after 20 years of experience. MATERIAL AND METHODS: The study includes 623 patients, median age of 66 years, treated from 1995 to 2008 and a median follow up of 11 years (range 2-266 months)...
February 26, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Ronald D Ennis, Liangyuan Hu, Shannon N Ryemon, Joyce Lin, Madhu Mazumdar
Purpose There are no randomized trials to guide treatment decisions between radiotherapeutic and surgical options for patients with high-risk localized prostate cancer. Comparative studies have been limited by their ability to match patients on the basis of pretreatment prognostic variables and to adjust for the cancer-related, medical, and socioeconomic differences between patients who choose radiotherapeutic or surgical approaches. Methods We analyzed the outcome of all patients in the National Cancer Database with high-risk, clinically localized prostate cancer with complete prognostic data who were treated with either radical prostatectomy (RP), external beam radiotherapy (EBRT) combined with androgen deprivation (AD), or EBRT plus brachytherapy with or without AD...
February 28, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Marc Gaudet, Mathieu Pharand-Charbonneau, Marie-Pierre Desrosiers, Debbie Wright, Alain Haddad
PURPOSE: To determine the acute toxicity and effect on health-related quality of life of a two-fraction regimen of high-dose-rate (HDR) prostate brachytherapy. METHODS AND MATERIALS: Patients with low- or intermediate-risk prostate cancer were treated with HDR brachytherapy as monotherapy in two implants of 13.5 Gy spaced 7-14 days apart. Patients completed International Prostate Symptom Score (IPSS) and Expanded Prostate Index Composite (EPIC) questionnaires at 1, 3, 6, 9, 12, 16, 20, and 24 months after brachytherapy...
February 23, 2018: Brachytherapy
Amanda F Saltzman, Nicholas G Cost
PURPOSE OF REVIEW: Rhabdomyosarcoma (RMS) is the most common sarcoma diagnosed in the first 20 years of life; bladder/prostate (BP) RMS accounts for 5% of all cases. Through efforts from multiple cooperative study groups, survival has improved significantly. This article aims to review the complex RMS classification system and treatment of BP RMS, with a focus on developing aspects of treatment. RECENT FINDINGS: Recent advancements in technology are responsible for most of the progress in RMS treatment...
February 22, 2018: Current Urology Reports
Young Kwok, Adeel Kaiser, Stephanie R Rice, Randi Cohen, Mark Mishra
PURPOSE OF REVIEW: The overview summarizes recent developments in radiation oncology for high risk and recurrent prostate cancer. RECENT FINDINGS: A number of well known phase III prostate hypofractionated radiation therapy (HFxRT) trials were finally published with long-term follow-ups. These trials demonstrate patterns of equivalent tumor control with several showing worse toxicity rates. The ASCENDE-RT randomized trial demonstrated the superiority of brachytherapy boost in intermediate and high-risk prostate cancer...
February 19, 2018: Current Opinion in Oncology
Mikael G Jacobsen, Frederik B Thomsen, Mikkel Fode, Rasmus Bisbjerg, Peter B Østergren
OBJECTIVE: Brachytherapy is one of several curative treatments for localized prostate cancer (PCa). The objective of this study was to report biochemical recurrence-free survival (BRFS), metastatic-free survival (MFS) and PCa-specific mortality after low-dose brachytherapy, stratified according to the D'Amico risk classification in a large Danish cohort. MATERIALS AND METHODS: The study population comprised 502 men treated with brachytherapy in 1998-2012. BRFS was defined by the Phoenix criteria...
February 20, 2018: Scandinavian Journal of Urology
Inês Pita, Pedro Bastos, Mário Dinis-Ribeiro
Chronic radiation proctopathy is a frequent complication after both pelvic external radiation therapy and brachytherapy and most commonly presents as rectal bleeding. Deep rectal ulcers and fistulae are much rarer and more clinically challenging consequences. We present the case of a 72-year-old male with a history of prostate adenocarcinoma treated with brachytherapy, who was referred to our institution due to a deep painful rectal ulcer refractory to medical treatment. The ulcer presented shortly after a haemorrhoid elastic band ligation and progressed to rectourethral fistulisation despite both faecal and urinary diversion...
January 2018: GE Portuguese Journal of Gastroenterology
Shearwood McClelland, Kiri A Sandler, Catherine Degnin, Yiyi Chen, Timur Mitin
INTRODUCTION: Three randomized clinical trials have established brachytherapy (BT) boost in combination with external beam radiation therapy (EBRT) and androgen deprivation therapy (ADT) as superior to definitive EBRT and ADT alone in terms of biochemical control (but not overall survival) at the expense of increased toxicity in men with high-risk (HR) prostate cancer (PCa). The current view regarding these 2 treatment algorithms among North American genitourinary (GU) experts is not known...
February 2, 2018: Clinical Genitourinary Cancer
J R Garcia, P Bassa, M Soler, F J Alvarez Moro, T Blanch, E Riera
No abstract text is available yet for this article.
February 11, 2018: Revista Española de Medicina Nuclear e Imagen Molecular
Janusz Skowronek
Cancer incidence and mortality depend on a number of factors, including age, socio-economic status and geographical location, and its prevalence is growing around the world. Most of cancer treatments include external beam radiotherapy or brachytherapy. Brachytherapy, a type of radiotherapy with energy from radionuclides inserted directly into the tumor, is increasingly used in cancer treatment. For cervical and skin cancers, it has become a standard therapy for more than 100 years as well as an important part of the treatment guidelines for other malignancies, including head and neck, skin, breast, and prostate cancers...
December 2017: Journal of Contemporary Brachytherapy
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