Prostate cancer radiation dose response: results of the M.D. Anderson phase III randomized trial

Pollack, Alan; Zagars, Gunar K.; Starkschall, George; Antolak, John A.; Lee, J.J; Huang, Eugene; Eschenbach, Andrew C. von; Kuban, Deborah A.; Rosen, Isaac I.; Ritter, Mark A.

doi:10.1016/s1078-1439(03)00092-9

Cited by 144 publications

(207 citation statements)

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“…Late grade III rectal toxicity was not encountered but grade II was present in 4%. Our results are thus in the range of those found in literature [10,12,13,22,23,32], even if our urinary toxicity was within the less favourable and rectal toxicity within the most favourable results. We did not in fact exclude patients previously treated with TURP and obtained similar toxicity rates as those reporting on similar selection criteria [10].…”

Section: Discussionsupporting

confidence: 83%

192Ir low dose rate brachytherapy for boosting locally advanced prostate cancers after external beam radiotherapy: A phase II trial

Nickers¹,

Coppens

Leval

et al. 2006

Radiotherapy and Oncology

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Background and purpose: To evaluate on 201 locally advanced prostatic cancers prospectively treated in a phase II trial, the efficacy of a combination of external beam radiotherapy (39.6 Gy) and 192 Ir low dose rate brachytherapy (Bt) (40-45 Gy).Patients and methods: Sixty-four patients were included in the intermediate prognosis group with only one of the following adverse factors (PSAO10 ng/ml, Gleason scoreR7 or clinical stageRT2b) and 137 in the unfavourable group when at least two of these factors were present.Results: The actuarial 4 years biochemical no evidence of disease is 82.8% for the entire population. It is, respectively, 97 and 76% in the intermediate and unfavourable prognosis groups (P!0.0001). GradeR3 late urinary complications occurred in 13 patients (6.5%). Eight patients (4%) presented late grade 2 rectal complications but no grades 3-5 was observed.Conclusions: Even if an a/b of 1.5-3 Gy theoretically favours the use of a high dose rate mode of irradiation, the early results presented here are as good as those reported for similar groups of patients with high dose rate treatments. Late toxicity is identical but our urinary toxicity is within the less favourable and rectal toxicity within the most favourable results.We can postulate that while inducing very high hyperdosage regions (V150) mainly focused on the peripheral zone, most of the Bt techniques consist of a more ablative treatment. Many of the radiobiological studies on Bt did not in fact take into account the heterogeneity of irradiation inside the CTV. This study highlights the need to explore pulsed dose rate therapies, permanent implant and new available radioisotopes such as 169 Ytterbium that will offer the safety of low and lower dose rates. The actual late toxicity of the different Bt techniques is not yet inexistent indeed. q

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Section: Discussionsupporting

confidence: 83%

192Ir low dose rate brachytherapy for boosting locally advanced prostate cancers after external beam radiotherapy: A phase II trial

Nickers¹,

Coppens

Leval

et al. 2006

Radiotherapy and Oncology

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“…7,8 Assuming that PSA recurrence translates into prostate cancer death and sufficient power exists in the studies to measure differences in PCSM, after accounting for competing causes of mortality, then with longer follow-up decreased PCSM should be observed in men randomized to higher-dose RT. Such a benefit may justify accepting the small but significant increase in risk of rectal toxicity that has been associated with higher RT doses.…”

Section: Discussionmentioning

confidence: 99%

“…Such a benefit may justify accepting the small but significant increase in risk of rectal toxicity that has been associated with higher RT doses. 7,8 Criteria for selecting patients that are likely to benefit from dose escalation could optimize cancer control while minimally impacting quality of life. PSA velocity during the year before diagnosis is independently associated with PCSM after both surgery and external beam radiation therapy, even in patients with low-risk disease.…”

Section: Discussionmentioning

confidence: 99%

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Prostate‐specific antigen recurrence and mortality after conventional dose radiation therapy in select men with low‐risk prostate cancer

Petit

Chen

Loffredo

et al. 2006

Cancer

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Underlying the importance of research on the biology of aging is the fact that many nations face the demographic reality of a rapidly aging populace and the looming healthcare challenges that it brings. This reality is a result of aging itself being the most significant risk factor for a range of the most prevalent diseases, including many cancers, cardiovascular disease, and diabetes. Accordingly, interventions are sorely needed that would be able to delay or prevent diseases and disorders associated with the aging process and thereby increase the period of time that aging individuals are in good health (the health‐span). Caloric restriction (CR) has emerged as a model of major interest as it is widely agreed that CR is the most potent environmental intervention that delays the onset of aging and extends life span in diverse experimental organisms. A better understanding of the mechanisms by which CR delays aging will reveal new insights into the aging process and the underlying causes of disease vulnerability with age. These novel insights will allow the development of novel treatments and preventive measures for age‐associated diseases and disorders. Am. J. Hum. Biol. 2012. © 2012 Wiley Periodicals, Inc.

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“…[1][2][3][4][5][6][7][8] The optimal dose with regard to local tumor control and normal tissue tolerance in the treatment of adenocarcinoma of the prostate, however, remains unclear. Statistically significant improvements with dose escalation in terms of freedom from biochemical failure (bNED) have already been shown by two randomized studies using photons 2 or combined photons and proton boost. 5 Whether these improvements will eventually translate into increased overall survival is still a matter of scientific speculation.…”

Section: Introductionmentioning

confidence: 99%

Particle therapy in prostate cancer: a review

Greco

2007

Prostate Cancer Prostatic Dis

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While dose escalation is proving important to achieve satisfactory long-term outcomes in prostate cancer, the optimal radiation modality to deliver the treatment is still a topic of debate. Charged particle beams can offer improved dose distributions to the target volume as compared to conventional 3D-conformal radiotherapy, with better sparing of surrounding healthy tissues. Exquisite dose distributions, with the fulfillment of dose-volume constraints to normal tissues, however, can also be achieved with photon-based intensity-modulated techniques. This review summarizes the literature on the use of particle therapy in prostate cancer and attempts to put in perspective its relative merits compared to current photon-based radiotherapy.

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Prostate cancer radiation dose response: results of the M.D. Anderson phase III randomized trial

Cited by 144 publications

References 0 publications

192Ir low dose rate brachytherapy for boosting locally advanced prostate cancers after external beam radiotherapy: A phase II trial

192Ir low dose rate brachytherapy for boosting locally advanced prostate cancers after external beam radiotherapy: A phase II trial

Prostate‐specific antigen recurrence and mortality after conventional dose radiation therapy in select men with low‐risk prostate cancer

Particle therapy in prostate cancer: a review

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