Prostatic Artery Embolization Obviates the Need for Androgen Deprivation Therapy prior to Stereotactic Body Radiation Therapy in Prostate Cancer

2019 ◽  
Vol 30 (10) ◽  
pp. 1635-1637
Author(s):  
Diane Szaflarski ◽  
Miltiadis Tembelis ◽  
Aaron Katz ◽  
Jonathan Haas ◽  
Jason C. Hoffmann
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Androgen Deprivation Therapy ◽  
Stereotactic Body Radiation Therapy ◽  
Androgen Deprivation ◽  
Artery Embolization ◽  
Prostatic Artery Embolization ◽  
Stereotactic Body Radiation ◽  
Prostatic Artery

scholarly journals Rationale for Involved Field Stereotactic Body Radiation Therapy-Enhanced Intermittent Androgen Deprivation Therapy in Hormone-Sensitive Nodal Oligo-Recurrent Prostate Cancer Following Prostate Stereotactic Body Radiation Therapy

2021 ◽  
Vol 10 ◽  
Author(s):  
Michael Carrasquilla ◽  
Michael L. Creswell ◽  
Abigail N. Pepin ◽  
Edina Wang ◽  
Matthew Forsthoefel ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Lymph Node ◽  
Androgen Deprivation Therapy ◽  
Systemic Therapy ◽  
Stereotactic Body Radiation Therapy ◽  
Recurrent Prostate Cancer ◽  
Stereotactic Body Radiation ◽  
Hormone Sensitive ◽  
Involved Field

Lymph node recurrent prostate cancer is a common clinical scenario that is likely to increase significantly with the widespread adoption of novel positron emission tomography (PET) agents. Despite increasing evidence that localized therapy is disease modifying, most men with lymph node recurrent prostate cancer receive only systemic therapy with androgen deprivation therapy (ADT). For men who receive localized therapy the intent is often to delay receipt of systemic therapy. Little evidence exists on the optimal combination of local and systemic therapy in this patient population. In this hypothesis generating review, we will outline the rationale and propose a framework for combining involved field SBRT with risk adapted intermittent ADT for hormone sensitive nodal recurrent prostate cancer. In patients with a limited number of nodal metastases, involved field stereotactic body radiation therapy (SBRT) may have a role in eliminating castrate-resistant clones and possibly prolonging the response to intermittent ADT. We hypothesize that in a small percentage of patients, such a treatment approach may lead to long term remission or cure.

scholarly journals Radiation therapy dose and androgen deprivation therapy in localized prostate cancer: a meta-regression of 5-year outcomes in phase III randomized controlled trials

2021 ◽  
Author(s):  
Tommy Jiang ◽  
Daniela Markovic ◽  
Jay Patel ◽  
Jesus E. Juarez ◽  
Ting Martin Ma ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Androgen Deprivation Therapy ◽  
Dose Escalation ◽  
Low Dose ◽  
Androgen Deprivation ◽  
Phase Iii ◽  
Localized Prostate Cancer ◽  
Treatment Intensification ◽  
Meta Regression

Abstract Background While multiple randomized trials have evaluated the benefit of radiation therapy (RT) dose escalation and the use and prolongation of androgen deprivation therapy (ADT) in the treatment of prostate cancer, few studies have evaluated the relative benefit of either form of treatment intensification with each other. Many trials have included treatment strategies that incorporate either high or low dose RT, or short-term or long-term ADT (STADT or LTADT), in one or more trial arms. We sought to compare different forms of treatment intensification of RT in the context of localized prostate cancer. Methods Using preferred reporting items for systemic reviews and meta-analyses (PRISMA) guidelines, we collected over 40 phases III clinical trials comparing different forms of RT for localized prostate cancer. We performed a meta-regression of 40 individual trials with 21,429 total patients to allow a comparison of the rates and cumulative proportions of 5-year overall survival (OS), prostate cancer-specific mortality (PCSM), and distant metastasis (DM) for each treatment arm of every trial. Results Dose-escalation either in the absence or presence of STADT failed to significantly improve any 5-year outcome. In contrast, adding LTADT to low dose RT significantly improved 5-year PCSM (Odds ratio [OR] 0.34, 95% confidence interval [CI] 0.22–0.54, p < 0.001) and DM (OR 0.35, 95% CI 0.20–0.63. p < 0.001) over low dose RT alone. Adding STADT also significantly improved 5-year PCSM over low dose RT alone (OR 0.55, 95% CI 0.41–0.75, p < 0.001). Conclusion While limited by between-study heterogeneity and a lack of individual patient data, this meta-analysis suggests that adding ADT, versus increasing RT dose alone, offers a more consistent improvement in clinical endpoints.

scholarly journals Predictors of multidomain decline in health-related quality of life after stereotactic body radiation therapy (SBRT) for prostate cancer

Cancer ◽  
2016 ◽  
Vol 123 (9) ◽  
pp. 1635-1642 ◽  
Author(s):  
Robert T. Dess ◽  
William C. Jackson ◽  
Simeng Suy ◽  
Payal D. Soni ◽  
Jae Y. Lee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Radiation Therapy ◽  
Stereotactic Body Radiation Therapy ◽  
Health Related Quality ◽  
Stereotactic Body Radiation ◽  
Related Quality ◽  
Health Related
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