radiation therapy for prostate cancer
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Indications
Management
- radiation therapy[2]
- preferred modality for stage T3 (C)
- impotence is less frequent than with surgery
- men with positive surgical margins benefit most[3][4]
- a 6 month course of androgen-deprivation therapy prior to radiation therapy improves mortality by 50% in men with locally-advanced prostate cancer[5] **** <- (MKSAP18[1])
- does not improve survival or distant metastases after radical prostatectomy in patients with T3 disease or positive surgical margins[6]
- external beam radiotherapy for localized painful bone metastasis[1][7]
- not needed in the absence of neurologic deficits or pain[1]
- IV radium-223 for multiple painful bone metastases (see bone metastases)
- bone-targeted alpha-emitting radiation may improve survival in metastatic castrate-resistant prostate cancer[9]
- beta-emitting radiation not as helpful
- radiation therapy for prostate cancer results in small increase in risk for bladder cancer & colorectal cancer[8]
More general terms
References
- ↑ 1.0 1.1 1.2 1.3 Medical Knowledge Self Assessment Program (MKSAP) 11, 14, 15 16, 17, 18. American College of Physicians, Philadelphia 1998, 2006, 2009, 2012, 2015, 2018.
- ↑ 2.0 2.1 Thompson IM JR et al, Adjuvant radiotherapy for pathologically advanced prostate cancer. A randomized clinical trial. JAMA 2006, 296:2329 PMID: https://www.ncbi.nlm.nih.gov/pubmed/17105795
- ↑ 3.0 3.1 Van der Kwast TH et al, Identification of patients with prostate cancer who benefit from immediate postoperative radiotherapy: EORTC 22911 J Clin Oncol 2007, 25:4178
- ↑ 4.0 4.1 Wiegel T et al Phase III postoperative adjuvant radiotherapy after radical prostatectomy compared with radical prostatectomy alone in pT3 prostate cancer with postoperative undetectable prostate-specific antigen: ARO 96-02/AUO AP 09/95. J Clin Oncol 2009 Jun 20; 27:2924. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19433689
- ↑ 5.0 5.1 Denham JW Short-term neoadjuvant androgen deprivation and radiotherapy for locally advanced prostate cancer: 10-year data from the TROG 96.01 randomised trial The Lancet Oncology, 25 March 2011 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/21440505 <Internet> http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(11)70063-8/fulltext
Parker C Androgen deprivation before prostate radiotherapy: how long is long enough? The Lancet Oncology, 25 March 2011 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/21440506 <Internet> http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(11)70072-9/fulltext - ↑ 6.0 6.1 Bolla M et al. Postoperative radiotherapy after radical prostatectomy for high-risk prostate cancer: Long-term results of a randomised controlled trial (EORTC trial 22911). Lancet 2012 Oct 19; PMID: https://www.ncbi.nlm.nih.gov/pubmed/23084481
- ↑ 7.0 7.1 Basch E et al Systemic Therapy in Men With Metastatic Castration-Resistant Prostate Cancer: American Society of Clinical Oncology and Cancer Care Ontario Clinical Practice Guideline. J Clin Oncol. Sept 8, 2014 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/25199761 <Internet> http://jco.ascopubs.org/content/early/2014/09/03/JCO.2013.54.8404.full.pdf+html
- ↑ 8.0 8.1 Wallis CJ et al Second malignancies after radiotherapy for prostate cancer: systematic review and meta-analysis. BMJ 2016;352:i851 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26936410 <Internet> http://www.bmj.com/content/352/bmj.i851 Eyler CE, Zietman AL A (relatively) risky business: the link between prostatic radiotherapy and second malignancies. BMJ 2016;352:i1073 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/26935234 <Internet> http://www.bmj.com/content/352/bmj.i1073
- ↑ 9.0 9.1 Terrisse S, Karamouza E, Parker CC et al Overall Survival in Men With Bone Metastases From Castration-Resistant Prostate Cancer Treated With Bone-Targeting Radioisotopes. A Meta-analysis of Individual Patient Data From Randomized Clinical Trials. JAMA Oncol. Published online December 12, 2019. PMID: https://www.ncbi.nlm.nih.gov/pubmed/31830233 https://jamanetwork.com/journals/jamaoncology/fullarticle/2757384