Importance of adding ADT to brachy boost therapy for men with unfavorable-risk prostate cancer

Last month, we looked at Level 1 evidence (highest level, superseding all previous studies) that for unfavorable-risk patients, brachy boost therapy (BBT) — i.e., external beam therapy (EBRT) with a brachytherapy boost to the prostate — has better results when accompanied by 18 months of androgen deprivation therapy (ADT) (see this link). … READ MORE …

SBRT has excellent outcomes for intermediate-risk patients

Stereotactic body radiation therapy or SBRT (sometimes referred to as SABR or SHARP or CyberKnife) has had excellent 7-year outcomes in an update of the consortium study, including data from 10 single-institution trials and two multi-institutional trials. … READ MORE …

Low-dose-rate brachytherapy monotherapy at the Mayo Clinic

A clinical research team from the Mayo Clinic (Routman et al.) has reported 10-year oncological results on 974 consecutive low- and intermediate-risk patients treated with low-dose-rate brachytherapy monotherapy (using iodine-125 seeds) from 1998 to 2013. … READ MORE …

5-year follow-up after focal therapy with HIFU for localized prostate cancer

A new paper from the Emberton-Ahmed group in the UK has reported 5-year follow-up data from a cohort of > 600 patients with clinically significant, localized prostate cancer, all treated with focal forms of high-intensity focused ultrasound (HIFU). … READ MORE …

Escalated radiation dose doesn’t improve 8-year overall survival in intermediate-risk men (but does it matter?)

Last week, we saw that escalated dose did not improve 10-year overall survival in high-risk men (see this link). The latest published findings of the randomized clinical trial (RTOG 0126) prove that 8-year overall survival was not improved in intermediate-risk men who received a higher radiation dose. … READ MORE …

Recovery of normal serum T levels after short-term ADT and radiation therapy

Two matters of concern to many prostate cancer patients who are considering radiation therapy as a treatment for their prostate cancer are : (a) Should I be having a short course of androgen deprivation therapy (ADT) along with the radiation therapy? (b) How well will I recover normal serum testosterone levels after such short-term treatment? … READ MORE …

Why did biochemical control not translate into a survival increase after brachy boost therapy?

The first randomized clinical trial to prove that brachy boost radiotherapy had better oncological outcomes among high-risk patients was the one published by Sathya et al. in 2005. … READ MORE …

Predicting outcomes on active surveillance for intermediate-risk patients

It is now clear that men who meet NCCN criteria for very low- and low-risk forms of prostate cancer are almost invariably good candidates for initial management on active surveillance (i.e., just monitoring as opposed to immediate treatment). … READ MORE …

Brachy boost: the gold standard for progression-free survival of high-risk prostate cancer

Several randomized clinical trials have established the superior oncological outcomes of the combination of external beam radiotherapy with a high-dose-rate brachytherapy boost (see this link). … READ MORE …

Increasing acceptance of different types of “intermediate-risk” prostate cancer

A new review article in the journal Oncology provides us with an overview of the appropriate management of men with “favorable” and “unfavorable” forms of intermediate-risk prostate cancer. … 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 …

Update on late stage, “intermediate atypical” mCRPC

According to a report this morning on the UroToday web site, Dr. Eric Small presented an update yesterday on so-called “intermediate atypical”, metastatic, castration-resistant prostate cancer (mCRPC) — at a general session of the 2015 meeting of the Society of Urologic Oncology in Washington, DC. … READ MORE …

The “best” form of first-line treatment for clinically significant, localized prostate cancer

From the perspective of the disinterested observer, one of the very least edifying aspects of issues related to the management of prostate cancer has been the nearly 50-year-long “discussion” between the urology community and the radiation oncology community about the most appropriate way(s) to treat localized disease. … 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 …

The development of drug-resistant, neuroendocrine forms of mCRPC

A sophisticated presentation at the annual meeting of the American Society of Clinical Oncology today (on behalf of the West Coast Prostate Cancer “Dream Team”) gave us insights into the the development of neuroendocrine forms of drug-resistant prostate cancer. … READ MORE …