Radiation therapy approaches to the treatment of high-risk prostate cancer
- First Online:
- 8 Downloads
Radiation therapy modalities have been shown to offer patients a nonoperative option for definitive treatment of localized prostate cancer as well as options for adjuvant or salvage therapy in high-risk prostate cancer patients. In patients with high-risk, localized disease, radiation therapy with or without adjuvant hormonal therapy is considered an excellent treatment option because of its efficacy within the prostate and among local periprostatic structures, addressing micrometastatic disease. Following radical prostatectomy in patients with high-risk or recurrent disease, radiotherapy can increase oncologic efficacy in both the adjuvant and salvage setting. Continued studies are underway to address ongoing concerns of sparing surrounding tissues unnecessary radiation while administering high-dose radiation to the prostate and targeted periprostatic structures. Newer technologies are using real-time imaging and computer-simulated motion calculation to adjust for physiological organ motion with respect to bony landmarks classically used to map areas of radiation administration.
Unable to display preview. Download preview PDF.
References and Recommended Reading
- 1.Scher HI, Leidel SA, Fuks Z, et al.: Cancer of the prostate. In Cancer: Principles and Practice of Oncology edn 7. Edited by Devita VT Jr, Hellman S, Rosenberg SA. Philadelphia: Lippincott Williams & Wilkins; 2005:1192–1295.Google Scholar
- 8.Pasteau O: Traitment du cancer de la prostate par le Radium. Rev Mal Nutr 1911, 363–367.Google Scholar
- 9.Young HH: Technique of radium treatment of cancer of the prostate in seminal vesicles. Surg Gynecol Obstet 1922, 34:93–98.Google Scholar
- 10.Denning CL: Carcinoma of the prostate seminal vesicles treated with radium. Surg Gynecol Obstet 1922, 34:99–118.Google Scholar
- 21.Roach M 3rd, Hanks G, Thames HJ, et al.: Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer: recommendations of the RTOG-ASTRO Phoenix Consensus Conference. Int J Radiat Oncol Biol Phys 2006, 65:965–974.PubMedCrossRefGoogle Scholar
- 35.Lawton CA, Bae K, Pilepich M, et al.: Long-term treatment sequelae after external beam irradiation with or without hormonal manipulation for adenocarcinoma of the prostate: analysis of radiation therapy oncology group studies 85-31, 86-10, and 92-02. Int J Radiat Oncol Biol Phys 2008, 70:437–441.PubMedCrossRefGoogle Scholar
- 36.Shapiro EY, Rais-Bahrami S, Morgenstern C, et al.: Long-term outcomes in younger men following permanent prostate brachytherapy. J Urol 2009 (in press).Google Scholar
- 40.Lawton CA, DeSilvio M, Roach M 3rd, et al.: An update of the phase III trial comparing whole pelvic to prostate only radiotherapy and neoadjuvant to adjuvant total androgen suppression: updated analysis of RTOG 94-13, with emphasis on unexpected hormone/radiation interactions. Int J Radiat Oncol Biol Phys 2007, 69:646–655.PubMedCrossRefGoogle Scholar
- 41.Stone NN, Potters L, Davis BJ, et al.: Multicenter analysis of effect of high biologic effective dose on biochemical failure and survival outcomes in patients with Gleason score 7–10 prostate cancer treated with permanent prostate brachytherapy. Int J Radiat Oncol Biol Phys (in press).Google Scholar
- 44.Trabulsi EJ, Valicenti RK, Hanlon AL, et al.: A multiinstitutional matched-control analysis of adjuvant and salvage postoperative radiation therapy for pT3-4N0 prostate cancer. Urology 2009 (in press).Google Scholar