Developments in External Beam Radiotherapy for Prostate Cancer

Lumen, Nicolaas; Ost, Piet; Praet, Charles Van; Meerleer, Gert De; Villeirs, Geert; Fonteyne, Valérie

doi:10.1016/j.urology.2013.03.043

Cited by 13 publications

(10 citation statements)

References 71 publications

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“…Current indications for external-beam radiotherapy (EBRT) in PC include primary treatment (in localized intracapsular tumors or combined with ADT in locally advanced and high-risk PC), adjuvant treatment in patient with adverse pathologic features, (extracapsular extension, positive surgical margins), and salvage radiotherapy (after radical prostatectomy) [137]. …”

Section: Impact Of Primary Treatment For Pca On Qol and Sexual Healthmentioning

confidence: 99%

Quality of Life and Sexual Health in the Aging of PCa Survivors

Gacci

Baldi

Detti

et al. 2014

International Journal of Endocrinology

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Prostate cancer (PCa) is the most common malignancy in elderly men. The progressive ageing of the world male population will further increase the need for tailored assessment and treatment of PCa patients. The determinant role of androgens and sexual hormones for PCa growth and progression has been established. However, several trials on androgens and PCa are recently focused on urinary continence, quality of life, and sexual function, suggesting a new point of view on the whole endocrinological aspect of PCa. During aging, metabolic syndrome, including diabetes, hypertension, dyslipidemia, and central obesity, can be associated with a chronic, low-grade inflammation of the prostate and with changes in the sex steroid pathways. These factors may affect both the carcinogenesis processes and treatment outcomes of PCa. Any treatment for PCa can have a long-lasting negative impact on quality of life and sexual health, which should be assessed by validated self-reported questionnaires. In particular, sexual health, urinary continence, and bowel function can be worsened after prostatectomy, radiotherapy, or hormone treatment, mostly in the elderly population. In the present review we summarized the current knowledge on the role of hormones, metabolic features, and primary treatments for PCa on the quality of life and sexual health of elderly Pca survivors.

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Section: Impact Of Primary Treatment For Pca On Qol and Sexual Healthmentioning

confidence: 99%

Quality of Life and Sexual Health in the Aging of PCa Survivors

Gacci

Baldi

Detti

et al. 2014

International Journal of Endocrinology

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“…Radiotherapy has been evolving and today it is possible to give radiation with higher precision enabling higher doses to be delivered with stronger effect but also lower risk for side-effects. 64,65 Three different randomized trials have shown that radiotherapy in combination with endocrine treatment decreases mortality in locally advanced prostate cancer. 66,67,68 Today there exists no randomized controlled trials that compares radiotherapy with radical prostatectomy.…”

Section: Radiotherapymentioning

confidence: 99%

Thromboembolic Complications in 3,544 Patients Undergoing Radical Prostatectomy with or without Lymph Node Dissection

et al. 2015

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“…Although recent observations suggest that survival and response to HT varies as a function of the number of metastases (i.e. oligometastases) and some authors have hypothesized that local treatment of limited metastases with surgery or radiotherapy might delay the start of potentially toxic systemic treatments [3,24]. Furuya Y et al reported that patients with an initial low-volume metastatic disease were more likely to progress locally during ADT instead of distantly, which might support delayed implementation of HT in patients with oligometastatic prostate cancer treated with SABR [24,25].…”

Section: Discussionmentioning

confidence: 99%

“…oligometastases) and some authors have hypothesized that local treatment of limited metastases with surgery or radiotherapy might delay the start of potentially toxic systemic treatments [3,24]. Furuya Y et al reported that patients with an initial low-volume metastatic disease were more likely to progress locally during ADT instead of distantly, which might support delayed implementation of HT in patients with oligometastatic prostate cancer treated with SABR [24,25]. Also studies of Berkovic et al and Decaestecker K et al showed that HT can be delayed until progression of the disease and part of the patients had not received HT for 3 years without PSA concentration increase [14,16].…”

Section: Discussionmentioning

confidence: 99%

CyberKnife stereotactic radiosurgery and stereotactic ablative radiation therapy of patients with prostate cancer bone metastases.

Napieralska¹,

Miszczyk²,

Stąpór-Fudzińska³

2016

neo

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The aim of the study was to evaluate the effectiveness and toxicity of CyberKnife (CK) stereotactic radiosurgery (SRS) and stereotactic ablative radiation therapy (SABR) of patients with prostate cancer bone metastases. Analysis of prognostic and predictive factors was also performed.Material consisted of 51 patients with 71 bone oligometastases treated using CK SRS/SABR. In half of the patients single lesion was treated, in half 2-5 lesions. Median PSA concentration at the time of metastasis detection was 5.75 ng/ml. Total dose of 6-45Gy (median 20) was delivered with 1-5 fractions of 6-15 Gy (median 9). Biologic equivalent dose (BED) (α/ β=1.6) over 100 Gy was delivered to 45 lesions (63%) in 38 patients (75%).In statistical analysis Kaplan-Meier method, log-rank test and the Cox proportional hazard model were used. One-, two-and three-year overall survival (OS) was 90%, 76% and 70%, respectively. All patients having PSA concentration lower that 1 ng/ml at last control lived at least three years. One-, two-and three-year local control (LC) was 97%, 70% and 30%. Patients with PSA below 20 ng/ml at the time of metastasis detection had better local control of lesions and lower PSA at the last control. Median of PSA concentration after CK based SRS/SABR remains stable during first 12 months of follow-up, dropped during the next months and at last control was comparable to initial level. Median PSA at last control in patients without disease progression was 1.67ng/ml and 20 patients had PSA below 1.0ng/ml. At the last control 59% of patients had no other metastases. Rapid pain decrease was observed in analysed group and during each control about 90% of patients had pain relief. No major toxicity was observed, 3 patients suffered from fracture of irradiated bone. SRS/SABR of prostate cancer bone oligometastases provides good LC of lesions, excellent pain control without additional toxicity. Patients with PSA concentration below 20ng/ml at the time of metastasis detection have better LC and PSA concentration response.

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Developments in External Beam Radiotherapy for Prostate Cancer

Cited by 13 publications

References 71 publications

Quality of Life and Sexual Health in the Aging of PCa Survivors

Quality of Life and Sexual Health in the Aging of PCa Survivors

Thromboembolic Complications in 3,544 Patients Undergoing Radical Prostatectomy with or without Lymph Node Dissection

CyberKnife stereotactic radiosurgery and stereotactic ablative radiation therapy of patients with prostate cancer bone metastases.

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