scholarly journals Predictors of castration-resistant prostate cancer after dose-escalated external beam radiotherapy

The Prostate ◽  
2014 ◽  
Vol 75 (2) ◽  
pp. 175-182 ◽  
Author(s):  
Daniel E. Spratt ◽  
Zachary S. Zumsteg ◽  
Xin Pei ◽  
Paul B. Romesser ◽  
Josh Yamada ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
External Beam Radiotherapy ◽  
External Beam ◽  
Castration Resistant Prostate Cancer ◽  
Castration Resistant

Long-term outcomes of definitive external-beam radiotherapy for non-metastatic castration-resistant prostate cancer

2018 ◽  
Vol 23 (4) ◽  
pp. 749-756 ◽  
Author(s):  
Rihito Aizawa ◽  
Kenji Takayama ◽  
Kiyonao Nakamura ◽  
Takahiro Inoue ◽  
Takashi Kobayashi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
External Beam Radiotherapy ◽  
External Beam ◽  
Castration Resistant Prostate Cancer ◽  
Long Term Outcomes ◽  
Castration Resistant

A meta-analysis on individual data of bone-targeting radio-isotopes in men with bone metastases from castration-resistant prostate cancer.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 352-352
Author(s):  
Safae Aarab Terrisse ◽  
Chris C. Parker ◽  
Karamouza Eleni ◽  
A. Oliver Sartor ◽  
Nicholas James ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Bone Metastases ◽  
Meta Analysis ◽  
External Beam Radiotherapy ◽  
Rank Test ◽  
Castration Resistant Prostate Cancer ◽  
Castration Resistant ◽  
Radium 223 ◽  
Significant Difference ◽  
Radio Isotopes

352 Background: Among bone-targeted radio-isotopes (RI), Radium-223 (an α-emitter) is the only one with clearly demonstrated overall survival (OS) benefit in men with castration-resistant prostate cancer (CRPC). The aim of this meta-analysis is to estimate the OS impact of RI in men with CRPC. Methods: An individual patient data meta-analysis was carried out from randomized trials with inclusion period 1993-2013. Eligible trials included more than 50 patients, mandated bone metastases from CRPC and randomly evaluated RI. Endpoints were OS (primary), symptomatic skeletal events (SSE) and toxicity. A fixed-effect model was used. The log-rank test stratified by trial was used to estimate individual and overall hazard ratios (HR). Subset analyses were performed by the type of radiation (α vs. β emission) and by trial comparison: RI + Chemotherapy (CT) vs. CT, RI+ External beam radiotherapy (EBRT) vs. EBRT, RI vs. EBRT. Results: From 9 identified trials, data from 6 trials comprising 2081 patients (min: 64, max: 921) were collected with 2 trials representing 80% of data. The data from 3 trials (n = 341) were not available. The overall effect on OS favoured RI with HR = 0.86 [0.77-0.95] but high heterogeneity between trials (p < 0.001, I2= 79.6%). The overall effect of α- emitters on OS (HR = 0.70 [0.58; 0.83], 2 trials, n = 985) significantly differed from that of β-emitters (HR = 0.96 [0.84; 1.10], n = 4 trials, n = 1096) (interaction p = 0.0041). The overall effect on SSE favoured RI with HR = 0.81 [0.69-0.93] (4 trials, n = 1806) with marked between trial heterogeneity (p = 0.08, I² = 55.3%) and a significant difference (p = 0.02) by the type of RI (α-emitters: HR = 0.65 [0.52-0.82]-2 trials, β-emitters: HR = 0.93 [0.77-1.13]-2 trials). Conclusions: In men with metastatic CRPC a significant improvement of OS and SSE was obtained with bone targeted α-emitter radio isotopes, but not with β-emitter. However, some between trial heterogeneity of effects on OS need further investigations.

scholarly journals A case of CRPC with multiple bladder invasions treated with EBRT followed by HDR-BT boost

2021 ◽  
pp. 20210039
Author(s):  
Yoshiaki Takagawa ◽  
Jun Itami
Keyword(s):  
Prostate Cancer ◽  
External Beam Radiotherapy ◽  
Intensity Modulated Radiotherapy ◽  
High Dose Rate ◽  
High Dose ◽  
Castration Resistant Prostate Cancer ◽  
Prostate Bed ◽  
Castration Resistant ◽  
Ultrasound Computed Tomography ◽  
Higher Doses

We report a case of postoperative local recurrence of castration-resistant prostate cancer with multiple bulky bladder invasions treated using external beam radiotherapy (EBRT) followed by a high-dose-rate brachytherapy (HDR-BT) boost. The EBRT dose was 46 Gy delivered in 23 fractions with intensity-modulated radiotherapy to the entire pelvis. The HDR-BT dose was 15 Gy delivered in one fraction using ultrasound, computed tomography, and magnetic resonance imaging-guided brachytherapy with 18 interstitial needles. We achieved excellent local control of cancer in the prostate bed and multiple bulky bladder invasions. EBRT plus HDR-BT boost can allow higher doses to be delivered than EBRT alone for locally recurrent bulky prostate cancer following prostatectomy.

scholarly journals Pain response in a population-based study of radium-223 (Ra223) for metastatic castration-resistant prostate cancer

2018 ◽  
Vol 13 (10) ◽  
pp. E311-6
Author(s):  
Sunil Parimi ◽  
Suraya Bondy ◽  
Erica Tsang ◽  
Michael Ross McKenzie ◽  
Francois Bachand ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
External Beam Radiotherapy ◽  
Brief Pain Inventory ◽  
Population Based ◽  
Response Threshold ◽  
Injection Pain ◽  
Pain Response ◽  
Castration Resistant Prostate Cancer ◽  
Castration Resistant ◽  
Radium 223

Introduction: Clinical trials have shown that radium-223 (Ra223) can prolong survival and improve quality of life in patients with metastatic castration-resistant prostate cancer (mCRPC). The objectives of this study were to evaluate pain responses with Ra223 at a population-based level and to determine if there is an association between pain response and alkaline phosphatase (ALP) response. Methods: All patients from the Vancouver and Kelowna Cancer Centers (CC) in British Columbia who were treated with Ra223 between June 2015 and December 2016 were identified. Patients completed the Brief Pain Inventory (BPI) just prior to each Ra223 injection. Pain response was defined as a two or more point improvement in worst pain relative to baseline, without an increase in pain medication level. ALP was determined at each visit, with a response threshold defined as a 30% decrease from baseline, consistent with the definition of response used in the ALSYMPCA trial. Results: A total of 65 patients in Vancouver and Kelowna CC received Ra223 during the study period and 56 patients had at least one BPI record, of which 44 (79%) patients were assessable for change in worst pain. Of the assessable patients, 23 (52%, 95% confidence interval [CI] 38–67) had a pain response, although the use of concurrent external beam radiotherapy was a confounder in four cases. Of the 44 patients assessable for change in worst pain, 59% had ALP responses greater than 30%. An ALP response was seen in 56% of pain-responders vs. 43% of non-pain-responders. There was no association between pain response and ALP response (Phi =-0.05; p=0.77). Conclusions: Ra223 administration was associated with a meaningful pain response rate in this cohort. There was no correlation between pain response and ALP response.

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