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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. 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

3. 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.

4. 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

5. 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

6. 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

7. 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

8. 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)

9. 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

10. 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

11. 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

12. [Adjuvant radiotherapy for lymph-node-positive prostate cancer with low tumor load after radical prostatectomy : Multicenter randomized phase III study of the effect of adjuvant radiotherapy in patients with prostate cancer with or without a positive marg (PubMed)

[Adjuvant radiotherapy for lymph-node-positive prostate cancer with low tumor load after radical prostatectomy : Multicenter randomized phase III study of the effect of adjuvant radiotherapy in patients with prostate cancer with or without a positive marg 28667345 2018 07 11 1433-0563 56 8 2017 Aug Der Urologe. Ausg. A Urologe A [Adjuvant radiotherapy for lymph-node-positive prostate cancer with low tumor load after radical prostatectomy : Multicenter randomized phase III study of the effect (...) of adjuvant radiotherapy in patients with prostate cancer with or without a positive margin after radical prostatectomy (RP) and lymph node metastasis with low tumor load (micrometastases, ≤ 2 lymph node macrometastases). ART-2 - study AP 61/10 of the AUO]. 1040-1043 10.1007/s00120-017-0435-z Rexer H H MeckEvidence, Geschäftsstelle der AUO, Seestr. 11, 17252, Schwarz, Deutschland. Bartkowiak D D Klinik für Strahlentherapie und Radioonkologie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm

2017 Der Urologe. Ausg. A

13. Toxicity and Patient-Reported Outcomes of a Phase 2 Randomized Trial of Prostate and Pelvic Lymph Node Versus Prostate only Radiotherapy in Advanced Localised Prostate Cancer (PIVOTAL). (PubMed)

Toxicity and Patient-Reported Outcomes of a Phase 2 Randomized Trial of Prostate and Pelvic Lymph Node Versus Prostate only Radiotherapy in Advanced Localised Prostate Cancer (PIVOTAL). To establish the toxicity profile of high-dose pelvic lymph node intensity-modulated radiation therapy (IMRT) and to assess whether it is safely deliverable at multiple centers.In this phase 2 noncomparative multicenter trial, 124 patients with locally advanced, high-risk prostate cancer were randomized between (...) prostate-only IMRT (PO) (74 Gy/37 fractions) and prostate and pelvic lymph node IMRT (P&P; 74 Gy/37 fractions to prostate, 60 Gy/37 fractions to pelvis). The primary endpoint was acute lower gastrointestinal (GI) Radiation Therapy Oncology Group (RTOG) toxicity at week 18, aiming to exclude a grade 2 or greater (G2+) toxicity-free rate of 80% in the P&P group. Key secondary endpoints included patient-reported outcomes and late toxicity.One hundred twenty-four participants were randomized (62 PO, 62 P&P

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2018 Biology and Physics

14. Biodegradable spacer insertion to reduce rectal toxicity during radiotherapy for prostate cancer

Biodegradable spacer insertion to reduce rectal toxicity during radiotherapy for prostate cancer Biodegr Biodegradable spacer insertion to reduce rectal adable spacer insertion to reduce rectal to toxicity during r xicity during radiother adiotherap apy for prostate cancer y for prostate cancer Interventional procedures guidance Published: 23 August 2017 nice.org.uk/guidance/ipg590 Y Y our responsibility our responsibility This guidance represents the view of NICE, arrived at after careful (...) Recommendations 1.1 Current evidence on the safety and efficacy of insertion of a biodegradable spacer to reduce rectal toxicity during radiotherapy for prostate cancer is adequate to support the use of this procedure provided that standard arrangements are in place for clinical governance, consent and audit. © NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- conditions#notice-of-rights). Page 1 of 81.2 The procedure should only be done by clinicians

2017 National Institute for Health and Clinical Excellence - Interventional Procedures

15. Long-term outcome of hypofractionated intensity-modulated radiotherapy using TomoTherapy for localized prostate cancer: A retrospective study. (PubMed)

Long-term outcome of hypofractionated intensity-modulated radiotherapy using TomoTherapy for localized prostate cancer: A retrospective study. Recently, the clinical outcome of prostate cancer treated by hypofractionated radiation therapy has been reported. However, there are few reports from Japan. In Hidaka Hospital, hypofractionated intensity-modulated radiotherapy (HIMRT) for prostate cancer was initiated in 2007. The purpose of this study is to analyze the long-term outcome.Ninety-two (...) patients with localized prostate cancer treated with HIMRT at Hidaka Hospital between 2007 and 2009 were retrospectively analyzed. HIMRT was delivered using TomoTherapy. The prescription dose was 66 Gy at 95% of the PTV in 22 fractions performed 3 days a week over 7 weeks in all patients. The overall survival rate, biochemical relapse-free rate, and acute and late toxicities were evaluated.The median follow-up duration was 78 (range 14-100) months. The median age at the start of the HIMRT was 72 (range

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2019 PLoS ONE

16. Real-time adaptive planning method for radiotherapy treatment delivery for prostate cancer patients, based on a library of plans accounting for possible anatomy configuration changes. (PubMed)

Real-time adaptive planning method for radiotherapy treatment delivery for prostate cancer patients, based on a library of plans accounting for possible anatomy configuration changes. In prostate cancer treatment with external beam radiation therapy (EBRT), prostate motion and internal changes in tissue distribution can lead to a decrease in plan quality. In most currently used planning methods, the uncertainties due to prostate motion are compensated by irradiating a larger treatment volume (...) and on a clinical case. For the first, a pilot study was performed on an in-silico pelvic phantom. A "library" of intensity modulated RT (IMRT) plans corresponding to possible positions of the prostate during a treatment fraction was generated at planning stage. Then a 3D random walk model was used to simulate possible displacements of the prostate during the treatment fraction. At treatment stage, at the end of each beam, based on the current position of the target, the beam from the library of plans, which

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2019 PLoS ONE

17. Report from the ESMO 2018 presidential symposium—Radiotherapy to the primary tumour for men with newly diagnosed metastatic prostate cancer: survival results from STAMPEDE (PubMed)

Report from the ESMO 2018 presidential symposium—Radiotherapy to the primary tumour for men with newly diagnosed metastatic prostate cancer: survival results from STAMPEDE

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2018 ESMO open

18. Re: Hypofractionated Radiotherapy versus Conventionally Fractionated Radiotherapy for Patients with Intermediate-Risk Localised Prostate Cancer: 2-Year Patient-Reported Outcomes of the Randomised, Non-Inferiority, Phase 3 CHHiP Trial. (PubMed)

Re: Hypofractionated Radiotherapy versus Conventionally Fractionated Radiotherapy for Patients with Intermediate-Risk Localised Prostate Cancer: 2-Year Patient-Reported Outcomes of the Randomised, Non-Inferiority, Phase 3 CHHiP Trial. 27751451 2018 09 11 2018 12 02 1527-3792 196 5 2016 11 The Journal of urology J. Urol. Re: Hypofractionated Radiotherapy versus Conventionally Fractionated Radiotherapy for Patients with Intermediate-Risk Localised Prostate Cancer: 2-Year Patient-Reported Outcomes (...) of the Randomised, Non-Inferiority, Phase 3 CHHiP Trial. 1445-1447 S0022-5347(16)31052-7 10.1016/j.juro.2016.08.067 Taneja Samir S SS eng Journal Article Comment 2016 08 23 United States J Urol 0376374 0022-5347 AIM IM Lancet Oncol. 2015 Dec;16(16):1605-16 26522334 Dose Fractionation, Radiation Humans Male Patient Reported Outcome Measures Prostatic Neoplasms radiotherapy Radiation Dose Hypofractionation 2016 08 11 2016 10 19 6 0 2018 9 12 6 0 2016 10 19 6 0 ppublish 27751451 S0022-5347(16)31052-7 10.1016

2018 The Journal of urology

19. Stereotactic body-radiotherapy boost dose of 18 Gy vs 21 Gy in combination with androgen-deprivation therapy and whole-pelvic radiotherapy for intermediate- or high-risk prostate cancer: a study protocol for a randomized controlled, pilot trial (PubMed)

Stereotactic body-radiotherapy boost dose of 18 Gy vs 21 Gy in combination with androgen-deprivation therapy and whole-pelvic radiotherapy for intermediate- or high-risk prostate cancer: a study protocol for a randomized controlled, pilot trial Combination therapy using external-beam radiotherapy (EBRT) with a brachytherapy boost has demonstrated superior biochemical control than dose-escalated EBRT alone. Whereas brachytherapy is disadvantageous because it is an invasive procedure (...) , stereotactic body-radiotherapy (SBRT) using CyberKnife could emulate the dose distribution of brachytherapy and is a non-invasive and safe modality to control intra-fractional movement. We therefore adopted SBRT using CyberKnife as a boost therapy after whole-pelvic radiotherapy (WPRT).In this prospective, randomized, single-center, pilot study for intermediate- and high-risk prostate cancer without nodal or distant metastasis, after androgen-deprivation therapy and WPRT, patients will be randomized to one

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2018 Trials

20. Comparison of Image-Guided Intensity-Modulated Radiotherapy and Low-dose Rate Brachytherapy with or without External Beam Radiotherapy in Patients with Localized Prostate Cancer (PubMed)

Comparison of Image-Guided Intensity-Modulated Radiotherapy and Low-dose Rate Brachytherapy with or without External Beam Radiotherapy in Patients with Localized Prostate Cancer To compare the outcome of low-dose rate brachytherapy (LDR-BT) and image-guided intensity-modulated radiotherapy (IG-IMRT) for localized prostate cancer, we examined 488 LDR-BT and 269 IG-IMRT patients. IG-IMRT treated older and advanced disease with more hormonal therapy than LDR-BT, which excluded T3b-T4 tumor

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2018 Scientific reports

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