scholarly journals Practical Guidelines on Implementing Hypofractionated Radiotherapy for Prostate Cancer in Africa

2021 ◽  
Vol 11 ◽  
Author(s):  
William Swanson ◽  
Richard Ndi Samba ◽  
Michael Lavelle ◽  
Ahmed Elzawawy ◽  
Erno Sajo ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Clinical Trials ◽  
Radiation Therapy ◽  
Intensity Modulated Radiation Therapy ◽  
Cost Savings ◽  
Limited Resource ◽  
Conformal Radiotherapy ◽  
Hypofractionated Radiotherapy ◽  
Middle Income ◽  
Image Guided Radiotherapy

Among a growing body of literature in global oncology, several articles project increased cost savings and radiotherapy access by adopting hypofractionated radiotherapy (HFRT) in low- and middle-income countries (LMICs) like those in Africa. Clinical trials in Europe and the USA have demonstrated HFRT to be non-inferior to conventional radiotherapy for eligible patients with several cancers, including prostate cancer. This could be a highly recommended option to battle a severely large and growing cancer burden in resource-limited regions. However, a level of implementation research may be needed in limited resource-settings like in Africa. In this article, we present a list of evidence-based recommendations to practice HFRT on eligible prostate cancer patients. As literature on HFRT is still developing, these guidelines were compiled from review of several clinical trials and professionally accredited material with minimal resource requirements in mind. HFRT guidelines presented here include patient eligibility, prescription dose schedules, treatment planning and delivery techniques, and quality assurance procedures. The article provides recommendations for both moderately hypofractionated (2.4-3.4Gy per fraction) and ultrahypofractionated (5Gy or more per fraction) radiation therapy when administered by 3D-Conformal Radiotherapy, Intensity Modulated Radiation Therapy, or Image-Guided Radiotherapy. In each case radiation oncology health professionals must make the ultimate judgment to ensure safety as more LMIC centers adopt HFRT to combat the growing scourge of cancer.

Intensity Modulated Radiation Therapy Replaces 3-Dimensional Conformal Radiotherapy as Prostate Cancer Treatment

2012 ◽  
Vol 187 (4) ◽  
pp. 1253-1258 ◽  
Author(s):  
Sean P. Elliott ◽  
Oluwakayode O. Adejoro ◽  
Badrinath R. Konety ◽  
Stephanie L. Jarosek ◽  
Kathryn E. Dusenbery ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Cancer Treatment ◽  
Intensity Modulated Radiation Therapy ◽  
Conformal Radiotherapy ◽  
Prostate Cancer Treatment ◽  
3 Dimensional ◽  
Intensity Modulated

scholarly journals Dosimetric Comparison: Intensity Modulated Radiation Therapy Vs. 3D Conformal Radiotherapy In Prostate Cancer Radical Treatment

2019 ◽  
Vol 0 (0) ◽  
Author(s):  
Slavica Maric ◽  
Snezana Lukic ◽  
Milan Mijailovic ◽  
Ljiljana Tadic Latinovic ◽  
Milan Zigic ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Planning Target Volume ◽  
Intensity Modulated Radiation Therapy ◽  
Absorbed Dose ◽  
Conformal Radiotherapy ◽  
Target Volume ◽  
Intensity Modulated ◽  
Radical Treatment ◽  
3D Conformal Radiotherapy

Abstract 3D - Conformal Radiotherapy (3DCRT) for decades was a standard technique in the prostate cancer radical radiotherapy treatment. Technological advances and implementation of an innovative radiotherapy technique - Intensity Modulated Radiation Therapy (IMRT), enable even more precise treatment of the prostate cancer patients. Intensity Modulated Radiation Therapy (IMRT) is a technological advancement in Conformal Radiotherapy which allows superior conformity and homogeneity of the absorbed dose in planning target volume with maximal sparing organs of risk. This technique gives us possibility to escalate the radiotherapy dose, prerequisite for the adequate local tumor control. Evaluation of dosimetric parameters 3DCRT vs. IMRT: the homogeneity index, the conformity index, parameters of absorbed dose in planning target volume, dose volume constraints for organs of risk shows that IMRT is an optimal technique in the prostate cancer radical treatment.

scholarly journals Review of Hypofractionated Radiotherapy for Prostate Cancer

ISRN Oncology ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
Despina Spyropoulou ◽  
Dimitrios Kardamakis
Keyword(s):  
Prostate Cancer ◽  
Large Fraction ◽  
Prostate Gland ◽  
Intensity Modulated Radiation Therapy ◽  
Conformal Radiotherapy ◽  
Convincing Evidence ◽  
External Beam Radiation ◽  
Hypofractionated Radiotherapy ◽  
Beam Radiation ◽  
Conventional Fractionation

Hypofractionated radiotherapy for prostate cancer has become of increasing interest with the recognition of a potential improvement in therapeutic outcome with treatments delivered in large-sized daily fractions. In addition, hypofractionation offers a reduction in fraction number and produces attractive cost and increased convenience for patients. There is convincing evidence, by several clinical trials, that biochemical control is significantly improved with higher administered radiation doses to the prostate gland. Furthermore, the improved radiation delivery techniques such as 3D conformal radiotherapy (3DCRT) or, better, intensity modulated radiation therapy (IMRT) allow high administered doses to the prostate while sparing the normal surrounding tissues. Several studies of the radiobiology of prostate cancer suggest that it may be more susceptible to large fraction sizes compared with conventional fractionation of external beam radiation.

Incidence, predictors, and cost implications of gastrointestinal complications following intensity-modulated radiation therapy for prostate cancer.

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 31-31
Author(s):  
Monica J. Wood ◽  
Gally Reznor ◽  
Quoc-Dien Trinh ◽  
Paul Linh Nguyen
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Intensity Modulated Radiation Therapy ◽  
Cost Savings ◽  
Gastrointestinal Complications ◽  
Intensity Modulated ◽  
Coagulation Therapy ◽  
Gi Toxicity ◽  
Medicare Spending

31 Background: The objective of this study was to examine the incidence and predictors of gastrointestinal (GI) complications following intensity-modulated radiation therapy (IMRT) for prostate cancer and their impact on national healthcare expenditure. Methods: Using Surveillance, Epidemiology, and End Results (SEER)-Medicare-linked data, we identified 11,781 men diagnosed with non-metastatic prostate cancer from 2002 to 2006 who underwent definitive IMRT, had no pre-existing GI toxicity, and had at least 36 months of follow-up after IMRT initiation. Annual incremental spending was defined as the difference between the total Medicare payments in the year after the development of the first GI complication and the total Medicare payments in the year preceding prostate cancer diagnosis, excluding prostate cancer treatment-related costs. We used multivariate logistic regression to evaluate the odds ratio of developing IMRT-related GI toxicity, and quantile regression to compare the annual incremental costs between groups. All analyses were done using SAS 9.3. Results: Over the 36-month follow-up period, the incidence of post-IMRT GI complications was 26.5% (n=3,118). Patients on anti-coagulation therapy or receiving brachytherapy boost were more likely to develop IMRT-related GI toxicities (OR 1.11, 95% CI 1.01-1.22 (p=0.029) and OR 1.18, 95% CI 1.08-1.30 (p<0.001), respectively). The median Medicare annual incremental cost per patient associated with post-IMRT GI complications was $3,375 in 2014 dollars (95% CI $3,222-3,529, p<0.0001). Among patients with post-IMRT GI complications, the presence of diabetes was associated with an additional $610 (95% CI $206-1,014, p=0.003) per patient in Medicare spending. Conclusions: Medicare spending associated with post-IMRT GI complications is considerable, often in excess of 10% of IMRT cost. Quantifying these expenditures may better frame the potential for cost savings of emerging technologies that aim to reduce the incidence and severity of IMRT-related GI toxicities.

scholarly journals Intensity modulated radiation therapy vs 3D conformal radiotherapy in the radical treatment prostate cancer: Analysis of acute and late toxicity

2018 ◽  
Vol 34 (3) ◽  
pp. 1626-1633
Author(s):  
Slavica Marić ◽  
Ljiljana Tadić-Latinović ◽  
Branislava Jakovljević ◽  
Milan Žigić ◽  
Pavle Banović ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Intensity Modulated Radiation Therapy ◽  
Late Toxicity ◽  
Conformal Radiotherapy ◽  
Intensity Modulated ◽  
Radical Treatment ◽  
3D Conformal Radiotherapy

scholarly journals Cost-Effectiveness Analysis of Stereotactic Body Radiation Therapy Versus Intensity-Modulated Radiation Therapy: An Emerging Initial Radiation Treatment Option for Organ-Confined Prostate Cancer

2012 ◽  
Vol 8 (3S) ◽  
pp. e31s-e37s ◽  
Author(s):  
Joseph C. Hodges ◽  
Yair Lotan ◽  
Thomas P. Boike ◽  
Rhonda Benton ◽  
Alyson Barrier ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radiation Therapy ◽  
Stereotactic Body Radiation Therapy ◽  
Radiation Treatment ◽  
Intensity Modulated Radiation Therapy ◽  
Cost Savings ◽  
Potential Cost ◽  
Stereotactic Body Radiation ◽  
Risk Prostate Cancer

Stereotactic body radiation therapy for low- to intermediate-risk prostate cancer has potential cost savings and may improve access to radiation, increase convenience, and boost quality of life.

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