The estimation of the position of the tumor centroid and tumor shape may vary with the use of different respiratory monitoring systems. This implies that it is preferable to use the same respiratory monitoring system with 4DCT, 4DPET-CT, and linac.

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BackgroundThe optimal protocol for 125I-transperineal prostatic brachytherapy (TPPB) in intermediate-risk prostate cancer (PCa) patients remains controversial. Data on the efficacy of combining androgen-deprivation therapy (ADT) with 125I-TPPB in this group remain limited and consequently the guidelines of the American Brachytherapy Society (ABS) provide no firm recommendations.Methods/DesignSeed and Hormone for Intermediate-risk Prostate Cancer (SHIP) 0804 is a phase III, multicenter, randomized, controlled study that will investigate the impact of adjuvant ADT following neoadjuvant ADT and 125I-TPPB. Prior to the end of March, 2011, a total of 420 patients with intermediate-risk, localized PCa will be enrolled and randomized to one of two treatment arms. These patients will be recruited from 20 institutions, all of which have broad experience of 125I-TPPB. Pathological slides will be centrally reviewed to confirm patient eligibility. The patients will initially undergo 3-month ADT prior to 125I-TPPB. Those randomly assigned to adjuvant therapy will subsequently undergo 9 months of adjuvant ADT. All participants will be assessed at baseline and at the following intervals: every 3 months for the first 24 months following 125I-TPPB, every 6 months during the 24- to 60-month post-125I-TPPB interval, annually between 60 and 84 months post-125I-TPPB, and on the 10th anniversary of treatment.The primary endpoint is biochemical progression-free survival (BPFS). Secondary endpoints are overall survival (OS), clinical progression-free survival, disease-specific survival, salvage therapy non-adaptive interval, acceptability (assessed using the international prostate symptom score [IPSS]), quality of life (QOL) evaluation, and adverse events. In the correlative study (SHIP36B), we also evaluate biopsy results at 36 months following treatment to examine the relationship between the results and the eventual recurrence after completion of radiotherapy.DiscussionThese two multicenter trials (SHIP0804 & SHIP36B) are expected to provide crucial data regarding the efficacy, acceptability and safety of adjuvant ADT. SHIP36B will also provide important information about the prognostic implications of PSA levels in intermediate-risk PCa patients treated with 125I-TPPB.Trial registrationNCT00664456, NCT00898326, JUSMH-BRI-GU05-01, JUSMH-TRIGU0709

The J-POPS, a nationwide prospective cohort study that enrolled approximately 40 % of all PI cases in Japan, will provide highly reliable evidence, including outcomes and quality of life, after long-term follow-up.

NCT00534196.

Abstract:The exposure rate of screening for prostate cancer using prostate-specific antigen (PSA) in Japan is still very low compared with that in the USA or western Europe. The mortality rate of prostate cancer will increase in the future and in 2020 it will be 2.8-fold higher than in 2000. Therefore, there is an urgent need to determine the best available countermeasures to decrease the rate of prostate cancer death. PSA screening, which can reduce the risk of death as a result of prostate cancer, should be offered to all men at risk of developing prostate cancer with fact sheets showing updated benefits and drawbacks of screening for prostate cancer.Key words: prostate cancer, PSA, screening, guidelines. Policy statement of the Japanese Urological Association on screening for prostate cancerThe Japanese Urological Association (JUA) recommends prostate-specific antigen (PSA) screening, which can reduce the risk of death as a result of prostate cancer, 1 for men at risk of prostate cancer. The recommendation is based on fact sheets showing the benefits and drawbacks of screening for prostate cancer. The JUA provides the best available screening system for men who want to be screened. Theoretical background of the policy statement1 The exposure rate of screening for prostate cancer using PSA in Japan is still very low compared with that in the USA or western Europe. Therefore, many clinically significant cancer cases in Japan might be undetected and missed until they develop into clinically advanced disease.2 At present, approximately 30% of newly detected prostate cancer cases have bone metastases in municipalities where the exposure rates of populationbased PSA screening have been lower than 5%. 3 In the mean time, mortality rates as a result of prostate cancer have increased and were estimated to be 9985 in 2008. 4 The number of deaths as a result of prostate cancer will reach 21 062 in 2020.5 Therefore, there is an urgent need to determine the best available countermeasures to decrease the rate of prostate cancer death. 2 The Cancer Countermeasure Fundamental Law, which is an important national policy in Japan declared in 2007, stated the goal of a 20% decrease in the mortality rates as a result of cancer in people aged below 75 years within 10 years. The JUA recommends PSA screening, which can lead to a decrease in the mortality rate of prostate cancer, based on well-balanced fact sheets in human dry-dock (Ningen dock) and also populationbased screening for prostate cancer to contribute to achieving the goal in terms of reducing the mortality rate of prostate cancer in all age ranges. 3 The latest results from the European Randomized Study of Screening for Prostate Cancer (ERSPC) showed that the mortality rate of prostate cancer showed a 20% and 31% decrease in the screening group compared with the control group during 9 years of observation on average by intention-to-screen (ITS) analysis 1 and a second analysis adjusted by compliance and contamination for the PSA test, 6 respectively. This study clearly s...

Local control and survival rates in patients treated with radiation therapy were excellent, especially in the group treated with external and intraluminal radiation therapy; however, the optimal dose and optimal combination of external and intraluminal radiation therapy should be further assessed.

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