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Radioterapia Ca Próstata

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https://www.readbyqxmd.com/read/27986213/options-for-salvage-of-radiation-failures-for-prostate-cancer
#1
REVIEW
Audrey Tetreault-Laflamme, Juanita Crook
Biochemical failure after primary external beam radiotherapy for prostate cancer is common, and a significant proportion of these failures are due to local residual or recurrent disease. Early or delayed palliation using androgen deprivation therapy is the most common approach. Although a conservative approach is appropriate for many individuals, selected patients would benefit from retreatment with curative intent. We review the pertinent literature on salvage of locally recurrent prostate cancer after primary radiotherapy, including the modalities of surgery, cryotherapy, high-intensity focused ultrasound, or reirradiation with brachytherapy or stereotactic body radiotherapy...
January 2017: Seminars in Radiation Oncology
https://www.readbyqxmd.com/read/28134800/immune-modulation-by-androgen-deprivation-and-radiation-therapy-implications-for-prostate-cancer-immunotherapy
#2
REVIEW
Jennifer L Kalina, David S Neilson, Alexandra P Comber, Jennifer M Rauw, Abraham S Alexander, Joanna Vergidis, Julian J Lum
Prostate cancer patients often receive androgen deprivation therapy (ADT) in combination with radiation therapy (RT). Recent evidence suggests that both ADT and RT have immune modulatory properties. First, ADT can cause infiltration of lymphocytes into the prostate, although it remains unclear whether the influx of lymphocytes is beneficial, particularly with the advent of new classes of androgen blockers. Second, in rare cases, radiation can elicit immune responses that mediate regression of metastatic lesions lying outside the field of radiation, a phenomenon known as the abscopal response...
January 27, 2017: Cancers
https://www.readbyqxmd.com/read/28244406/six-questions-to-ask-before-we-shorten-radiation-treatments-for-intact-prostate-cancer
#3
EDITORIAL
Justin E Bekelman, W Robert Lee
No abstract text is available yet for this article.
March 15, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28146658/radiation-with-or-without-antiandrogen-therapy-in-recurrent-prostate-cancer
#4
RANDOMIZED CONTROLLED TRIAL
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
https://www.readbyqxmd.com/read/28187996/pattern-of-solid-and-hematopoietic-second-malignancy-after-local-therapy-for-prostate-cancer
#5
Chenyang Wang, Christopher R King, Mitchell Kamrava, Keisuke S Iwamoto, Allen M Chen, Daniel Low, Patrick A Kupelian, Michael L Steinberg
BACKGROUND AND PURPOSE: Second malignancies (SM) after external beam radiotherapy (EBRT) or brachytherapy (BT) for prostate cancer (PCa) are rare but serious sequelae. MATERIALS AND METHODS: The Surveillance, Epidemiology, and End Results (SEER) database was used to identify men diagnosed with cT1-2N0M0 PCa between 1999 and 2005, who underwent EBRT, BT or radical prostatectomy (RP). Patients with time interval to second malignancy or follow-up shorter than five and two years were excluded for solid and hematopoietic SM analyses respectively...
February 7, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28097325/imaging-locally-advanced-recurrent-and-metastatic-prostate-cancer-a-review
#6
Maria L Lindenberg, Baris Turkbey, Esther Mena, Peter L Choyke
Importance: Prostate cancer is the second leading cause of cancer deaths in US men. The course of prostate cancer is highly variable, and timely and accurate detection of clinically significant cancer is critical in positively affecting outcomes. Observations: Molecular imaging methods and magnetic resonance imaging (MRI) are the most promising new developments for prostate tumor visualization. While the benefits of MRI are many, positron emission tomography (PET) radiotracers are still available only as research tools...
January 12, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/28126300/effect-of-long-term-hormonal-therapy-vs-short-term-hormonal-therapy-a-secondary-analysis-of-intermediate-risk-prostate-cancer-patients-treated-on-nrg-oncology-rtog-9202
#7
Amin J Mirhadi, Qiang Zhang, Gerald E Hanks, Herbert Lepor, David J Grignon, Christopher A Peters, Seth A Rosenthal, Kenneth Zeitzer, John S Radwan, Colleen Lawton, Matthew B Parliament, Robert S Reznik, Howard M Sandler
PURPOSE: NRG Oncology RTOG 9202 was a randomized trial testing long-term adjuvant androgen deprivation (LTAD) versus initial androgen deprivation only (STAD) with external beam radiation therapy (RT) in mostly high-risk and some intermediate-risk prostate cancer patients. RTOG 9408 found an overall survival (OS) advantage in patients with cT1b-T2b disease and prostate-specific antigen (PSA) <20 ng/mL, with benefit observed mostly among intermediate-risk patients. It was still unknown whether intermediate-risk patients would experience an additional survival benefit with LTAD; thus, we performed a secondary analysis to explore whether LTAD had any incremental benefit beyond STAD among the intermediate-risk subset of RTOG 9202...
March 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/27155934/high-risk-prostate-cancer-the-role-of-surgical-management
#8
REVIEW
Alessandro Morlacco, R Jeffrey Karnes
High-risk prostate cancer (HR Pca) is a highly heterogeneous disease from a biological and clinical standpoint, and it carries a significant chance of morbidity and mortality. Despite the impact of PSA screening, a significant number of men continue to present with high risk disease and need adequate management: clinical evidence shows that a considerable fraction on men with HR PCa can be actually cured with either uni- or multi-modality approaches. Surgical treatment, once considered unfeasible in this setting, is acquiring more and more diffusion in modern clinical practice...
June 2016: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/27823639/prostate-cancer-perspectives-after-chaarted-optimizing-treatment-sequence
#9
REVIEW
Sergio Vázquez Estévez, Urbano Anido Herranz, Ovidio Fernández Calvo, Francisco Javier Afonso Afonso, Lucía Santomé Couto, Martín Lázaro Quintela, Luis León Mateos, Sonia Maciá Escalante
Prostate cancer is the most frequent cancer amongst men. Until recently, only two therapeutic options, initial androgen-deprivation therapy in patients without castration-resistant prostate cancer, with addition of docetaxel when the disease becomes castration-resistant, were considered as standard. In the last years, new drugs (abiraterone, enzalutamide, Ra-223, Sipuleucel) have been developed for prostate cancer treatment with important advantages in safety and efficacy. Results from the recent Chaarted study, in patients that received docetaxel for the hormone sensitive disease, have contributed to change the initial treatment approach in metastatic prostate cancer, in order to adapt the best sequence for each patient...
November 2016: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/26482453/prostate-dose-painting-radiotherapy-and-radiobiological-guided-optimisation-enhances-the-therapeutic-ratio
#10
J Uzan, A E Nahum, I Syndikus
AIMS: To describe the treatment of 11 patients with radiobiologically guided dose-painting radiotherapy and report on toxicity. MATERIALS AND METHODS: Boost volumes were identified with functional magnetic resonance imaging scans in 11 patients with high-risk prostate cancer. Patients were treated using a dose-painting approach; the boost dose was limited to 86 Gy in 37 fractions, while keeping the rectal normal tissue complication probability to 5-6%. Rotational intensity-modulated radiotherapy was used with daily image guidance and fiducial markers...
March 2016: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/27133945/should-treatment-with-radiation-and-androgen-deprivation-therapy-be-considered-the-gold-standard-for-men-with-unfavourable-intermediate-to-high-risk-and-locally-advanced-prostate-cancer
#11
EDITORIAL
M Roach
No abstract text is available yet for this article.
August 2016: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/27051534/pelvic-radiotherapy-versus-radical-prostatectomy-with-limited-lymph-node-sampling-for-high-grade-prostate-adenocarcinoma
#12
Christopher B Baker, Andrew M McDonald, Eddy S Yang, Rojymon Jacob, Soroush Rais-Bahrami, Jeffrey W Nix, John B Fiveash
Purpose. To compare oncologic outcomes for patients with Gleason score (GS) ≥ 8 prostate adenocarcinoma treated with radical prostatectomy (RP) versus external beam radiotherapy combined with androgen deprivation (RT + ADT). Methods. Between 2001 and 2014, 121 patients with GS ≥ 8 were treated at our institution via RT + ADT (n = 71) or RP (n = 50) with ≥ 1 year of biochemical follow-up. Endpoints included biochemical failure (BF), distant metastasis, and initiation of salvage ADT. Results. The RT + ADT group was older, had higher biopsy GS, and had greater risk of lymph node involvement...
2016: Prostate Cancer
https://www.readbyqxmd.com/read/27022486/prostate-radiotherapy-in-the-era-of-advanced-imaging-and-precision-medicine
#13
REVIEW
Caleb R Dulaney, Daniel O Osula, Eddy S Yang, Soroush Rais-Bahrami
Tremendous technological advancements in prostate radiotherapy have decreased treatment toxicity and improved clinical outcomes for men with prostate cancer. While these advances have allowed for significant treatment volume reduction and whole-organ dose escalation, further improvement in prostate radiotherapy has been limited by classic techniques for diagnosis and risk stratification. Developments in prostate imaging, image-guided targeted biopsy, next-generation gene expression profiling, and targeted molecular therapies now provide information to stratify patients and select treatments based on tumor biology...
2016: Prostate Cancer
https://www.readbyqxmd.com/read/27891254/prostate-cancer-epigenetic-alterations-risk-factors-and-therapy
#14
REVIEW
Mankgopo M Kgatle, Asgar A Kalla, Muhammed M Islam, Mike Sathekge, Razia Moorad
Prostate cancer (PCa) is the most prevalent urological cancer that affects aging men in South Africa, and mechanisms underlying prostate tumorigenesis remain elusive. Research advancements in the field of PCa and epigenetics have allowed for the identification of specific alterations that occur beyond genetics but are still critically important in the pathogenesis of tumorigenesis. Anomalous epigenetic changes associated with PCa include histone modifications, DNA methylation, and noncoding miRNA. These mechanisms regulate and silence hundreds of target genes including some which are key components of cellular signalling pathways that, when perturbed, promote tumorigenesis...
2016: Prostate Cancer
https://www.readbyqxmd.com/read/28049538/risk-of-second-cancer-following-radiotherapy-for-prostate-cancer-a-population-based-analysis
#15
Nina-Sophie Hegemann, Anne Schlesinger-Raab, Ute Ganswindt, Claudia Hörl, Stephanie E Combs, Dieter Hölzel, Jürgen E Gschwend, Christian Stief, Claus Belka, Jutta Engel
BACKGROUND: To investigate the risk of second cancer and radiation induced second cancer following prostate cancer radiotherapy. METHODS: We compared men with radiotherapy only with those treated with radical prostatectomy only and those with radiotherapy after radical prostatectomy. Cumulative incidences of second cancers were calculated. Cox analyses were performed to identify determinants influencing second cancer incidence. RESULTS: Nineteen thousand five hundred thirty eight patients were analyzed...
January 3, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28061904/classifying-high-risk-versus-very-high-risk-prostate-cancer-is-it-relevant-to-outcomes-of-conformal-radiotherapy-and-androgen-deprivation
#16
Akram Saad, Jeffrey Goldstein, Yaacov R Lawrence, Benjamin Spieler, Raya Leibowitz-Amit, Raanan Berger, Tima Davidson, Damien Urban, Lev Tsang, Dror Alezra, Ilana Weiss, Zvi Symon
OBJECTIVE: To evaluate outcomes in prostate cancer patients classified as high-risk (HR) or very high-risk (VHR) who were treated with conformal radiation therapy (CRT) and androgen deprivation therapy (ADT). METHODS: Between 11/2001 and 3/2012, 203 patients with HR disease received CRT to the prostate (78-82 Gy) and pelvic lymph nodes (46-50 Gy) with ADT (6 m-2 years). Median follow-up was 50 months (12 m-142 m). Biochemical failure was defined according to Phoenix definition...
January 6, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/27825433/advancement-of-mr-and-pet-mr-in-prostate-cancer
#17
REVIEW
Liza Lindenberg, Mark Ahlman, Baris Turkbey, Esther Mena, Peter Choyke
Multiparametric magnetic resonance (mpMRI) imaging has assumed a larger role in the diagnosis and management of prostate cancer. The current method of detecting prostate cancer relies on blind systematic biopsy, guided only by transrectal ultrasound that generally directs the needle biopsy to sextants of the prostate rather than specific lesions. MpMRI is playing an increasing role in the detection of primary cancer as it can visualize cancers and direct biopsies. However, even mpMRI is inherently nonspecific and numerous biopsies performed under MR guidance prove to be negative...
November 2016: Seminars in Nuclear Medicine
https://www.readbyqxmd.com/read/27838147/long-term-outcomes-of-a-phase-ii-trial-of-moderate-hypofractionated-image-guided-intensity-modulated-radiotherapy-ig-imrt-for-localized-prostate-cancer
#18
Hester Lieng, Melania Pintilie, Andrew Bayley, Alejandro Berlin, Robert Bristow, Peter Chung, Mary Gospodarowicz, Roger Huang, Cynthia Ménard, Padraig Warde, Charles Catton
PURPOSE: To evaluate long-term radiation toxicity and biochemical control of two moderately hypofractionated radiotherapy regimens for prostate cancer. MATERIAL AND METHODS: Eligible men with localized prostate cancer received image-guided intensity modulated radiotherapy (IG-IMRT) to a dose of 60 or 66Gy in 3Gy fractions in a phase II trial. Endpoints included late gastrointestinal (GI) and genitourinary (GU) toxicity and biochemical failure (FFBF). RESULTS: Ninety-six men received 60Gy and 27 received 66Gy...
January 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/27802360/prostate-cancer-developing-novel-approaches-to-castration-sensitive-disease
#19
REVIEW
Edoardo Francini, Mary-Ellen Taplin
Although androgen-deprivation therapy (ADT) remains the mainstay of castration-sensitive prostate cancer (CSPC) therapy, the disease's heterogeneity and the limited duration of the response have chaperoned the introduction of chemotherapy and the investigation of novel hormonal targeted agents in this setting. Combinations of ADT plus chemotherapy or novel hormonal therapies are being tested at various stages of CSPC with promising results. Furthermore, immunotherapy and experimental drugs are also being actively investigated in this setting...
January 1, 2017: Cancer
https://www.readbyqxmd.com/read/27860163/11c-acetate-positron-emission-tomography-computed-tomography-imaging-for-detection-of-recurrent-disease-after-radical-prostatectomy-or-radiotherapy-in-patients-with-prostate-cancer
#20
Lukas Hendrik Esch, Melanie Fahlbusch, Peter Albers, Hubertus Hautzel, Volker Müller-Mattheis
OBJECTIVES: To evaluate, in a prospective study, the effectiveness of computed tomography (CT)-matched 11C-acetate (AC) positron-emission tomography (PET) in patients with prostate cancer (PCa) who had prostate-specific antigen (PSA) relapse after radical prostatectomy (RP) or radiotherapy (RT). PATIENTS AND METHODS: In 103 relapsing patients after RP (n = 97) or RT (n = 6) AC-PET images and CT scans were obtained. In patients with AC-PET-positive results with localized PCa recurrence, detected lesions were resected and histologically verified or, after local RT, followed-up by PSA testing...
November 8, 2016: BJU International
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