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Prostate Radiotherapy

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1. Biodegradable Rectal Spacers for Prostate Cancer Radiotherapy

Biodegradable Rectal Spacers for Prostate Cancer Radiotherapy Recommendation Report 21-5 A Quality Initiative of the Program in Evidence-Based Care (PEBC), Cancer Care Ontario (CCO) Biodegradable Rectal Spacers for Prostate Cancer Radiotherapy P Chung, J Brown, D D‘Souza, W Koll, S Morgan and the biodegradable spacer insertion during radiotherapy for prostate cancer recommendation report group (SPACER RRG) Report Date: January 16, 2019 For information about this document, please contact Dr (...) Spacers for Prostate Cancer Radiotherapy. Toronto (ON): Cancer Care Ontario: 2019, January 16. Program in Evidence- based Care Recommendation Report No.: 21-5. Copyright This report is copyrighted by Cancer Care Ontario; the report and the illustrations herein may not be reproduced without the express written permission of Cancer Care Ontario. Cancer Care Ontario reserves the right at any time, and at its sole discretion, to change or revoke this authorization. Disclaimer Care has been taken

2019 Cancer Care Ontario

2. Daily online image-guided radiotherapy for people undergoing radical prostate cancer treatment

Daily online image-guided radiotherapy for people undergoing radical prostate cancer treatment Daily online image-guided radiotherapy (prostate cancer) - Health Technology Wales > Daily online image-guided radiotherapy (prostate cancer) Daily online image-guided radiotherapy (prostate cancer) Topic Status Complete Daily online image-guided radiotherapy for people undergoing radical prostate cancer treatment. Summary This report was prepared by Health Technology Wales and Cedar (Cardiff & Vale (...) University Health Board) on behalf of Velindre Cancer Centre. It summarises the existing evidence on the technology of interest to support a prioritisation discussion related to the implementation of radiotherapy procedures/techniques at Velindre Cancer Centre. Topic Exploration Report TER038 (03.2019) TER Access our guidance Our advice documents are free to download, but we would be grateful if you could help us improve our services by telling us why you are looking at our advice and how you intend

2019 Health Technology Wales

3. Short-term androgen suppression and radiotherapy versus intermediate-term androgen suppression and radiotherapy, with or without zoledronic acid, in men with locally advanced prostate cancer (TROG 03.04 RADAR): 10-year results from a randomised, phase 3,

Short-term androgen suppression and radiotherapy versus intermediate-term androgen suppression and radiotherapy, with or without zoledronic acid, in men with locally advanced prostate cancer (TROG 03.04 RADAR): 10-year results from a randomised, phase 3, The optimal duration of androgen suppression for men with locally advanced prostate cancer receiving radiotherapy with curative intent is yet to be defined. Zoledronic acid is effective in preventing androgen suppression-induced bone loss (...) , but its role in preventing castration-sensitive bone metastases in locally advanced prostate cancer is unclear. The RADAR trial assessed whether the addition of 12 months of adjuvant androgen suppression, 18 months of zoledronic acid, or both, can improve outcomes in men with locally advanced prostate cancer who receive 6 months of androgen suppression and prostatic radiotherapy. This report presents 10-year outcomes from this trial.For this randomised, phase 3, 2 × 2 factorial trial, eligible men

2019 EvidenceUpdates

4. Prostate Radiotherapy for Metastatic Hormone-sensitive Prostate Cancer: A STOPCAP Systematic Review and Meta-analysis

Prostate Radiotherapy for Metastatic Hormone-sensitive Prostate Cancer: A STOPCAP Systematic Review and Meta-analysis Many trials are evaluating therapies for men with metastatic hormone-sensitive prostate cancer (mHSPC).To systematically review trials of prostate radiotherapy.Using a prospective framework (framework for adaptive meta-analysis [FAME]), we prespecified methods before any trial results were known. We searched extensively for eligible trials and asked investigators when results (...) would be available. We could then anticipate that a definitive meta-analysis of the effects of prostate radiotherapy was possible. We obtained prepublication, unpublished, and harmonised results from investigators.We included trials that randomised men to prostate radiotherapy and androgen deprivation therapy (ADT) or ADT only.Hazard ratios (HRs) for the effects of prostate radiotherapy on survival, progression-free survival (PFS), failure-free survival (FFS), biochemical progression, and subgroup

2019 EvidenceUpdates

5. Comparative effectiveness review of cryoablation for salvage treatment of recurrent prostate cancer following radiotherapy

Comparative effectiveness review of cryoablation for salvage treatment of recurrent prostate cancer following radiotherapy Comparative effectiveness review of cryoablation for salvage treatment of recurrent prostate cancer following radiotherapy Comparative effectiveness review of cryoablation for salvage treatment of recurrent prostate cancer following radiotherapy HAYES, Inc Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA (...) . No evaluation of the quality of this assessment has been made for the HTA database. Citation HAYES, Inc. Comparative effectiveness review of cryoablation for salvage treatment of recurrent prostate cancer following radiotherapy. Lansdale: HAYES, Inc. Directory Publication. 2017 Authors' conclusions Cryoablation of the prostate gland provides a minimally invasive treatment option for the management of localized prostate cancer. The technique uses percutaneously inserted cryoprobes to freeze and thereby

2018 Health Technology Assessment (HTA) Database.

6. Hydrogel Spacer to reduce rectal toxicity in prostate cancer radiotherapy: a health technology assessment

Hydrogel Spacer to reduce rectal toxicity in prostate cancer radiotherapy: a health technology assessment Report available from http://www.muhc.ca/tau Technology Assessment Unit of the McGill University Health Centre (MUHC) Hydrogel Spacer to reduce rectal toxicity in prostate cancer radiotherapy: a health technology assessment Report number: 82 DATE: April 16, 2018 Report available from http://www.muhc.ca/tau Report prepared for the Technology Assessment Unit (TAU) of the McGill University (...) Health Centre (MUHC) by David Felipe Forero, Nisha Almeida, Nandini Dendukuri Approved by the Committee of the TAU on April 16 th , 2018 TAU Committee Andre Bonnici, James Brophy, Nandini Dendukuri, Todd Lee, Brenda MacGibbon-Taylor, Emily McDonald, Teresa Mack, Nancy Mayo, Maurice McGregor, Alyson Turner Suggested citation Forero DF, Almeida ND, Dendukuri N. Hydrogel Spacer to reduce rectal toxicity in prostate cancer radiotherapy: a health technology assessment. Montreal (Canada): Technology

2018 McGill TAU reports

7. Radical Prostatectomy, External Beam Radiotherapy, or External Beam Radiotherapy With Brachytherapy Boost and Disease Progression and Mortality in Patients With Gleason Score 9-10 Prostate Cancer. (PubMed)

Radical Prostatectomy, External Beam Radiotherapy, or External Beam Radiotherapy With Brachytherapy Boost and Disease Progression and Mortality in Patients With Gleason Score 9-10 Prostate Cancer. The optimal treatment for Gleason score 9-10 prostate cancer is unknown.To compare clinical outcomes of patients with Gleason score 9-10 prostate cancer after definitive treatment.Retrospective cohort study in 12 tertiary centers (11 in the United States, 1 in Norway), with 1809 patients treated (...) between 2000 and 2013.Radical prostatectomy (RP), external beam radiotherapy (EBRT) with androgen deprivation therapy, or EBRT plus brachytherapy boost (EBRT+BT) with androgen deprivation therapy.The primary outcome was prostate cancer-specific mortality; distant metastasis-free survival and overall survival were secondary outcomes.Of 1809 men, 639 underwent RP, 734 EBRT, and 436 EBRT+BT. Median ages were 61, 67.7, and 67.5 years; median follow-up was 4.2, 5.1, and 6.3 years, respectively. By 10 years

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2018 JAMA

8. Comparative Toxicities and Cost of Intensity-Modulated Radiotherapy, Proton Radiation, and Stereotactic Body Radiotherapy Among Younger Men With Prostate Cancer.

Comparative Toxicities and Cost of Intensity-Modulated Radiotherapy, Proton Radiation, and Stereotactic Body Radiotherapy Among Younger Men With Prostate Cancer. Purpose To compare the toxicities and cost of proton radiation and stereotactic body radiotherapy (SBRT) with intensity-modulated radiotherapy (IMRT) for prostate cancer among men younger than 65 years of age with private insurance. Methods Using the MarketScan Commercial Claims and Encounters database, we identified men who received (...) radiation for prostate cancer between 2008 and 2015. Patients undergoing proton therapy and SBRT were propensity score-matched to IMRT patients on the basis of clinical and sociodemographic factors. Proportional hazards models compared the cumulative incidence of urinary, bowel, and erectile dysfunction toxicities by treatment. Cost from a payer's perspective was calculated from claims and adjusted to 2015 dollars. Results A total of 693 proton therapy patients were matched to 3,465 IMRT patients

2018 EvidenceUpdates

9. Adjuvant radiotherapy or salvage therapy? A prospective aggregate data meta-analysis of radiotherapy timing for treatment of intermediate or high risk localised prostate cancer

Adjuvant radiotherapy or salvage therapy? A prospective aggregate data meta-analysis of radiotherapy timing for treatment of intermediate or high risk localised prostate cancer Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability

2019 PROSPERO

10. Radiotherapy benefits some men whose prostate cancer has spread to their bones

Radiotherapy benefits some men whose prostate cancer has spread to their bones Radiotherapy benefits some men whose prostate cancer has spread to their bones Discover Portal Discover Portal Radiotherapy benefits some men whose prostate cancer has spread to their bones Published on 22 January 2019 doi: Adding radiotherapy directed at the prostate to hormone treatment for all men with metastatic prostate cancer makes no difference to overall survival. However, when men with a limited number (...) of metastases confined to the bones of the pelvis and spine are treated with radiotherapy to the prostate, their survival improves. The standard treatment for men with metastatic prostate cancer is anti-androgen hormone therapy, and this is sometimes combined with chemotherapy. Radiotherapy of the prostate itself is only usually used for symptom relief. This NIHR part-funded trial compared the effects of standard care with or without radiotherapy to the prostate on overall survival for over 2,000 men

2019 NIHR Dissemination Centre

11. Patient-reported Quality of Life Following Stereotactic Body Radiotherapy and Conventionally Fractionated External Beam Radiotherapy Compared with Active Surveillance Among Men with Localized Prostate Cancer. (PubMed)

Patient-reported Quality of Life Following Stereotactic Body Radiotherapy and Conventionally Fractionated External Beam Radiotherapy Compared with Active Surveillance Among Men with Localized Prostate Cancer. Evidence supporting the efficacy of stereotactic body radiotherapy (SBRT) for localized prostate cancer is accumulating, but comparative studies of patient-reported quality of life (QOL) following SBRT versus conventionally fractionated external beam radiotherapy (EBRT) or active (...) surveillance (AS) are limited.To compare QOL of patients pursuing SBRT and EBRT versus AS.A population-based cohort of 680 men with newly diagnosed localized prostate cancer was prospectively enrolled from 2011 to 2013.SBRT, EBRT without androgen deprivation therapy, or AS.QOL was prospectively assessed before treatment (baseline), and at 3, 12, and 24mo after treatment using the validated Prostate Cancer Symptom Indices, which contain four domains: sexual dysfunction, urinary obstruction/irritation

2019 European Urology

12. Consensus statements on ablative radiotherapy for oligometastatic prostate cancer: A position paper of Italian Association of Radiotherapy and Clinical Oncology (AIRO). (PubMed)

Consensus statements on ablative radiotherapy for oligometastatic prostate cancer: A position paper of Italian Association of Radiotherapy and Clinical Oncology (AIRO). Oligometastatic prostate cancer comprises a wide spectrum of conditions, ranging from de novo oligometastatic cancer at diagnosis to oligometastatic castration-resistant disease, which are distinct entities in terms of biology and prognosis. In order to clarify and standardize the clinical role of ablative radiotherapy (...) in oligometastatic prostate cancer, the Italian Association of Radiotherapy and Clinical Oncology (AIRO) formed an expert panel to review the current literature and develop a formal consensus. Oligometastatic prostate cancer was defined as the presence of up to three metastatic lesions involving bones or nodes outside pelvis. Thereafter, four clinical scenarios were explored: metastatic castration-sensitive disease at diagnosis and after primary treatment, and metastatic castration-resistant disease at diagnosis

2019 Critical reviews in oncology/hematology

13. Leukotoxicity after moderately Hypofractionated radiotherapy versus conventionally fractionated dose escalated radiotherapy for localized prostate Cancer: a secondary analysis from a randomized study. (PubMed)

Leukotoxicity after moderately Hypofractionated radiotherapy versus conventionally fractionated dose escalated radiotherapy for localized prostate Cancer: a secondary analysis from a randomized study. To compare WBC counts during treatment of localized prostate cancer with either conventionally fractionated (CF) or moderately hypofractionated (HYPO) radiotherapy.Weekly blood test results were extracted from the charts of patients treated within a phase III study comparing HYPO to CF. In order (...)  = 0.04). Interestingly, while WBC counts tend to drop throughout all dose levels in the CF arm, this is the case only in the earlier part of treatment in the HYPO arm.This secondary analysis of a phase III study shows that dose fractionation is correlated to WBC drop during treatment of localized prostate cancer, favoring HYPO over CF.

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2019 Radiation oncology (London, England) Controlled trial quality: uncertain

14. Intensity-modulated fractionated radiotherapy versus stereotactic body radiotherapy for prostate cancer (PACE-B): acute toxicity findings from an international, randomised, open-label, phase 3, non-inferiority trial. (PubMed)

Intensity-modulated fractionated radiotherapy versus stereotactic body radiotherapy for prostate cancer (PACE-B): acute toxicity findings from an international, randomised, open-label, phase 3, non-inferiority trial. Localised prostate cancer is commonly treated with external-beam radiotherapy. Moderate hypofractionation has been shown to be non-inferior to conventional fractionation. Ultra-hypofractionated stereotactic body radiotherapy would allow shorter treatment courses but could increase (...) acute toxicity compared with conventionally fractionated or moderately hypofractionated radiotherapy. We report the acute toxicity findings from a randomised trial of standard-of-care conventionally fractionated or moderately hypofractionated radiotherapy versus five-fraction stereotactic body radiotherapy for low-risk to intermediate-risk localised prostate cancer.PACE is an international, phase 3, open-label, randomised, non-inferiority trial. In PACE-B, eligible men aged 18 years and older

2019 Lancet Oncology

15. Metastasis-directed Therapy in Treating Nodal Oligorecurrent Prostate Cancer: A Multi-institutional Analysis Comparing the Outcome and Toxicity of Stereotactic Body Radiotherapy and Elective Nodal Radiotherapy. (PubMed)

Metastasis-directed Therapy in Treating Nodal Oligorecurrent Prostate Cancer: A Multi-institutional Analysis Comparing the Outcome and Toxicity of Stereotactic Body Radiotherapy and Elective Nodal Radiotherapy. Stereotactic body radiotherapy (SBRT) and elective nodal radiotherapy (ENRT) are being investigated as metastasis-directed treatments in oligorecurrent prostate cancer (PC); however, comparative data are still lacking.To compare outcome and toxicity between both treatments. Primary (...) of nodal recurrences as compared with SBRT, however at higher toxicity. Our findings hypothesize that ENRT should be preferred to SBRT in the treatment of nodal oligorecurrences. This hypothesis needs to be evaluated in a randomized trial.This study investigated the difference between stereotactic and elective nodal radiotherapy in treating limited nodal metastatic prostate cancer. Nodal relapse was less frequent following elective nodal radiotherapy than following stereotactic body radiotherapy

2019 European Urology

16. Prostate Radiotherapy for Metastatic Hormone-sensitive Prostate Cancer: A STOPCAP Systematic Review and Meta-analysis. (PubMed)

Prostate Radiotherapy for Metastatic Hormone-sensitive Prostate Cancer: A STOPCAP Systematic Review and Meta-analysis. Many trials are evaluating therapies for men with metastatic hormone-sensitive prostate cancer (mHSPC).To systematically review trials of prostate radiotherapy.Using a prospective framework (framework for adaptive meta-analysis [FAME]), we prespecified methods before any trial results were known. We searched extensively for eligible trials and asked investigators when results (...) would be available. We could then anticipate that a definitive meta-analysis of the effects of prostate radiotherapy was possible. We obtained prepublication, unpublished, and harmonised results from investigators.We included trials that randomised men to prostate radiotherapy and androgen deprivation therapy (ADT) or ADT only.Hazard ratios (HRs) for the effects of prostate radiotherapy on survival, progression-free survival (PFS), failure-free survival (FFS), biochemical progression, and subgroup

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2019 European Urology

17. Prostate-specific antigen after neoadjuvant androgen suppression in prostate cancer patients receiving short-term androgen suppression and external beam radiotherapy: pooled analysis of four NRG Oncology RTOG randomized clinical trials. (PubMed)

Prostate-specific antigen after neoadjuvant androgen suppression in prostate cancer patients receiving short-term androgen suppression and external beam radiotherapy: pooled analysis of four NRG Oncology RTOG randomized clinical trials. To validate if prostate specific antigen (PSA) level after neoadjuvant androgen suppression (neoAS) is associated with long-term outcome after neoAS and external radiation therapy (RT) with concurrent short-term AS in prostate cancer patients.2404 patients

2019 Biology and Physics

18. Prostate-specific membrane antigen-positron emission tomography/computed tomography (PSMA-PET/CT)-guided stereotactic ablative body radiotherapy for oligometastatic prostate cancer: a single-institution experience and review of the published literature. (PubMed)

Prostate-specific membrane antigen-positron emission tomography/computed tomography (PSMA-PET/CT)-guided stereotactic ablative body radiotherapy for oligometastatic prostate cancer: a single-institution experience and review of the published literature. To report the outcomes of stereotactic ablative body radiotherapy (SABR) in men with oligometastatic prostate cancer (PCa) diagnosed on prostate-specific membrane antigen (PSMA)-positron emission tomography/computed tomography (PET/CT), based (...) LPFS of 93%. Ten men had distant progression outside of their SABR treatment field, confirmed on PSMA-PET/CT, with 12-month DPFS of 62%, of whom four were treated with palliative ADT, two received prostate bed radiotherapy for prostate bed progression (confirmed on magnetic resonance imaging), and four received a further course of SABR (of whom one had further progression and was treated with palliative ADT). At last follow-up, six men (one with local progression and five with distant progression

2019 BJU international

19. Randomised Trial of Adjuvant Radiotherapy Following Radical Prostatectomy Versus Radical Prostatectomy Alone in Prostate Cancer Patients with Positive Margins or Extracapsular Extension

Randomised Trial of Adjuvant Radiotherapy Following Radical Prostatectomy Versus Radical Prostatectomy Alone in Prostate Cancer Patients with Positive Margins or Extracapsular Extension It remains unclear whether patients with positive surgical margins or extracapsular extension benefit from adjuvant radiotherapy following radical prostatectomy.To compare the effectiveness and tolerability of adjuvant radiotherapy following radical prostatectomy.This was a randomised, open-label, parallel-group (...) trial. A total of 250 patients were enrolled between April 2004 and October 2012 in eight Finnish hospitals, with pT2 with positive margins or pT3a, pN0, M0 cancer without seminal vesicle invasion.A total of 126 patients received adjuvant radiotherapy at 66.6Gy.The primary endpoint was biochemical recurrence-free survival, which we analysed using the Kaplan-Meier method and Cox proportional hazard regression. Overall survival, cancer-specific survival, local recurrence, and adverse events were

2019 EvidenceUpdates

20. Effect of Chemotherapy With Docetaxel With Androgen Suppression and Radiotherapy for Localized High-Risk Prostate Cancer: The Randomized Phase III NRG Oncology RTOG 0521 Trial

Effect of Chemotherapy With Docetaxel With Androgen Suppression and Radiotherapy for Localized High-Risk Prostate Cancer: The Randomized Phase III NRG Oncology RTOG 0521 Trial Radiotherapy (RT) plus long-term androgen suppression (AS) are a standard treatment option for patients with high-risk localized prostate cancer. We hypothesized that docetaxel chemotherapy (CT) could improve overall survival (OS) and clinical outcomes among patients with high-risk prostate cancer.The multicenter (...) randomized NRG Oncology RTOG 0521 study enrolled patients with high-risk nonmetastatic disease between 2005 and 2009. Patients were randomly assigned to receive standard long-term AS plus RT with or without adjuvant CT.A total of 612 patients were enrolled; 563 were evaluable. Median prostate-specific antigen was 15.1 ng/mL; 53% had a Gleason score 9 to 10 cancer; 27% had cT3 to cT4 disease. Median follow-up was 5.7 years. Treatment was well tolerated in both arms. Four-year OS rate was 89% (95% CI, 84

2019 EvidenceUpdates

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