Recent evolution of prostate cancer treatment reflects technological arms races driven by economic incentives rather than high-quality evidence—as exemplified by proton-beam radiation, recently found markedly inferior to far less-expensive alternatives. Another study found promise for focal treatment, but much research is required before this could become a standard option.
Key Points
Proton-beam therapy for prostate cancer costs two to four times as much as standard alternatives and in a recent study has been shown to yield inferior quality-of-life outcomes. Focal therapy may eventually offer a favourable alternative, but much research is needed on patient selection, workup, follow up, and outcomes assessment.
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References
Sheets, N. C. et al. Intensity-modulated radiation therapy, proton therapy, or conformal radiation therapy and morbidity and disease control in localized prostate cancer. JAMA 307, 1611–1620 (2012).
Hu, J. C. et al. Comparative effectiveness of minimally invasive vs open radical prostatectomy. JAMA 302, 1557–1564 (2009).
Cooperberg, M. R., Odisho, A. Y. & Carroll, P. R. Outcomes for radical prostatectomy: is it the singer, the song, or both? J. Clin. Oncol. 30, 476–478 (2012).
Tewari, A. et al. Positive surgical margin and perioperative complication rates of primary surgical treatments for prostate cancer: a systematic review and meta-analysis comparing retropubic, laparoscopic, and robotic prostatectomy. Eur. Urol. http://dx.doi.org/10.1016/j.eururo.2012.02.029.
Nguyen, P. L. et al. Cost implications of the rapid adoption of newer technologies for treating prostate cancer. J. Clin. Oncol. 29, 1517–1524 (2011).
Konski, A., Speier, W., Hanlon, A., Beck, J. R. & Pollack, A. Is proton beam therapy cost effective in the treatment of adenocarcinoma of the prostate? J. Clin. Oncol. 25, 3603–3608 (2007).
Aaronson, D. S. et al. Proton beam therapy and treatment for localized prostate cancer: if you build it, they will come. Arch. Intern. Med. 172, 280–283 (2012).
Ahmed, H. U. et al. Focal therapy for localised unifocal and multifocal prostate cancer: a prospective development study. Lancet Oncol. http://dx.doi.org/10.1016/S1470-2045(12)70121-3.
Lukka, H. et al. High-intensity focused ultrasound for prostate cancer: a systematic review. Clin. Oncol. (R. Coll. Radiol.) 23, 117–127 (2011).
Cooperberg, M. R., Carroll, P. R. & Klotz, L. Active surveillance for prostate cancer: progress and promise. J. Clin. Oncol. 29, 3669–3676 (2011).
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Cooperberg, M. For localized prostate cancer, does technology equal progress?. Nat Rev Clin Oncol 9, 371–372 (2012). https://doi.org/10.1038/nrclinonc.2012.96
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DOI: https://doi.org/10.1038/nrclinonc.2012.96
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