Brachy boost therapy and surgery extend survival about the same in high-risk patients, but brachy boost does more

Two retrospective studies were published in the last week, and they had some similar findings, but some dissimilar things to say about which treatment is best for high-risk prostate cancer. … READ MORE …

For very high-risk patients, EBRT + BT is superior to surgery or EBRT only (redux)

In August last year, Kishan et al. showed a preliminary analysis of oncological outcomes among patients diagnosed with Gleason score 9 and 10 and treated with brachy boost therapy (EBRT + BT), external beam radiation therapy alone (EBRT), or surgery (see this link). … READ MORE …

EBRT works better with ADT for intermediate- and high-risk prostate cancer

The EORTC trial 22991 was designed and implemented to compare external beam radiation therapy (EBRT) + short-term androgen deprivation therapy (ADT) to EBRT alone as first-line therapy in patients with intermediate- and high-risk prostate cancer. … READ MORE …

Brachytherapy boost may lower mortality rate in high-risk patients

The ASCENDE-RT randomized clinical trial demonstrated that the combination of external beam radiation therapy with a brachytherapy boost (EBRT + BT) significantly reduced biochemical progression-free survival. … READ MORE …

Low dose rate brachytherapy monotherapy across risk groups

New registry data from the Cleveland Clinic shows good oncological control with low dose rate brachytherapy (LDRBT) monotherapy, at least for low-risk and low  intermediate-risk groups. This is the first time I’ve seen LDRBT monotherapy data for higher-risk groups. … READ MORE …

Is combination EBRT + LDR-BT worth the risk for most patients?

Long-term data from the Radiaton Treatment Oncology Group (RTOG) 00-19 Phase II trial of external beam radiation therapy (EBRT) + low-dose-rate permanent implant brachytherapy (LDR-BT) has suggested that this type of radiation treatment is probably no more effective than either EBRT or LDR-BT alone … but does have a greater risk for long-term side effects. … READ MORE …

The management of recurrent prostate cancer after first-line therapy

Traditionally, men with prostate cancer who had recurrent disease after first-line surgery or first-line radiation therapy had a limited number of treatment options, but we are now seeing a significant expansion in the range of options available (although limited data are as yet available to support the effectiveness of nearly all these options). … READ MORE …

EBRT + total (combined) ADT in treatment of high-risk, localized and locally advanced prostate cancer

The big news today is the publication, in The Lancet, of the interim results of the NCIC CTG PR.3/MRC UK PR07 trial, originally presented by Warde et al. at the annual meeting of the American Society for Clinical Oncology in June 2010 and then by Mason et al. at the annual meeting of the American Society for Radiation Oncology (ASTRO) that September. … READ MORE …

All the different types of external beam radiation therapy for prostate cancer: a good introduction

Over the past 20 years there has been an explosion in the different ways that we use varied types of external beam radiation therapy for the treatment of localized and locally advanced forms of prostate cancer. Where is the newly diagnosed patient able to find a good, basic introduction? … READ MORE …

A new way to look at side effects of first-line prostate cancer treatment

Academic research into the side effects of different treatments for localized prostate cancer have long been hampered by the lack of consistently used criteria for the assessment of those side effects at baseline and at defined time-periods post-treatment. … READ MORE …

Further experience with salvage HIFU after first-line EBRT

A second, small study has now offered additional data on clinical experience of the use of high-intensity focused ultrasound (HIFU) as a form of salvage therapy in men initially diagnosed with localized prostate cancer, but with a rising PSA after external beam radiation therapy (EBRT) as their first-line treatment. … READ MORE …

Health-related QOL after salvage HIFU for recurrent, localized prostate cancer

Men with locally recurrent prostate cancer after first-line external beam radiation therapy (EBRT) have historically had three options for second-line treatment: salvage radical prostatectomy, salvage cryoablation, and salvage brachytherapy. … READ MORE …

Results of RTOG 94-08 finally published in NEJM

As we first reported in March 2010, when data were originally presented at the Genitourinary Cancers Symposium, RTOG 94-08 has shown that 4 months of androgen deprivation therapy (ADT) before and during external beam radiation therapy (EBRT) reduces the overall and the prostate cancer-specific mortality rates for men with localized prostate cancer (clinical stages T1b, T1c, T2a, or T2b). … READ MORE …

GI toxicity, radiation therapy, and androgen deprivation

For men undergoing the combination of external beam radiation therapy (EBRT) and androgen deprivation therapy (ADT), for treatment of prostate cancer there is a significant risk for gastrointestinal (GI) toxicity over time. … READ MORE …

A matched, case-control study of EBRT + PBRT vs brachytherapy

It would be all too easy to get the idea — from the title and abstract of a recently published study — that proton beam radiation therapy (PBRT) was more effective than permanent seed brachytherapy in the treatment of men with low- and some intermediate-risk prostate cancers. This would be a very inappropriate conclusion. … READ MORE …