Lower salvage radiation dose — are outcomes the same?

A large randomized clinical trial, SAKK 09/10, found that a salvage radiation dose of 64 Gy over 32 treatments had equivalent biochemical outcomes compared to 70 Gy over 35 treatments. … READ MORE …

New guidelines for salvage radiation dimensions

It has always been troubling that only about half of all salvage radiation treatments after failure of radical prostatectomy are successful. Usually, only the prostate bed is treated. But sometimes recurrent patients (or those with persistently elevated PSA) receive salvage radiation to the pelvic lymph nodes as well, or subsequently. … READ MORE …

“Dose painting”: simultaneous integrated boost to the dominant intraprostatic lesion

Two technologies have come together to allow for a new kind of radiation treatment known as simultaneous integrated boost (SIB), or, more informally, “dose painting.” … READ MORE …

SBRT for high-risk prostate cancer patients

As we have seen, stereotactic body radiation therapy (SBRT) is a preferred therapy for low- and intermediate-risk patients (see this link). It is effective, safe, convenient, and relatively inexpensive. However, its use for high-risk patients remains controversial. … READ MORE …

Whole pelvic salvage radiation may be better than precisely targeted lymph node salvage radiation

Last week, I looked at a retrospective study of metastasis-directed therapy (MDT) at the Mayo Clinic among oligorecurrent patients (see this link). … READ MORE …

Targeting bone metastases with radiation in oligorecurrent men has no survival benefit in Mayo study

Oligometastases in Bones

Metastasis-directed therapy (MDT) when there are only a few bone metastases (called “oligometastatic”) is controversial. … READ MORE …

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).

… READ MORE …

Adding ADT to external beam radiation only benefits unfavorable risk patients

In 2013, Zumsteg et al. proposed a refinement in the NCCN “intermediate risk” classification into two subcategories, “favorable intermediate-risk (FIR)” and “unfavorable intermediate-risk (UIR).” … READ MORE …

RP vs. RT as first-line treatment for prostate cancer: that word “may” again

A newly published commentary on the CancerNetwork web site is entitled, “Radical prostatectomy as primary treatment for prostate cancer leads to better survival.” … READ MORE …

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 …

Long-term adjuvant ADT improves results of brachy-boost therapy in unfavorable-risk prostate cancer patients

TROG 01.03 RADAR, begun in 2003, was a (partly) randomized clinical trial to help optimize therapy of unfavorable-risk patients. … READ MORE …

Radiation therapy for prostate cancer in the time of COVID-19

A panel of top radiation oncologists in the US and the UK has addressed the question of putting off or shortening various kinds of radiation treatment (RT) for prostate cancer at a time when it is best to maintain distance from institutions that treat patients. … READ MORE …

“Adjuvant” similar to “early salvage” radiation outcome in meta-analysis

Although at least three randomized clinical trials have told us that adjuvant radiation after prostatectomy often affords better results than just taking a “wait-and-see” approach, … READ MORE …

The first-line treatment of locally advanced prostate cancer (clinical stage T3)

Does radical prostatectomy (with or without external beam radiation therapy) improve prostate-cancer specific survival by comparison with primary radiation treatment and androgen deprivation therapy (ADT) among patients initially diagnosed with locally advanced (T3) prostate cancer? … READ MORE …

SABR to oligometastases slows progression via immune response

Stereotactic ablative body radiation (SABR, or sometimes, SBRT) significantly slowed metastatic progression in men with three or fewer metastases (oligometastatic disease). … READ MORE …