scholarly journals Safety of image-guided radiotherapy in definitive radiotherapy for localized prostate cancer: a population-based analysis

2021 ◽  
Vol 94 (1121) ◽  
pp. 20200456
Author(s):  
Yao-Hung Kuo ◽  
Ji-An Liang ◽  
Guan-Heng Chen ◽  
Chia-Chin Li ◽  
Chun-Ru Chien
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Cancer Mortality ◽  
Phase Iii ◽  
Localized Prostate Cancer ◽  
Image Guided Radiotherapy ◽  
Definitive Radiotherapy ◽  
Image Guided ◽  
The Impact

Objectives: Image-guided radiotherapy (IGRT) is a recommended advanced radiation technique that is associated with fewer acute and chronic toxicities. However, one Phase III trial showed worse overall survival in the IGRT arm. The purpose of this observational study is to evaluate the impact of IGRT on overall survival. Methods: We used the Taiwan Cancer Registry Database to enroll cT1-4N0M0 prostate cancer patients who received definitive radiotherapy between 2011 and 2015. We used inverse probability treatment weighting (IPW) to construct balanced IGRT and non-IGRT groups. We compared the overall survival of those in the IGRT and non-IGRT groups. Supplementary analyses (SA) were performed with alternative covariates in propensity score (PS) models and PS approaches. The incidence rates of prostate cancer mortality (IPCM), other cancer mortality (IOCM), and cardiovascular mortality (ICVM) were also evaluated. Results: There were 360 patients in the IGRT arm and 476 patients in the non-IGRT arm. The median follow-up time was 50 months. The 5-year overall survival was 88% in the IGRT arm and 86% in the non-IGRT arm (adjusted hazard ratio [HR] of death = 0.93; 95% CI, 0.61–1.45; p = 0.77). The SA also showed no significant differences in the overall survival between those in the IGRT and non-IGRT arms. Both groups did not significantly differ in terms of IPCM, IOCM, and ICVM. Conclusions: The overall survival of localized prostate cancer patients who underwent IGRT was not inferior to those who did not. Advances in knowledge: We demonstrated that the overall survival for prostate cancer patients with IGRT was not worse than those who did not undergo IGRT; this important outcome comparison has not been previously examined in the general population.

scholarly journals A comparison of treatment outcome between fiducial-based and bone-based image guided radiotherapy in prostate cancer patients

2018 ◽  
Vol 13 (1) ◽  
Author(s):  
Aleksandra Napieralska ◽  
Wojciech Majewski ◽  
Roland Kulik ◽  
Grzegorz Głowacki ◽  
Leszek Miszczyk
Keyword(s):  
Prostate Cancer ◽  
Treatment Outcome ◽  
Cancer Patients ◽  
Image Guided Radiotherapy ◽  
Image Guided

scholarly journals The Impact of Metformin Use with Survival Outcomes in Urologic Cancers: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-14
Author(s):  
Xiangyang Yao ◽  
Haoran Liu ◽  
Hua Xu
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Bladder Cancer ◽  
Cancer Patients ◽  
Kidney Cancer ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Effect Model ◽  
Urologic Cancers ◽  
The Impact

Background. Conflicting results exist between the potential protective effects of metformin and the prognosis of urologic cancers. This meta-analysis summarized the effects of metformin exposure on the recurrence, progression, cancer-specific survival (CSS), and overall survival (OS) of the three main urologic cancers (kidney cancer, bladder cancer, and prostate cancer). Methods. We systematically searched PubMed, Embase, Web of Science, Wanfang, and China National Knowledge Infrastructure databases (January 2010 to December 2019), which identified studies regarding metformin users and nonusers with urologic cancers and extracted patient data. A random effect model or fixed effect model was used to analyze hazard ratios (HRs) and 95% confidence intervals (CIs). Results. Among the 1883 confirmed studies, 27 eligible studies were identified, including 123,212 participants. In prostate cancer, patients using metformin have significant benefits for recurrence ( HR = 0.74 ; 95% CI: 0.61-0.90; P = 0.007 ; I 2 = 56 % ), CSS ( HR = 0.74 ; 95% CI: 0.61-0.91; P = 0.002 ; I 2 = 79 % ), and OS ( HR = 0.76 ; 95% CI: 0.65-0.90; P < 0.001 ; I 2 = 86 % ). Moreover, further subgroup analysis showed that the beneficial effects of metformin may be more significant for patients receiving radical radiotherapy. For kidney cancer, metformin was beneficial for progression ( HR = 0.80 ; 95% CI: 0.65-0.98; P = 0.14 ; I 2 = 46 % ). Analysis revealed that the effect of metformin on the overall survival of kidney cancer patients may be related to nationality (American: HR = 0.76 ; 95% CI: 0.59-0.98; P = 0.88 ; I 2 = 0 % ). For bladder cancer, no obvious benefits of metformin use were identified. However, subgroup analysis indicated that metformin may improve the recurrence of bladder cancer, but this improvement was only found in patients with a median follow-up time of more than 4 years ( HR = 0.43 ; 95% CI: 0.28-0.67; P = 0.61 ; I 2 = 0 % ).

Clinical outcomes with high-dose image guided radiotherapy (IGRT) compared with non-IGRT for the treatment of clinically localized prostate cancer.

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 12-12
Author(s):  
Michael J. Zelefsky ◽  
Marisa Kollmeier ◽  
Brett Wayne Cox ◽  
Xin Pei ◽  
Margie Hunt
Keyword(s):  
Prostate Cancer ◽  
External Beam Radiotherapy ◽  
Localized Prostate Cancer ◽  
Tumor Control ◽  
High Dose ◽  
External Beam ◽  
Fiducial Markers ◽  
Image Guided Radiotherapy ◽  
Image Guided ◽  
Risk Patients

12 Background: To compare toxicity profiles and biochemical tumor control outcomes between patients treated with high-dose image-guided radiotherapy (IGRT) and high-dose intensity-modulated radiotherapy (IMRT) for clinically localized prostate cancer. Methods: 186 patients with prostate cancer were treated with IGRT to a dose of 86.4 Gy with daily correction of the target position based upon kilovoltage imaging of implanted prostatic fiducial markers. This group of patients was retrospectively compared with a similar cohort of 190 patients who were treated with IMRT to the same prescription dose without, implanted fiducial markers in place (non-IGRT). In both groups the margins used for the prostate were the same. The median follow-up time was 2.8 years (range, 2-4 years). Results: A significant reduction in late urinary toxicity was observed for IGRT patients compared with the non-IGRT patients. The 3-year likelihood of urinary toxicity for the IGRT and non-IGRT cohorts were 10.4% and 20.0%, respectively (p=0.02).Multivariate analysis identifying predictors for late urinary toxicity demonstrated that, in addition to the baseline IPSS, IGRT was associated with significantly less late urinary toxicity compared with non-IGRT. The incidence of late rectal toxicity was low for both treatment groups (1.0% and 1.6%, respectively; p = 0.81). No differences in prostate-specific antigen relapse–free survival outcomes were observed for low- and intermediate-risk patients when treated with IGRT and non-IGRT. For high-risk patients a significant improvement was observed at 3-years for patients treated with IGRT compared with non-IGRT. Conclusions: IGRT is associated with a reduction in late urinary toxicity and improvement in biochemical tumor control after definitive high-dose external beam radiotherapy compared with high-dose IMRT. These data suggest that, for definitive radiotherapy, the placement of fiducial markers and daily tracking of target positioning should be the preferred mode of external beam radiotherapy delivery for the treatment of prostate cancer.

scholarly journals EP-1605: Outcome and toxicity in a cohort of prostate cancer patients treated with image-guided radiotherapy

2018 ◽  
Vol 127 ◽  
pp. S864
Author(s):  
P. Toncheva ◽  
N. Volegova-Neher ◽  
K. Henne ◽  
A. Grosu ◽  
S. Kirste
Keyword(s):  
Prostate Cancer ◽  
Cancer Patients ◽  
Image Guided Radiotherapy ◽  
Image Guided
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