Is modern external beam radiotherapy with androgen deprivation therapy still a viable alternative for prostate cancer in an era of robotic surgery and brachytherapy: A comparison of Australian series

Abstract

Modern EBRT is at least as effective as modern Australian surgical and brachytherapy techniques. All patients considering treatment for localised prostate cancer should be referred to a radiation oncologist to discuss EBRT as an equivalent option.

Ten-year outcomes of intensity-modulated radiation therapy combined with neoadjuvant hormonal therapy for intermediate- and high-risk patients with T1c-T2N0M0 prostate cancer

“…In addition, 46 % of the cases were treated with IMRT alone, Table 3 Comparison of the backgrounds between IMRT and 3D-CRT cases IMRT intensity-modulated radiation therapy, 3D-CRT three-dimensional conformal radiation therapy, iPSA initial (pretreatment) prostate-specific antigen, NA-HT neoadjuvant hormonal therapy, PSA@S-HT prostate-specific antigen when salvage hormonal therapy was initiated a D'Amico's risk classification which is no longer the standard approach to EBRT for both intermediate-risk and high-risk prostate cancer. When focusing on the outcomes of high-dose IMRT combined uniformly with HT for cohorts of patients with intermediate-and high-risk localized prostate cancer, reports on outcomes up to 5 years are now available [18][19][20][21]. In this article, we report the long-term outcomes of high-dose IMRT combined with short-term NA-HT for patients with clinically localized prostate cancer over a 10-year median follow-up.…”

Radiation resistance: Cancer stem cells (CSCs) and their enigmatic pro-survival signaling

“…It was recently estimated that one-half to two-thirds of cancer patients receive radiation therapy in curative or palliative settings during their disease [1,2]. Radiotherapy is a therapeutic approach with a very high potential for local control: ionizing radiation is equally as effective as surgery in curing prostate [3,4], laryngeal [5], cervical [6], and anal cancers [7]. However, and despite very effective radiation-induced cancer cell elimination and local tumor control, not all malignant tumors respond equally to radiation therapy: some patients do not derive clinical benefit from it because their tumors are constitutively insensitive to therapeutic doses of ionizing radiation, or are able to acquire such insensitivity.…”

Prostate intensity-modulated radiotherapy planning in seven mouse clicks: Development of a class solution for cancer

“…This final stage of the class solution demonstrated that 89% of prostate patients met treatment criteria outright (S. Greenham, personal communication). Further research is required to determine whether prostate class solutions can maintain or improve upon the clinical and patient-reported outcomes 5,6,15 of dose-escalated image-guided IMRT.…”

“…These patients were volumed using magnetic resonance imaging (MRI) and computed tomography (CT) fusion 4 and treated to 81 Gy as previously described. 5,6 Planning criteria and OAR constraints are summarised in Tables 1 and 2 and were based on evidencebased guidelines (EviQ recommendations). 7 Minor violations were acceptable when all reasonable efforts to achieve ideal constraints had been made.…”