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By Alessandro Franciscon doctor
Sergio Faria, Russel Ruo, Fabio Cury, Marie Duclos, Luis Souhami
PURPOSE: To report acute and late toxicity rates in patients with high-risk prostate cancer treated with androgen deprivation therapy (ADT) and moderate hypofractionated radiation therapy (HypoRT) to the prostate and nodal areas. METHODS AND MATERIALS: Patients with localized, high-risk prostate cancer were treated with a HypoRT regimen of 60 Gy in 20 fractions (4 weeks) to the prostate volume while the nodal areas received 44 Gy in the same 20 fractions delivered with intensity modulated RT with a simultaneous integrated boost technique...
July 2017: Practical Radiation Oncology
Scott C Morgan, Karen Hoffman, D Andrew Loblaw, Mark K Buyyounouski, Caroline Patton, Daniel Barocas, Soren Bentzen, Michael Chang, Jason Efstathiou, Patrick Greany, Per Halvorsen, Bridget F Koontz, Colleen Lawton, C Marc Leyrer, Daniel Lin, Michael Ray, Howard Sandler
No abstract text is available yet for this article.
October 11, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Christopher C Parker, Nicholas D James, Christopher D Brawley, Noel W Clarke, Alex P Hoyle, Adnan Ali, Alastair W S Ritchie, Gerhardt Attard, Simon Chowdhury, William Cross, David P Dearnaley, Silke Gillessen, Clare Gilson, Robert J Jones, Ruth E Langley, Zafar I Malik, Malcolm D Mason, David Matheson, Robin Millman, J Martin Russell, George N Thalmann, Claire L Amos, Roberto Alonzi, Amit Bahl, Alison Birtle, Omar Din, Hassan Douis, Chinnamani Eswar, Joanna Gale, Melissa R Gannon, Sai Jonnada, Sara Khaksar, Jason F Lester, Joe M O'Sullivan, Omi A Parikh, Ian D Pedley, Delia M Pudney, Denise J Sheehan, Narayanan Nair Srihari, Anna T H Tran, Mahesh K B Parmar, Matthew R Sydes
BACKGROUND: Based on previous findings, we hypothesised that radiotherapy to the prostate would improve overall survival in men with metastatic prostate cancer, and that the benefit would be greatest in patients with a low metastatic burden. We aimed to compare standard of care for metastatic prostate cancer, with and without radiotherapy. METHODS: We did a randomised controlled phase 3 trial at 117 hospitals in Switzerland and the UK. Eligible patients had newly diagnosed metastatic prostate cancer...
October 18, 2018: Lancet
Scott C Morgan, Karen Hoffman, D Andrew Loblaw, Mark K Buyyounouski, Caroline Patton, Daniel Barocas, Soren Bentzen, Michael Chang, Jason Efstathiou, Patrick Greany, Per Halvorsen, Bridget F Koontz, Colleen Lawton, C Marc Leyrer, Daniel Lin, Michael Ray, Howard Sandler
PURPOSE: The aim of this guideline is to present recommendations regarding moderately hypofractionated (240-340 cGy per fraction) and ultrahypofractionated (500 cGy or more per fraction) radiation therapy for localized prostate cancer. METHODS AND MATERIALS: The American Society for Radiation Oncology convened a task force to address 8 key questions on appropriate indications and dose-fractionation for moderately and ultrahypofractionated radiation therapy, as well as technical issues, including normal tissue dose constraints, treatment volumes, and use of image guided and intensity modulated radiation therapy...
November 2018: Practical Radiation Oncology
Justin E Bekelman, R Bryan Rumble, Ronald C Chen, Thomas M Pisansky, Antonio Finelli, Andrew Feifer, Paul L Nguyen, D Andrew Loblaw, Scott T Tagawa, Silke Gillessen, Todd M Morgan, Glenn Liu, Neha Vapiwala, John J Haluschak, Andrew Stephenson, Karim Touijer, Terry Kungel, Stephen J Freedland
Purpose In April 2017, the American Urological Association, American Society for Radiation Oncology, and Society of Urologic Oncology released a joint evidence-based practice guideline on clinically localized prostate cancer. The American Society of Clinical Oncology (ASCO) has a policy and set of procedures for endorsing clinical practice guidelines that have been developed by other professional organizations. Methods The Clinically Localized Prostate Cancer guideline was reviewed for developmental rigor by methodologists...
September 5, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Sebastian Zschaeck, Fabian Lohaus, Marcus Beck, Gregor Habl, Stephanie Kroeze, Constantinos Zamboglou, Stefan Alexander Koerber, Jürgen Debus, Tobias Hölscher, Peter Wust, Ute Ganswindt, Alexander D J Baur, Klaus Zöphel, Nikola Cihoric, Matthias Guckenberger, Stephanie E Combs, Anca Ligia Grosu, Pirus Ghadjar, Claus Belka
68 Gallium prostate specific membrane antigen (PSMA) ligand positron emission tomography (PET) is an increasingly used imaging modality in prostate cancer, especially in cases of tumor recurrence after curative intended therapy. Owed to the novelty of the PSMA-targeting tracers, clinical evidence on the value of PSMA-PET is moderate but rapidly increasing. State of the art imaging is pivotal for radiotherapy treatment planning as it may affect dose prescription, target delineation and use of concomitant therapy...
May 11, 2018: Radiation Oncology
Zachary S Zumsteg, Michael J Zelefsky
What is the best way to manage patients with intermediate-risk prostate cancer? One of the most controversial aspects of treatment is the role of short-term androgen deprivation therapy in combination with definitive radiotherapy. In two randomised trials of patients with mostly intermediate-risk prostate cancer, increased overall survival was reported when short-term androgen deprivation therapy was added to radiotherapy. However, radiation doses in these studies were far below the current standard of care...
June 2012: Lancet Oncology
William L Hwang, Rahul D Tendulkar, Andrzej Niemierko, Shree Agrawal, Kevin L Stephans, Daniel E Spratt, Jason W Hearn, Bridget F Koontz, W Robert Lee, Jeff M Michalski, Thomas M Pisansky, Stanley L Liauw, Matthew C Abramowitz, Alan Pollack, Drew Moghanaki, Mitchell S Anscher, Robert B Den, Anthony L Zietman, Andrew J Stephenson, Jason A Efstathiou
Importance: Prostate cancer with adverse pathological features (ie, pT3 and/or positive margins) after prostatectomy may be managed with adjuvant radiotherapy (ART) or surveillance followed by early-salvage radiotherapy (ESRT) for biochemical recurrence. The optimal timing of postoperative radiotherapy is unclear. Objective: To compare the clinical outcomes of postoperative ART and ESRT administered to patients with prostate cancer with adverse pathological features...
May 10, 2018: JAMA Oncology
James M Wilson, David P Dearnaley, Isabel Syndikus, Vincent Khoo, Alison Birtle, David Bloomfield, Ananya Choudhury, John Graham, Catherine Ferguson, Zafar Malik, Julian Money-Kyrle, Joe M O'Sullivan, Miguel Panades, Chris Parker, Yvonne Rimmer, Christopher Scrase, John Staffurth, Andrew Stockdale, Clare Cruickshank, Clare Griffin, Emma Hall
PURPOSE: Outcome data on radiation therapy for prostate cancer in an elderly population are sparse. The CHHiP (Conventional or Hypofractionated High Dose Intensity Modulated Radiotherapy in Prostate Cancer) trial provides a large, prospectively collected, contemporary dataset in which to explore outcomes by age. METHODS AND MATERIALS: CHHiP participants received 3 to 6 months of androgen deprivation therapy and were randomly assigned (1:1:1) to receive 74 Gy in 37 fractions (conventional fractionation), 60 Gy in 20 fractions, or 57 Gy in 19 fractions...
April 1, 2018: International Journal of Radiation Oncology, Biology, Physics
David Dearnaley, Isabel Syndikus, Helen Mossop, Vincent Khoo, Alison Birtle, David Bloomfield, John Graham, Peter Kirkbride, John Logue, Zafar Malik, Julian Money-Kyrle, Joe M O'Sullivan, Miguel Panades, Chris Parker, Helen Patterson, Christopher Scrase, John Staffurth, Andrew Stockdale, Jean Tremlett, Margaret Bidmead, Helen Mayles, Olivia Naismith, Chris South, Annie Gao, Clare Cruickshank, Shama Hassan, Julia Pugh, Clare Griffin, Emma Hall
BACKGROUND: Prostate cancer might have high radiation-fraction sensitivity that would give a therapeutic advantage to hypofractionated treatment. We present a pre-planned analysis of the efficacy and side-effects of a randomised trial comparing conventional and hypofractionated radiotherapy after 5 years follow-up. METHODS: CHHiP is a randomised, phase 3, non-inferiority trial that recruited men with localised prostate cancer (pT1b-T3aN0M0). Patients were randomly assigned (1:1:1) to conventional (74 Gy delivered in 37 fractions over 7·4 weeks) or one of two hypofractionated schedules (60 Gy in 20 fractions over 4 weeks or 57 Gy in 19 fractions over 3·8 weeks) all delivered with intensity-modulated techniques...
August 2016: Lancet Oncology
W Robert Lee, James J Dignam, Mahul B Amin, Deborah W Bruner, Daniel Low, Gregory P Swanson, Amit B Shah, David P D'Souza, Jeff M Michalski, Ian S Dayes, Samantha A Seaward, William A Hall, Paul L Nguyen, Thomas M Pisansky, Sergio L Faria, Yuhchyau Chen, Bridget F Koontz, Rebecca Paulus, Howard M Sandler
PURPOSE: Conventional radiotherapy (C-RT) treatment schedules for patients with prostate cancer typically require 40 to 45 treatments that take place from > 8 to 9 weeks. Preclinical and clinical research suggest that hypofractionation-fewer treatments but at a higher dose per treatment-may produce similar outcomes. This trial was designed to assess whether the efficacy of a hypofractionated radiotherapy (H-RT) treatment schedule is no worse than a C-RT schedule in men with low-risk prostate cancer...
July 10, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Joseph Chin, R Bryan Rumble, Marisa Kollmeier, Elisabeth Heath, Jason Efstathiou, Tanya Dorff, Barry Berman, Andrew Feifer, Arthur Jacques, D Andrew Loblaw
Purpose To jointly update the Cancer Care Ontario guideline on brachytherapy for patients with prostate cancer to account for new evidence. Methods An Update Panel conducted a targeted systematic literature review and identified more recent randomized controlled trials comparing dose-escalated external beam radiation therapy (EBRT) with brachytherapy in men with prostate cancer. Results Five randomized controlled trials provided the evidence for this update. Recommendations For patients with low-risk prostate cancer who require or choose active treatment, low-dose rate brachytherapy (LDR) alone, EBRT alone, and/or radical prostatectomy (RP) should be offered to eligible patients...
May 20, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
J Athene Lane, Jenny L Donovan, Michael Davis, Eleanor Walsh, Daniel Dedman, Liz Down, Emma L Turner, Malcolm D Mason, Chris Metcalfe, Tim J Peters, Richard M Martin, David E Neal, Freddie C Hamdy
BACKGROUND: Prostate cancer is a major public health problem with considerable uncertainties about the effectiveness of population screening and treatment options. We report the study design, participant sociodemographic and clinical characteristics, and the initial results of the testing and diagnostic phase of the Prostate testing for cancer and Treatment (ProtecT) trial, which aims to investigate the effectiveness of treatments for localised prostate cancer. METHODS: In this randomised phase 3 trial, men aged 50-69 years registered at 337 primary care centres in nine UK cities were invited to attend a specialist nurse appointment for a serum prostate-specific antigen (PSA) test...
September 2014: Lancet Oncology
Johannes Schwenck, Hansjoerg Rempp, Gerald Reischl, Stephan Kruck, Arnulf Stenzl, Konstantin Nikolaou, Christina Pfannenberg, Christian la Fougère
PURPOSE: Prostate-specific membrane antigen (PSMA) is expressed ubiquitously on the membrane of most prostate tumors and its metastasis. While PET/CT using 11 C-choline was considered as the gold standard in the staging of prostate cancer, PET with radiolabelled PSMA ligands was introduced into the clinic in recent years. Our aim was to compare the PSMA ligand 68 Ga-PSMA-11 with 11 C-choline in patients with primary and recurrent prostate cancer. METHODS: 123 patients underwent a whole-body PET/CT examination using 68 Ga-PSMA-11 and 11 C-choline...
January 2017: European Journal of Nuclear Medicine and Molecular Imaging
Paul B Romesser, Xin Pei, Weiji Shi, Zhigang Zhang, Marisa Kollmeier, Sean M McBride, Michael J Zelefsky
PURPOSE: To evaluate the difference in prostate-specific antigen (PSA) recurrence-free, distant metastasis-free, overall, and cancer-specific survival between PSA bounce (PSA-B) and non-bounce patients treated with dose-escalated external beam radiation therapy (DE-EBRT). METHODS AND MATERIALS: During 1990-2010, 1898 prostate adenocarcinoma patients were treated with DE-EBRT to ≥75 Gy with ≥5 years follow-up. Patients receiving neoadjuvant/concurrent androgen-deprivation therapy (n=1035) or with fewer than 4 PSA values obtained 6 months or more after post-EBRT completion (n=87) were excluded...
January 1, 2018: International Journal of Radiation Oncology, Biology, Physics
Nina-Sophie Schmidt-Hegemann, Wolfgang Peter Fendler, Alexander Buchner, Christian Stief, Paul Rogowski, Maximilian Niyazi, Chukwuka Eze, Minglun Li, Peter Bartenstein, Claus Belka, Ute Ganswindt
BACKGROUND: To determine the potential role of 68 Ga-PSMA positron emission tomography/computed tomography (PET/CT) in radiotherapy (RT) planning for prostate cancer (PCa). METHODS: One hundred twenty-nine patients (pts) with 68 Ga-PSMA PET/CT were retrospectively analysed. Potentially influencing factors (androgen deprivation therapy, amount of 68 Ga-PSMA-HBED-CC, PSA doubling time ≤/> 10 months, PSA before PET/CT, T-/N-category and Gleason score) were evaluated by logistic regression analysis...
November 10, 2017: Radiation Oncology
Karim Fizazi, NamPhuong Tran, Luis Fein, Nobuaki Matsubara, Alfredo Rodriguez-Antolin, Boris Y Alekseev, Mustafa Özgüroğlu, Dingwei Ye, Susan Feyerabend, Andrew Protheroe, Peter De Porre, Thian Kheoh, Youn C Park, Mary B Todd, Kim N Chi
BACKGROUND: Abiraterone acetate, a drug that blocks endogenous androgen synthesis, plus prednisone is indicated for metastatic castration-resistant prostate cancer. We evaluated the clinical benefit of abiraterone acetate plus prednisone with androgen-deprivation therapy in patients with newly diagnosed, metastatic, castration-sensitive prostate cancer. METHODS: In this double-blind, placebo-controlled, phase 3 trial, we randomly assigned 1199 patients to receive either androgen-deprivation therapy plus abiraterone acetate (1000 mg daily, given once daily as four 250-mg tablets) plus prednisone (5 mg daily) (the abiraterone group) or androgen-deprivation therapy plus dual placebos (the placebo group)...
July 27, 2017: New England Journal of Medicine
William U Shipley, Wendy Seiferheld, Himanshu R Lukka, Pierre P Major, Niall M Heney, David J Grignon, Oliver Sartor, Maltibehn P Patel, Jean-Paul Bahary, Anthony L Zietman, Thomas M Pisansky, Kenneth L Zeitzer, Colleen A F Lawton, Felix Y Feng, Richard D Lovett, Alexander G Balogh, Luis Souhami, Seth A Rosenthal, Kevin J Kerlin, James J Dignam, Stephanie L Pugh, Howard M Sandler
BACKGROUND: Salvage radiation therapy is often necessary in men who have undergone radical prostatectomy and have evidence of prostate-cancer recurrence signaled by a persistently or recurrently elevated prostate-specific antigen (PSA) level. Whether antiandrogen therapy with radiation therapy will further improve cancer control and prolong overall survival is unknown. METHODS: In a double-blind, placebo-controlled trial conducted from 1998 through 2003, we assigned 760 eligible patients who had undergone prostatectomy with a lymphadenectomy and had disease, as assessed on pathological testing, with a tumor stage of T2 (confined to the prostate but with a positive surgical margin) or T3 (with histologic extension beyond the prostatic capsule), no nodal involvement, and a detectable PSA level of 0...
February 2, 2017: New England Journal of Medicine
James R Broughman, Ronald C Chen
Historically, stage IV prostate cancer was considered incurable. Although node-positive and oligometastatic prostate cancers are both classified as stage IV, these likely represent distinct clinical groups, and some patients may be curable with aggressive multimodality treatments. There is a lack of randomized evidence, but retrospective studies suggest that radical prostatectomy or radiotherapy may improve survival in these patients. This is an area of great current research interest and prospective randomized trials are needed to help define the optimal treatments for these patients...
January 2017: Seminars in Radiation Oncology
Dirk Boehmer, Philippe Maingon, Philip Poortmans, Marie-Hélène Baron, Raymond Miralbell, Vincent Remouchamps, Christopher Scrase, Alberto Bossi, Michel Bolla
BACKGROUND AND PURPOSES: The appropriate application of 3-D conformal radiotherapy, intensity modulated radiotherapy or image guided radiotherapy for patients undergoing radiotherapy for prostate cancer requires a standardisation of target delineation as well as clinical quality assurance procedures. PATIENTS AND METHODS: Pathological and imaging studies provide valuable information on tumour extension. In addition, clinical investigations on patient positioning and immobilisation as well as treatment verification data offer an abundance of information...
June 2006: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
2016-07-07 20:06:01
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