Techniques for and follow-up after external beam radiation treatment for prostate cancer

2018 ◽  
Keyword(s):  
Prostate Cancer ◽  
Radiation Treatment ◽  
External Beam Radiation ◽  
External Beam ◽  
Beam Radiation

scholarly journals External beam radiation treatment for rectal cancer is associated with a decrease in subsequent prostate cancer diagnosis

Cancer ◽  
2008 ◽  
Vol 112 (4) ◽  
pp. 943-949 ◽  
Author(s):  
Karen E. Hoffman ◽  
Theodore S. Hong ◽  
Anthony L. Zietman ◽  
Anthony H. Russell
Keyword(s):  
Prostate Cancer ◽  
Rectal Cancer ◽  
Cancer Diagnosis ◽  
Radiation Treatment ◽  
External Beam Radiation ◽  
External Beam ◽  
Beam Radiation ◽  
Prostate Cancer Diagnosis

Combined brachytherapy and external beam radiation for prostate cancer in a community setting

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e16147-e16147
Author(s):  
G. J. Kubicek ◽  
G. J. Kubicek ◽  
S. Brown ◽  
S. Redfield
Keyword(s):  
Prostate Cancer ◽  
External Beam Radiotherapy ◽  
Treatment Options ◽  
Community Setting ◽  
Late Toxicity ◽  
Biochemical Failure ◽  
External Beam Radiation ◽  
External Beam ◽  
Beam Radiation

e16147 Background: Prostate cancer is the most common male malignancy, and there is no one standard treatment modality. One treatment option is the combination of external beam radiotherapy and permanent transperineal brachytherapy seed implant Methods: Retrospective review of prostate cancer and side effect outcomes at a single institution in the community setting. All patients were treated with a combination of low dose rate transperineal brachytherapy seed placement and external beam radiation. Results: A total of 897 patients were analyzed, 781 had a minimum follow-up of one year. Median pre-treatment PSA was 8.1 (range 0.3 to 106) and the median Gleason score was 6. With a median follow-up of 3.6 years, 33 (3.4 %) patients had biochemical failure based on the phoenix definition of Nadir + 2. Not including impotence, acute toxicity greater than or equal to Grade 2 was seen in 115 patients (102 GU and 13 GI) and 193 patients had late toxicity greater than or equal to Grade 2 (155 GU and 38 GI). 563 patients received hormone therapy prior to or concurrent with the radiation. Conclusions: This is the largest series reporting on the outcome of combination brachytherpay implant and external beam radiation in the treatment of prostate cancer. Combination treatment using brachytherapy and external beam radiation is well tolerated, with a low rate of biochemical failure and should be considered one of the treatment options for prostate cancer. No significant financial relationships to disclose.

scholarly journals Trimodal therapy with high-dose-rate brachytherapy and hypofractionated external beam radiation combined with long-term androgen deprivation for unfavorable-risk prostate cancer

2021 ◽  
Author(s):  
Keiichiro Mori ◽  
Hiroshi Sasaki ◽  
Yuki Tsutsumi ◽  
Shun Sato ◽  
Yuki Takiguchi ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
High Dose Rate ◽  
External Beam Radiation ◽  
High Dose ◽  
External Beam ◽  
Beam Radiation ◽  
Trimodal Therapy

Abstract Purpose To assess the outcomes of high-dose-rate (HDR) brachytherapy and hypofractionated external beam radiation therapy (EBRT) combined with long-term androgen deprivation therapy (ADT) in very-high-risk (VHR) versus high-risk (HR) prostate cancer (PCa), as defined in the National Comprehensive Cancer Network (NCCN) criteria. Methods Data from 338 consecutive HR or VHR PCa patients who had undergone this tri-modal therapy between 2005 and 2018 were retrospectively analyzed. Biochemical recurrence (BCR)-free, progression-free, overall, and cancer-specific survival (BCRFS/PFS/OS/CSS) rates were analyzed using the Kaplan–Meier method and Wilcoxon test. Cox regression models were used to evaluate candidate prognostic factors for survival. C‑indexes were used to assess model discrimination. Results Within a median follow-up of 84 months, 68 patients experienced BCR, 58 had disease progression including only 3 with local progression, 27 died of any cause, and 2 died from PCa. The 5‑year BCRFS, PFS, OS, and CSS rates were 82.2% (HR 86.5%; VHR 70.0%), 90.0% (HR 94.3%; VHR 77.6%), 95.7% (HR, 97.1%; VHR, 91.8%), and 99.6% (HR, 100%; VHR, 98.0%), respectively. In multivariable analyses that adjusted for standard clinicopathologic features, the risk subclassification was associated both PFS and OS (p = 0.0003 and 0.001, respectively). Adding the risk subclassification improved the accuracy of models in predicting BCRFS, PFS, and OS. Conclusion While the outcome of this trimodal approach appears favorable, VHR PCa patients had significantly worse oncological outcomes than those with HR PCa. The NCCN risk subclassification should be integrated into prognostic tools to guide risk stratification, treatment, and follow-up for unfavorable PCa patients receiving this trimodal therapy.

Prostate cancer screening, treatment, and outcomes— A population-based study

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10017-10017
Author(s):  
G. L. Lu-Yao ◽  
P. C. Albertsen ◽  
J. L. Stanford ◽  
T. A. Stukel ◽  
E. S. Walker-Corkery ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Screening ◽  
Cancer Mortality ◽  
Prostate Cancer Screening ◽  
Population Based ◽  
External Beam Radiation ◽  
External Beam ◽  
Beam Radiation ◽  
Prostate Cancer Mortality

10017 Background: It remains unknown whether more intense prostate cancer screening and treatment reduces prostate cancer mortality. We describe the experiences of two population-based cohorts with 15-years follow-up (1987–2001) to address the following questions: 1) does more intense screening and treatment for prostate cancer lead to lower mortality in community settings, and 2) do older men (age ≥75–79) benefit from more intense prostate cancer screening and treatment. Methods: Population-based cohort study consisting of white male Medicare beneficiaries who resided in the regions covered by the Seattle (N=88,863) and Connecticut (N=114,785) cancer registries. Inclusion criteria are age 65–79 and free of prostate cancer on January 1, 1987. All study subjects were followed through death or the end of 2001. The main outcomes are rates of screening for prostate cancer, treatment with radical prostatectomy, external beam radiotherapy, and prostate cancer specific mortality. Results: Between 1987 and 1990, compared to men in Connecticut, men in the Seattle region were 5.4 times (95% C.I. 4.8 - 6.1) more likely to undergo PSA testing, 2.2 times (95% C.I. 1.8 - 2.7) more likely to under go prostate biopsy, 5.9 times (95% C.I. 5.5 - 6.9) more likely to have radial prostatectomy, and 2.3 times (95% C.I. 2.2 - 2.5) more likely to have external beam radiation. The cumulative risk of radical prostatectomy or external beam radiation reached 9.1% in the Seattle cohort and 5.0% in the Connecticut cohort in 2001. After 15 years of follow-up, prostate cancer mortality rates were similar for subjects in the two study regions (hazard ratio of Seattle to CT: 1.01, 95% C.I. 0.93 - 1.09). For older men (aged 75–79 in 1987), however, the prostate cancer mortality rate was slightly higher in the Seattle than the Connecticut cohort (hazard ratio: 1.16, 95% C.I. 1.02 - 1.32). Conclusion: More intense screening for prostate cancer, surgery or radiation among a cohort of Medicare beneficiaries in the Seattle area compared with their counterparts in Connecticut has not lead to significantly lower mortality from prostate cancer over 15 years of follow-up. No significant financial relationships to disclose.

Role of interstitial radiotherapy in the management of clinically organ-confined prostate cancer: the jury is still out.

1996 ◽  
Vol 14 (1) ◽  
pp. 304-315 ◽  
Author(s):  
A V D'Amico ◽  
C N Coleman
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Clinical Stage ◽  
Specific Antigen ◽  
External Beam Radiation ◽  
High Dose ◽  
External Beam ◽  
Beam Radiation ◽  
Interstitial Radiotherapy

PURPOSE AND DESIGN To discuss the evolution of the use of brachytherapy in the treatment of clinically organ-confined prostate cancer and to review modern techniques, results of therapy, and optimal patient selection criteria. RESULTS Using modern localization and immobilization techniques, interstitial prostate radiotherapy for patients with a prostate-specific antigen (PSA) level less than 10 ng/mL yields an at least 87% rate of freedom from biochemical relapse at 3 years, which is numerically equivalent to results achieved with external-beam radiotherapy or radical prostatectomy. With a minimum median follow-up time of 24 months, 81% to 85% (2-year actuarial and 3-year crude) potency rates have been reported concomitant with 2-year actuarial rates of 12% for grade > or = 2 rectal complications and 10% for grade > or = 3 urethral complications. CONCLUSION The combination of clinical stage, PSA level, and biopsy Gleason sum allows for selection of patients with the highest probability of having all of the prostate cancer encompassed by the high-dose implant volume, while simultaneously respecting the normal-tissue tolerance doses of the juxtaposed normal tissues (rectum and bladder). In particular, patients with nonpalpable (T1c) lesions, a biopsy Gleason sum < or = 6 (ideally < or = 4), and a PSA level less than 10 ng/mL represent the optimal implant candidates. Differential loading of the implant away from the geometric center and not accepting patients with large prostate glands (> or = 60 cm3) or history of a transurethral resection of the prostate (TURP) as implant candidates, may reduce urethral toxicity. Further follow-up evaluation of prostate cancer patients treated with interstitial radiotherapy will verify if favorable potency preservation rates and rates of freedom from biochemical failure equivalent to those achieved with radical prostatectomy or external-beam radiation therapy are maintained.

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