SBRT vs. EBRT in treatment of painful spine metastases

New data on this topic — from a Phase II/III clinical trial — have just been presented at the virtual annual meeting of the American Society for Radiation Oncology (ASTRO). Basically, the data from this study by Sahgal et al. indicated that 24 Gy (in two 12 Gy doses) of stereotactic body radiation therapy (SBRT) was more effective in the elimination of spinal pain in patients with metastatic cancer as compared to 20 Gy (in five 4 Gy doses) of conventional, external beam radiation therapy (EBRT).

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The APCCC in Basel, Switzerland: Day 2

The second day of the APCCC here in Basel ran for 10 hours and encompassed a total of six sessions, as follows: … READ MORE …

One large “zap” for painful bone metastases is enough

In 2011, the American Society for Radiation Oncology (ASTRO) issued a consensus statement as part of its “Choosing Wisely” campaign that found that 30 Gy in 10 fractions (treatments), 20 Gy in 5 fractions, and 8 Gy in 1 fraction all gave equivalent pain relief. … READ MORE …

Unnecessary imaging studies … it’s on the docs!

Here in the USA, about half the patients diagnosed with low-risk prostate cancer are still (apparently) being sent for “guideline-discordant” (i.e., unnecessary) bone scans and CT scans, … READ MORE …

Can PSMA PET scans replace the need for bone and CT scans?

A new review article suggests the possibility that radiolabeled prostate specific membrane antigens (PSMAs) and PET scans may, at some point in the not too distant future, replace bone and CT scans in diagnosis and monitoring of men with advanced forms of prostate cancer. … READ MORE …

Risk for fractures and fracture prevention among prostate cancer patients

An interesting new paper in BJU International has provided us with a somewhat different perspective on which patients with prostate cancer do and do not need preventive therapy (e.g., zoledronic acid/Zometa, dasatinib/Xgeva) to minimize risk for bone fractures. … READ MORE …

The role of CT scanning in assessment of progression of men with CRPC

A newly published paper in the journal Cancer seems to be implying that every man with castration-resistant prostate cancer who progresses from non-metastatic to metastatic status (based on a bone scan or other indicators) should also be given a CT scan because of risk for soft tissue metastasis. … READ MORE … >

Newer types of whole body scanning are likely to be significantly better than older bone scans, but …

A new report in the Journal of Nuclear Medicine has suggested that it may be time to start looking seriously at whether the combined [18F]NaF/[18F]FDG PET/CT scan may be significantly better than the traditional [99m]Tc bone scan in evaluation of risk for or the actual presence of metastasis in men with prostate cancer. … READ MORE …

> 40 percent of low-risk prostate cancer patients were getting inappropriate imaging tests

A new paper in JAMA Oncology has shown that between 2004 and 2007 nearly 45 percent of men initially diagnosed with low-risk prostate cancer were receiving unnecessary bone scans and CT scans in some regions of the USA. … READ MORE …

Use of bisphosphonate therapy in men on ADT in Ontario, Canada

According to a research letter published in the Journal of the American Medical Association, most men in Ontario, Canada, who have androgen deprivation therapy (ADT) for treatment of prostate cancer have not been receiving bisphosphonate or comparable therapy. … READ MORE …

Can the “bone scan index” act as a surrogate marker for survival?

One of the problems with clinical trials for late-stage prostate cancer today is that we commonly need to follow all patients until death before we can collect sufficiently accurate data to be certain that a particular product is or is not effective in extending patient survival. … READ MORE …

Potential new imaging test for metastatic prostate cancer

According to a newly published study in the journal Cancer Research, a collaborative research team at the Massey Cancer Center of Virgina Commonwealth University and at Johns Hopkins has developed a new, systemically administered, non-invasive, molecular-genetic technique to image bone metastases resulting from prostate cancer. … READ MORE …

Single- vs. multi-fraction radiation therapy for metastatic, bone-related cancer pain

Data published in 2005 and later have clearly shown that — for most patients — single-fraction radiation therapy (e.g., a single dose of 8 Gy) is better than multi-fraction radiation therapy (e.g., 30 Gy given over 10 treatments) for the treatment of bone pain consequent to metastatic cancer that has spread into the bones (in prostate cancer and other forms of cancer). … READ MORE …

Use of imaging tests in low-risk prostate cancer — striking the right balance

An article published a couple of weeks ago in the Journal of the National Cancer Institute looks at the effects of a physician education campaign in Sweden to reduce the inappropriate use of bone scans and other imaging tests among men with an initial diagnosis of low-risk prostate cancer. … READ MORE …

Prevention of bone-related and metabolic complications of treatment for men on ADT

A new article from an Australian clinical research group in the journal Andrology addresses “the effectiveness of implementing standardized guidelines to mitigate metabolic and bone side effects of androgen deprivation therapy (ADT) in men with non-metastatic prostate cancer.” … READ MORE …