Trends in targeted prostate brachytherapy: from multiparametric MRI to nanomolecular radiosensitizers

Abstract

The treatment of localized prostate cancer is expected to become a significant problem in the next decade as an increasingly aging population becomes prone to developing the disease. Recent research into the biological nature of prostate cancer has shown that large localized doses of radiation to the cancer offer excellent long-term disease control. Brachytherapy, a form of localized radiation therapy, has been shown to be one of the most effective methods for delivering high radiation doses to the cancer; however, recent evidence suggests that increasing the localized radiation dose without bound may cause unacceptable increases in long-term side effects. This review focuses on methods that have been proposed, or are already in clinical use, to safely escalate the dose of radiation within the prostate. The advent of multiparametric magnetic resonance imaging (mpMRI) to better identify and localize intraprostatic tumors, and nanomolecular radiosensitizers such as gold nanoparticles (GNPs), may be used synergistically to increase doses to cancerous tissue without the requisite hazard of increased side effects.

Design and synthesis of phenylpiperazine derivatives as potent anticancer agents for prostate cancer

“…The thiourea derivatives (5a and 5b) exhibited robust inhibitory activity against DU 145 and PC-3 but they remained relatively weak against LNCaP. LnCaP is an androgen-responsive cell line, but the canonical androgen pathway does not work for PC-3 and DU145 cells (Marchiani et al, 2010), indicating that thiourea derivatives might target a different proliferation pathway other than the androgen pathway. As compound 5a was more effective against PC cell lines compared with compound 5b, we selected compound 5a for further action of mechanism studies.…”

“…While prostatectomy followed by radiation therapy is the standard therapy in clinics for early diagnosed cases (Sriprasad, Feneley, & Thompson, ), patients with advanced stage disease remain incurable due to resistance to chemotherapy, acquired androgen‐refractory phenotype and inefficient radiation therapies (Jarvis, Nelius, Martinez‐Marin, Sennoune, & Filleur, ; Oudard, ; Seruga, Ocana, & Tannock, ). Treatment at late stage of PC could only be possible by combining surgical removal, radiotherapy and chemotherapy options based on clinical priority to monitor adverse outcomes (Nicolae, Venugopal, & Ravi, ; Teply & Hauke, ). Although heterogenous nature of PC restricts the treatment, chemotherapy is generally considered as a prior treatment regimen with both adjuvant and neo‐adjuvant options (Beer & Raghavan, ).…”

Five‐year outcomes from a prospective comparative effectiveness study evaluating external‐beam radiotherapy with or without low‐dose‐rate brachytherapy boost for localized prostate cancer

“…However, we previously reported that the absolute differences in baseline scores between men enrolled in the CEASAR study who completed the baseline survey before versus after starting treatment were very small (range, 1‐3 points), and the Prostate Cancer Outcome Study validation study demonstrated most men accurately recall prediagnostic function 6 months after prostate cancer diagnosis 36,37 . Finally, this study did not account for the use of biodegradable rectal spacers, preoperative magnetic resonance imaging, or other technical advancements for LDR boost 38,39 . As such, the addition of biodegradable rectal spacers may lead to decreases in bowel toxicity, and preoperative magnetic resonance image planning allows better urethral delineation, which may translate to improved urinary toxicity.…”

“…36,37 Finally, this study did not account for the use of biodegradable rectal spacers, preoperative magnetic resonance imaging, or other technical advancements for LDR boost. 38,39 As such, the addition of biodegradable rectal spacers may lead to decreases in bowel toxicity, and preoperative magnetic resonance image planning allows better urethral delineation, which may translate to improved urinary toxicity.…”

Analysis of outcomes after non-contour-based dose painting of dominant intra-epithelial lesion in intra-operative low-dose rate brachytherapy

“…The accuracy ☆ Research Institution: Department of Oncology, University of Calgary, Tom Baker Cancer Centre, 1331-29 ST NW, Calgary, Alberta, Canada T2N 4N2. of registration of different MRI sequences with the live trans-rectal ultrasound (TRUS) images also remains doubtful despite use of deformable registration [26]. Other imaging modalities have been used instead of MP-MRI for dose compensation at the time of LDR brachytherapy.…”