A comparison of external beam radiation therapy versus radical prostatectomy for patients with low risk prostate carcinoma diagnosed, staged, and treated at a single institution

Martínez, Álvaro; Gonzalez, Jose A.; Chung, Andrew; Kestin, Larry L.; Balasubramaniam, M.; Diokno, Ananias C.; Ziaja, Ellen L.; Brabbins, D.; Vicini, Frank A.

doi:10.1002/(sici)1097-0142(20000115)88:2<425::aid-cncr25>3.0.co;2-z

Cited by 60 publications

(27 citation statements)

References 27 publications

(18 reference statements)

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“…The current results extend prior independently conducted studies by the authors [9,12], demonstrating the potential of SBRT monotherapy to provide durable disease control with few serious complications in low-risk prostate cancer patients. Our 5-year progression-free survival rate of 93% compares favorably with that obtained with surgery, LDR or HDR brachytherapy [21][22][23][24][25][26].…”

Section: Discussionsupporting

confidence: 52%

Stereotactic body radiotherapy for low-risk prostate cancer: Five-year outcomes.

Freeman

King

2011

JCO

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Purpose: Hypofractionated, stereotactic body radiotherapy (SBRT) is an emerging treatment approach for prostate cancer. We present the outcomes for low-risk prostate cancer patients with a median follow-up of 5 years after SBRT. Results: At a median follow-up of 5 years, the biochemical progression-free survival was 93% (95% CI = 84.7% to 100%). Acute side effects resolved within 1-3 months of treatment completion. There were no grade 4 toxicities. No late grade 3 rectal toxicity occurred, and only one late grade 3 genitourinary toxicity occurred following repeated urologic instrumentation. Conclusion: Five-year results of SBRT for localized prostate cancer demonstrate the efficacy and safety of shorter courses of high dose per fraction radiation delivered with SBRT technique. Ongoing clinical trials are underway to further explore this treatment approach. Method and

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Section: Discussionsupporting

confidence: 52%

Stereotactic body radiotherapy for low-risk prostate cancer: Five-year outcomes.

Freeman

King

2011

JCO

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“…Potters and colleagues found that the 7-year bRFS hazard ratio for radiotherapy (all treated with ≥70 Gy) compared to surgery was 1.18 (0.86-1.62), 22 while Martinez and colleagues found no difference in the 7-year bRFS odds ratio: 0.98 (0.55-1.74) with radiotherapy doses between 59-70 Gy. 23 Vicini and colleagues found no statistically significant differences in bRFS for any subgroup formed and varying approaches to radiotherapy delivery across seven institutions; 24 and Kupelian and colleagues computed a hazard ratio of 1.01 (p = 0.96) comparing radiotherapy (68-78 Gy) to surgery for difference in bRFS after control for disease severity and other key confounding variables. 25 D'Amico and colleagues found no difference in 8-year bRFS for intermediate-risk patients with high volume tumours and high-risk patients, however they did observe higher 8-year bRFS for low-risk patients or intermediate-risk patients with low volume tumours treated surgically compared to the radiotherapy group whose median dose was 66 Gy.…”

Section: Discussionsupporting

confidence: 56%

Prostate cancer-specific survival differences in patients treated by radical prostatectomy versus curative radiotherapy

DeGroot

Brundage

Lam

et al. 2013

CUAJ

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E299Cite as: Can Urol Assoc J 2013;7(5-6):e299-305. http://dx.doi.org/10.5489/cuaj.11294 Published online May 13, 2013 (early released July 16, 2012). AbstractObjective: We compared the cause-specific survival of patients who received radiotherapy to those who received surgery for cure of their prostate cancer using a number of design and analytic steps to mitigate confounding by indication. Methods: This was a case-cohort study of 2213 patients in the Ontario Cancer Registry diagnosed between 1990 and 1998 who were either treatment candidates or received curative radiotherapy or surgery. Cases included patients who died of prostate cancer within 10 years. The study population was restricted to those who were candidates for either treatment (radiotherapy or surgery) based on disease severity (low and intermediate risk using the Genitourinary Radiation Oncologists of Canada risk groups). The median follow-up was 51 months. Cause-specific survival was analyzed using Cox-proportional hazards regression with casecohort variance adjustment. Results from intent-to-treat analyses were compared to results by treatment received. Results: Adjusted hazard ratios for risk of prostate cancer death for radiotherapy compared to surgery for the entire study population were 1.62 (95%CI 1.00-2.61) and 2.02 (1.19-3.43) analyzing by intent-to-treat and treatment received, respectively. Intent-to-treat hazard ratios for the low-and intermediate-risk groups were 0.87 (0.28-2.76) and 1.57 (0.95-2.61), respectively. Conclusion: Overall results were driven by the finding in the intermediate-risk group, which indicated that radiotherapy was not as effective as surgery in this group. Confirmation was needed with special attention paid to risk stratification and the impact of more contemporary delivery of these treatment options.

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“…These efects occur when healthy tissue outside the target volume is irradiated and afect the patient's subsequent recovery and quality of life. For example, short-term detriments (e.g., incontinence and erectile dysfunction) occur following prostate cancer therapy [7]. Long-term efects include secondary cancers and cardiovascular disease [8].…”

Section: Introductionmentioning

confidence: 99%

Radiotherapy Dose Optimization in Target Tissues Using Internal Radiation-Generating Devices and Microspheres

Bevelacqua¹

2017

Radiotherapy

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Preferentially delivering ionizing radiation to target tissues during radiotherapy procedures is investigated using internal radiation-generating devices and microspheres loaded with radioactive material. This chapter presumes the existence of internal radiation-generating devices and develops their requisite characteristics to permit the selective irradiation of tumors. The feasibility of disrupting a tumor's vascular structure is also investigated. Calculated absorbed dose proiles for both approaches demonstrate that dose can be successfully localized in a target tissue while minimizing the delivery to healthy tissue.

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A comparison of external beam radiation therapy versus radical prostatectomy for patients with low risk prostate carcinoma diagnosed, staged, and treated at a single institution

Cited by 60 publications

References 27 publications

Stereotactic body radiotherapy for low-risk prostate cancer: Five-year outcomes.

Stereotactic body radiotherapy for low-risk prostate cancer: Five-year outcomes.

Prostate cancer-specific survival differences in patients treated by radical prostatectomy versus curative radiotherapy

Radiotherapy Dose Optimization in Target Tissues Using Internal Radiation-Generating Devices and Microspheres

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