New Technologies for the Radiotherapy of Prostate Cancer

2007 ◽  
pp. 315-337 ◽  
Author(s):  
J.L. Meyer ◽  
S. Leibel ◽  
M. Roach ◽  
S. Vijayakumar
Keyword(s):  
Prostate Cancer ◽  
New Technologies

Management of Biochemically Recurrent Prostate Cancer: Ensuring the Right Treatment of the Right Patient at the Right Time

2018 ◽  
pp. 355-362 ◽  
Author(s):  
Daniel E. Spratt ◽  
Deaglan J. McHugh ◽  
Michael J. Morris ◽  
Alicia K. Morgans
Keyword(s):  
Prostate Cancer ◽  
New Technologies ◽  
Postoperative Radiotherapy ◽  
The United States ◽  
Common Disease ◽  
Recurrent Prostate Cancer ◽  
Systemic Treatments ◽  
Effect Of Therapy ◽  
New Gene ◽  
The Right

Biochemically recurrent prostate cancer is an increasingly common disease state, with more than 25,000 cases occurring annually in the United States. Fortunately, progress continues to be made to more effectively identify metastatic disease, optimize existing therapies, and develop new technologies and therapeutic strategies for the timing and delivery of systemic treatments to improve outcomes. This review covers three topics related to the diagnosis and treatment of men with biochemical recurrence (BCR). First, we provide an update on the state of the rapidly evolving field of molecular imaging and its place in practice. Second, we describe validated clinicopathologic methods to risk stratify patients with biochemically recurrent disease, including new gene expression classifiers, to personalize postoperative radiotherapy (RT) timing. Last, we define our approach to optimal management with systemic therapy, including identifying the patients who may benefit most and balancing the duration and timing of treatment with consideration of the effect of therapy on quality of life (QOL) and medical complications associated with treatment.

Evolving Recommendations on Prostate Cancer Screening

2016 ◽  
pp. e80-e87
Author(s):  
Otis W. Brawley ◽  
Ian M. Thompson ◽  
Henrik Grönberg
Keyword(s):  
Prostate Cancer ◽  
Family History ◽  
New Technologies ◽  
Prostate Cancer Screening ◽  
Large Population ◽  
Specific Antigen ◽  
Population Based ◽  
Low Grade ◽  
Diagnostic Study ◽  
High Grade

Results of a number of studies demonstrate that the serum prostate-specific antigen (PSA) in and of itself is an inadequate screening test. Today, one of the most pressing questions in prostate cancer medicine is how can screening be honed to identify those who have life-threatening disease and need aggressive treatment. A number of efforts are underway. One such effort is the assessment of men in the landmark Prostate Cancer Prevention Trial that has led to a prostate cancer risk calculator (PCPTRC), which is available online. PCPTRC version 2.0 predicts the probability of the diagnosis of no cancer, low-grade cancer, or high-grade cancer when variables such as PSA, age, race, family history, and physical findings are input. Modern biomarker development promises to provide tests with fewer false positives and improved ability to find high-grade cancers. Stockholm III (STHLM3) is a prospective, population-based, paired, screen-positive, prostate cancer diagnostic study assessing a combination of plasma protein biomarkers along with age, family history, previous biopsy, and prostate examination for prediction of prostate cancer. Multiparametric MRI incorporates anatomic and functional imaging to better characterize and predict future behavior of tumors within the prostate. After diagnosis of cancer, several genomic tests promise to better distinguish the cancers that need treatment versus those that need observation. Although the new technologies are promising, there is an urgent need for evaluation of these new tests in high-quality, large population-based studies. Until these technologies are proven, most professional organizations have evolved to a recommendation of informed or shared decision making in which there is a discussion between the doctor and patient.

Salvage radiation therapy after radical prostatectomy with the use of new technologies in radiation oncology

2016 ◽  
Vol 21 (1-2) ◽  
pp. 26-31
Author(s):  
S. I Tkachev ◽  
V. B Matveev ◽  
Petr V. Bulychkin
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Radical Prostatectomy ◽  
New Technologies ◽  
Treatment Options ◽  
Clinical Recurrence ◽  
Salvage Radiation Therapy ◽  
Prostate Bed ◽  
Grade 3

Introduction: prostate cancer (PCa) is the second cancer after lung one among all males. The main treatmentfor patients with localized prostate cancer is a radical prostatectomy (RP). After RP PCa occurs in patients at the T1-T2 stage - in 25 - 35% of all cases and in patients at the T3 stage - in 33.5 - 66% of all cases. Currently, one of the treatment options for patients with recurrence PCa after RP is a «salvage» radiation therapy. Materials and methods: medical records of 59 patients with PCa recurrence after radical prostatectomy (pT1-3pN0M0) were analyzed. Biochemical recurrence was observed in 25 (42,4%) and clinical recurrence in 34 (57,6%) patients. Radiotherapy have been prescribed to the regional lymphatic nodes to 44,0 Gy of 2,0 Gy each, to the prostate bed to 66,0 Gy of 2,0 Gy each and if the region of the clinical recurrence was identified - to 72 Gy of 2,0 Gy. Treatment was realized on linear electron accelerators using 3D technology radiotherapy: 3DCRT, IMRT, VMAT. Results: all 59 patients were treated by the «salvage» radiotherapy. Median follow-up was 48 months (24-91). Biochemical control w as achieved in 51 (86.4%) patients, locoregional control in 58 (98.3%) patients. No acute and late grade 3 or greater toxicities were observed.

The impact of technology diffusion on treatment for prostate cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 5044-5044
Author(s):  
Florian Rudolf Schroeck ◽  
Samuel R Kaufman ◽  
Bruce L Jacobs ◽  
David Christopher Miller ◽  
Brent K. Hollenbeck
Keyword(s):  
Prostate Cancer ◽  
New Technologies ◽  
Multinomial Logistic Regression ◽  
Intensity Modulated Radiotherapy ◽  
Local Therapy ◽  
Expectant Management ◽  
Cancer Control ◽  
Robotic Prostatectomy ◽  
Hospital Referral ◽  
The Impact

5044 Background: Robotic prostatectomy and intensity modulated radiotherapy (IMRT) hold the promise of improving cancer control and minimizing side-effects for patients with prostate cancer, but are associated with significant upfront investments. Many worry that the perceived advantages of these new technologies and the need to recoup start-up costs could shift decision making in favor of local therapy in lieu of expectant management. In this context, we examined the association of market-level technology penetration with receipt of local therapy. Methods: We used the Surveillance Epidemiology and End Results (SEER) - Medicare linked database to identify all patients with loco-regional prostate cancer who were treated or managed expectantly from 2003 to 2007 (n=59,241). We measured technology penetration as the number of providers performing robotic prostatectomy or IMRT per population in a market (hospital referral region). We then performed multinomial logistic regression to examine the association of technology penetration with receipt of prostatectomy, radiotherapy, or no local therapy. Results: For each 1,000 patients diagnosed with prostate cancer, 171 underwent prostatectomy, 493 radiotherapy, and 336 had no local therapy. Markets with high robotic prostatectomy penetration had higher use of prostatectomy (175 vs. 141 per 1,000 men, p=0.004) but decreased use of radiotherapy (584 vs. 613 per 1,000 men, p=0.046), resulting in a stable rate of local therapy (Table). High versus low IMRT penetration did not significantly impact use of prostatectomy and radiotherapy (Table). Conclusions: Increased penetration of robotic surgical technology was associated with more use of prostatectomy and less use of radiotherapy. However, increased penetration of both robotic prostatectomy and IMRT did not change the overall rate of local therapy. Our findings allay concerns that new technology spurs additional local therapy of prostate cancer. [Table: see text]

scholarly journals Diffusion of New Technologies for Patients With Prostate Cancer

2015 ◽  
Vol 2 (2) ◽  
pp. 78
Author(s):  
Ramzi G Salloum ◽  
Matthew N Nielsen ◽  
Mark C Hornbrook ◽  
Maureen O'Keefe Rosetti ◽  
Paul A Fishman ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
New Technologies

Precision prostate cancer surgery: an overview of new technologies and techniques

2019 ◽  
Vol 71 (5) ◽  
Author(s):  
Enrico Checcucci ◽  
Daniele Amparore ◽  
Stefano De Luca ◽  
Riccardo Autorino ◽  
Cristian Fiori ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
New Technologies ◽  
Cancer Surgery
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