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Thread: (H) Radiation Treatment

  1. #1

    (H) Radiation Treatment

    Table of Contents
    A title in all caps does not reflect any emphasis; it is simply how it appeared on the page I copied from.
    Studies in red are new additions.

    [#1] Early toxicity and health-related quality of life results of high-dose-rate brachytherapy as monotherapy for low and intermediate-risk prostate cancer [2018]

    [#2] Effect of Standard vs Dose-Escalated Radiation Therapy for Patients With Intermediate-Risk Prostate Cancer: The NRG Oncology RTOG 0126 Randomized Clinical Trial [2018]

    [#3] Long-term outcomes following proton therapy for prostate cancer in young men with a focus on sexual health [2018]

    [#4] Online advertising and marketing claims by providers of proton beam therapy: are they guideline-based? [2018]

    [#5] Comparative Toxicities and Cost of Intensity-Modulated Radiotherapy, Proton Radiation, and Stereotactic Body Radiotherapy Among Younger Men With Prostate Cancer [2018]

    [#6] Too Big to Fail? The Current Status of Proton Therapy in the USA [2018]

    [#7] Stereotactic radiotherapy for prostate cancer: A review and future directions [2017]

    Stereotactic Body Radiotherapy for Low-Risk Prostate Cancer: A Ten-Year Analysis [2017]

    [#8] Recently published articles from the journal Brachytherapy [Current]

    [#9] Brachytherapy monotherapy may be sufficient for a subset of patients with unfavorable intermediate risk prostate cancer

    [#10] Two decades of high dose rate brachytherapy with external beam radiotherapy for prostate cancer [2018]

    [#11] Towards a Clinical Decision Support System for External Beam Radiation Oncology Prostate Cancer Patients: Proton vs. Photon Radiotherapy? A Radiobiological Study of Robustness and Stability [2018]

    [#12] Factors associated with the omission of androgen deprivation therapy in radiation-managed high-risk prostate cancer [2016]


    [#14] The Impact of Exercise during Radiation Therapy for Prostate Cancer on Fatigue and Quality of Life: A Systematic Review and Meta-analysis [2018]

    [#15] Proton Beam Therapy Alone for Intermediate- or High-Risk Prostate Cancer: An Institutional Prospective Cohort Study [2018]


    [#17] Prostate high dose-rate brachytherapy as monotherapy for low and intermediate risk prostate cancer: Early toxicity and quality-of life results from a randomized phase II clinical trial of one fraction of 19 Gy or two fractions of 13.5 Gy [2017]

    [#18] Comprehensive Geriatric Assessment and quality of life after localized prostate cancer radiotherapy in elderly patients [2018]

    [#19] Patient-reported anxiety with localized prostate cancer treated with stereotactic body radiation therapy (SBRT) [2018]

    [#20] Long-term outcomes in patients younger than 60 years of age treated with brachytherapy for prostate cancer [2018]

    [#21] High dose-rate brachytherapy in the treatment of prostate cancer [2018]

    [#22] A Pooled Analysis of Biochemical Failure in Intermediate-risk Prostate Cancer Following Definitive Stereotactic Body Radiotherapy (SBRT) or High-Dose-Rate Brachytherapy (HDR-B) Monotherapy [2018]

    [#23] The Efficacy and Safety of Conventional and Hypofractionated High-Dose Radiation Therapy for Prostate Cancer in an Elderly Population: A Subgroup Analysis of the CHHiP Trial [2018]

    [#24] A single institution analysis of low-dose-rate brachytherapy: 5-year reported survival and late toxicity outcomes [2018]

    [#25] Low-dose-rate brachytherapy for prostate cancer: outcomes at >10 years of follow-up [2018]

    Low-Dose-Rate Brachytherapy as Monotherapy for High-Risk Prostate Cancer: 15-Year Outcomes Data [2018]

    [#26] Patient-Reported Sexual Aid Utilization and Efficacy After Radiation Therapy for Localized Prostate Cancer [2018]

    [#27] Image-guided Stereotactic Body Radiotherapy in Metastatic Prostate Cancer [2018]

    [#28] Finding Value for Protons: The Case of Prostate Cancer? [2018]

    [#29] Factors influencing long‐term urinary symptoms following prostate brachytherapy [2018]

    [#30] Genitourinary and gastrointestinal toxicity among patients with localized prostate cancer treated with conventional versus moderately hypofractionated radiation therapy: systematic review and meta-analysis [2018]

    [#31] Stereotactic body radiotherapy for low and intermediate risk prostate cancer: Four-year outcomes [2018]

    [#32] Early Results of Extreme Hypofractionation Using Stereotactic Body Radiation Therapy for High-risk, Very High-risk and Node-positive Prostate Cancer [2018]

    [#33] Outcomes and toxicity from a prospective study of moderately hypofractionated radiation therapy for prostate cancer [2018]

    [#34] Rectal radiation dose-reduction techniques in prostate cancer: a focus on the rectal spacer [2018]

    [#35] High risk prostate cancer and external beam radiation therapy - 8 years outcome [2018]

    [#36] Single Fraction High Dose Rate Brachytherapy as Monotherapy for Low and Intermediate Risk Prostate Cancer: Early Results of a Single Institutional Experience [2018]


    [#38] High dose-rate brachytherapy in the treatment of prostate cancer [2018]

    [#39] Focal Salvage High Dose-Rate Brachytherapy for Locally Recurrent Prostate Cancer after Primary Radiotherapy Failure: Results from a Prospective Clinical Trial [2018]

    [#40] Long-Term Patient-Reported Outcomes From a Phase 3 Randomized Prospective Trial of Conventional Versus Hypofractionated Radiation Therapy for Localized Prostate Cancer

    [#41] Optimal scheduling of hypofractionated radiotherapy for localized prostate cancer: A systematic review and metanalysis of randomized clinical trials [2018]

    [#42] Stereotactic Body Radiation Therapy for Prostate Cancer: An Institutional Experience Using MRI-guided Treatment Planning [2018]

    [#43] Comparison of Image-Guided Intensity-Modulated Radiotherapy and Low-dose Rate Brachytherapy with or without External Beam Radiotherapy in Patients with Localized Prostate Cancer [2018]

    [#44] Comparison of Late Urinary Symptoms Following SBRT and SBRT with IMRT Supplementation for Prostate Cancer [2018]

    [#45] Hypofractionated external beam radiation therapy in combination with HDR boost for localized prostate cancer: patient reported quality of life outcomes [2018]

    [#46] Urinary toxicity in men treated with stereotactic body radiation therapy (SBRT) for localized prostate cancer following procedures for benign prostatic hyperplasia (BPH) [2018]

    [#47] Stereotactic Body Radiotherapy for Primary Prostate Cancer [2018]

    [#48] Hypofractionation for prostate cancer: an update [2018]

    [#49] Daily versus weekly prostate cancer image-guided radiotherapy: Phase 3 multicenter randomized trial [2018]

    [#50] Cost effectiveness of prostate cancer radiotherapy [2018]

    [#51] Moderate hypofractionation for prostate cancer [2018]

    [#52] Intensity-modulated radiotherapy for prostate cancer [2018]

    [#53] Radiation therapy for prostate cancer [2018]

    [#54] Cost-effectiveness of prostate boost with high-dose-rate brachytherapy versus intensity-modulated radiation therapy in the treatment of intermediate-high risk prostate cancer [2018]

    [#55] Long-term outcomes of stereotactic body radiotherapy for low- and intermediate-risk prostate adenocarcinoma: A multi-institutional consortium study [2018]

    [#56] Comparison of three moderate fractionated schedules employed in high-dose-rate brachytherapy monotherapy for clinically localized prostate cancer [2018]

    [#57] Multicenter Trial of Stereotactic Body Radiation Therapy for Low- and Intermediate-Risk Prostate Cancer: Survival and Toxicity Endpoints [2018]

    [#58] Five-year effectiveness of low-dose-rate brachytherapy: comparisons with nomogram predictions in patients with non-metastatic prostate cancer presenting significant control of intra- and periprostatic disease [2018]

    [#59] Quality of Life Outcomes After SBRT [2018]

    Conclusions: Perspectives on the Role of SBRT in the Management of Localized Prostate Cancer [2018]

    TOC Continues Below
    Last edited by DjinTonic; 11-28-2018 at 01:13 PM.

  2. #2

    Table of Contents


    [#61] Hypofractionated Radiation Therapy for Localized Prostate Cancer: An ASTRO, ASCO, and AUA Evidence-Based Guideline [2018]

    ASTRO, ASCO, & AUA strongly endorse a shortened course of IMRT for primary therapy [2018]

    [#62] Brachytherapy versus external beam radiotherapy boost for prostate cancer: Systematic review with meta-analysis of randomized trials [2018]

    [#63] Prostate Cancer Radiotherapy: An Evolving Paradigm [2018]

    [#64] Brachytherapy‐based radiotherapy with androgen deprivation for management of high‐risk prostate cancer – time to reverse the declining trend? [2018]

    [#65] Toxicity and risk factors after combined high-dose-rate brachytherapy and external beam radiation therapy in men ≥75 years with localized prostate cancer [2018]

    [#66] ‘Just as I expected’: A longitudinal cohort study of the impact of response expectancies on side effect experiences during radiotherapy for prostate cancer [2018]

    [#67] Hypofractionation in prostate cancer radiotherapy [2018]

    [#68] Hypofractionated Radiation Therapy for Localized Prostate Cancer: An ASTRO, ASCO, and AUA Evidence-Based Guideline Summary [2018]

    [#69] Radiation Protection Responsibility in Brachytherapy [2019]

    [#70] Impact of staging 68Ga-PSMA-11 PET scans on radiation treatment plans in patients with prostate cancer [2018]

    [#71] National practice patterns for lymph node irradiation in 197,000 men receiving external beam radiotherapy for localized prostate cancer [2019]

    [#72] Long-term results of a phase II study of hypofractionated proton therapy for prostate cancer: moderate versus extreme hypofractionation [2019]

    [#73] A comparative analysis of overall survival between high-dose-rate and low-dose-rate brachytherapy boosts for unfavorable-risk prostate cancer [2019]

    [#74] Time to PSA Nadir and the Risk of Death from Prostate Cancer following Radiation and Androgen Deprivation Therapy [2019]

    [#75] The Financial Impact of Hypofractionated Radiation for Localized Prostate Cancer in the United States [2019]

    [#76] The role of radiotherapy in localised and locally advanced prostate cancer [2019]

    [#77] Are we ready to use hypofractionated instead of conventional radiotherapy for prostate cancer? Not yet [2019]

    [#78] Improved survival for patients with prostate cancer receiving high-dose-rate brachytherapy boost to EBRT compared with EBRT alone [2019]

    [#79] Effect of Chemotherapy With Docetaxel With Androgen Suppression and Radiotherapy for Localized High-Risk Prostate Cancer: The Randomized Phase III NRG Oncology RTOG 0521 Trial [2019]

    [#80] Comparison of the morbidity in men with intermediate and high-risk prostate cancer treated with either I-125 or Pd-103 brachytherapy combined with external beam irradiation [2019]

    [#81] Single-fraction brachytherapy as monotherapy for early-stage prostate cancer: The UCSF experience [2019]

    [#82] Safety of SBRT in post TURP prostate cancer patients: A propensity score matched pair analysis [2019]

    [#83] Prostate-only Versus Whole-pelvis Radiation with or Without a Brachytherapy Boost for Gleason Grade Group 5 Prostate Cancer: A Retrospective Analysis [2019]

    [#84] Patient-Reported Sexual Survivorship Following High-Dose Image-Guided Proton Therapy for Prostate Cancer [2019]

    [#85] Long-term biochemical progression-free survival following brachytherapy for prostate cancer: Further insight into the role of short-term androgen deprivation and intermediate risk group subclassification [2019]

    [#86] Impact of Cribriform Pattern and Intraductal Carcinoma on Gleason 7 Prostate Cancer Treated with External Beam Radiotherapy [2019]

    [#87] Salvage radical prostatectomy for recurrent prostate cancer: morbidity and functional outcomes from a large multicenter series of open versus robotic approaches [2019]

    [#88] Current status of intensity‐modulated radiation therapy for prostate cancer: History, clinical results and future directions [2019]

    [#89] Are we ready for a paradigm shift from high-dose conventional to moderate hypofractionated radiotherapy in intermediate-high risk prostate cancer? A systematic review of randomized controlled trials with trial sequential analysis [2019]

    [#90] Testosterone Levels and Sexual Quality of Life Following Stereotactic Body Radiotherapy for Prostate Cancer: A Multi-Institutional Analysis of Prospective Trials [2019]

    [#91] Quality of life after external beam radiotherapy for localized prostate cancer: Comparison with other modalities [2019]

    [#92] Prostate-specific Antigen Bounce After Stereotactic Body Radiotherapy for Prostate Cancer: A Pooled Analysis of Four Prospective Trials [2019]

    [#93] Treatment outcomes of prostate cancer patients with Gleason score 8-10 treated with definitive radiotherapy : TROD 09-001 multi-institutional study [2019]

    [#94] Treatment-Related Toxicity Using Prostate-Only Versus Prostate and Pelvic Lymph Node Intensity-Modulated Radiation Therapy: A National Population-Based Study [2019]

    [#95] Basic radiobiology: fractionation, 5 Rs, α/β ratio, QUANTEC

    [#96] Analysis of Radiation Dose to Structures Involved in Penile Erections in Men Undergoing MRI-Based Prostate High Dose Rate Brachytherapy [2019]

    [#97] Survival Outcomes and Toxicity of Brachytherapy (BT) versus External Beam (EBRT) Boost in the Treatment of Localized Prostate Cancer: A Systematic Review and Meta-Analysis [2019]

    [#98] Efficacy Results of a Randomized Trial of Prostate HDR Monotherapy in Either One or Two Fractions for Low and Intermediate Risk Disease [2019]

    [#99] Ultra-hypofractionated versus conventionally fractionated radiotherapy for prostate cancer: 5-year outcomes of the HYPO-RT-PC randomised, non-inferiority, phase 3 trial [2019]

    [#100] Hypofractionated Intensity-modulated Radiotherapy for Intermediate- and High-risk Prostate Cancer: A Retrospective Study [2019]

    [#101] Stereotactic body radiation therapy with optional focal lesion ablative microboost in prostate cancer: Topical review and multicenter consensus [2019]

    [#102] Particle therapy for prostate cancer: The past, present and future

    [#103] Sexual Function in Patients Treated With Stereotactic Radiotherapy For Prostate Cancer: A Systematic Review of the Current Evidence [2019]

    [#104] High-dose-rate prostate brachytherapy appears safe in patients with high baseline International Prostate Symptom Scores [2019]

    [#105] Clinical outcomes of external beam radiotherapy in patients with localized prostate cancer: Does dose escalation matter? [2019]

    [#106] New approaches for effective and safe pelvic radiotherapy in high-risk prostate cancer [2019]

    [#107] Comparison of outcomes and toxicity between extreme and moderate radiotherapy hypofractionation in localized prostate cancer: a propensity score analysis [2019]

    [#108] Thirty-day hospital revisits after prostate brachytherapy: who is at risk? [2019]

    [#109] High Dose Rate Brachytherapy versus Low Dose Rate Brachytherapy for the Treatment of Prostate Cancer: A Review of Clinical Effectiveness and Cost-Effectiveness [2019]

    [#110] Patient-reported health-related quality of life up to three years after the treatment with permanent brachytherapy: Outcome of the large-scale, prospective longitudinal study in Japanese-Prostate Cancer Outcome Study by Permanent I-125 Seed Implantation (J-POPS) [2019]

    [#111] National practice patterns for lymph node irradiation in 197,000 men receiving external beam radiotherapy for localized prostate cancer [2019]

    [#112] Radiotherapy In The Definitive Management Of Oligometastatic Prostate Cancer: The Johns Hopkins Experience [2019]

    [#113] Analysis of Spatial Dose-Volume Relationships and Decline in Sexual Function Following Permanent Brachytherapy for Prostate Cancer [2019]

    [#114] Stereotactic Ablative Radiotherapy for Prostate Cancer-The Treatment Results of 500 Patients and Analysis of Failures [2019]

    [#115] Major Complications and Adverse Events Related to the Injection of the SpaceOAR® Hydrogel System Before Radiotherapy for Prostate Cancer [2019]

    Late toxicities of prostate cancer radiotherapy with and without hydrogel SpaceAOR insertion [2019]

    [#116] Hypofractionation for clinically localized prostate cancer [2019]

    [#117] Results of 15 Gy HDR-BT boost plus EBRT in intermediate-risk prostate cancer: Analysis of over 500 patients [2019]

    [#118] Treatment patterns of high-dose-rate and low-dose-rate brachytherapy as monotherapy for prostate cancer [2019]

    [#119] Comparative toxicity outcomes of proton-beam therapy versus intensity-modulated radiotherapy for prostate cancer in the postoperative setting [2019]

    [#120] Comparison of 5-Year Outcomes of Stereotactic Body Radiotherapy for African American and white Men Treated for Low Risk Prostate Cancer [2019]

    [#121] External beam radiotherapy (EBRT) and high-dose rate (HDR) brachytherapy for intermediate and high-risk prostate cancer: the impact of EBRT volume [2019]

    [#122] Stereotactic body radiation therapy for prostate cancer: systematic review and meta-analysis of prospective trials [2019]

    [#123] Comparison of outcome endpoints in intermediate- and high-risk prostate cancer after combined-modality radiotherapy [2019]

    [#124] A comparison of outcomes for patients with intermediate and high risk prostate cancer treated with low dose rate and high dose rate brachytherapy in combination with external beam radiotherapy [2019]

    [#125] Hypofractionation in Prostate Cancer Using Proton Beam [2019]

    [#126] Radiation Therapy for Prostate Cancer [2019]

    [#127] Stereotactic beam radiotherapy for prostate cancer: is less, more? [2019]

    [#128] Quantitative MRI changes during weekly ultra-hypofractionated prostate cancer radiotherapy with integrated boost [2019]

    TOC Continues Below
    Last edited by DjinTonic; 11-12-2019 at 03:12 PM.

  3. #3

    Table of Contents

    [#129] Seven or less Fractions is Not the Standard of Care for Intermediate-Risk Prostate Cancer [2019]

    Hypofractionated radiotherapy versus conventional radiotherapy in patients with intermediate- to high-risk localized prostate cancer: a meta-analysis of randomized controlled trials [2019]

    [#130] HDR Prostate Brachytherapy [2020]

    Since December

    [#131] High Dose Rate Brachytherapy in High-Risk Localised Disease – Why Do Anything Else? [2019]

    [#132] Current use of stereotactic body radiation therapy for low and intermediate risk prostate cancer: A National Cancer Database Analysis [2019]

    Last edited by DjinTonic; 12-03-2019 at 04:03 PM.

  4. #4
    [Table of Contents p.4]

  5. #5
    [Table of Contents p.5]

  6. #6
    Early toxicity and health-related quality of life results of high-dose-rate brachytherapy as monotherapy for low and intermediate-risk prostate cancer [Canadian study, 2018]



    To determine the acute toxicity and effect on health-related quality of life of a two-fraction regimen of high-dose-rate (HDR) prostate brachytherapy.

    Patients with low- or intermediate-risk prostate cancer were treated with HDR brachytherapy as monotherapy in two implants of 13.5 Gy spaced 7-14 days apart. Patients completed International Prostate Symptom Score (IPSS) and Expanded Prostate Index Composite (EPIC) questionnaires at 1, 3, 6, 9, 12, 16, 20, and 24 months after brachytherapy. Proportion of patients in each IPSS category (mild = 0-7, moderate = 8-18, severe = 19+) was evaluated at each of the intervals above. Paired t tests with baseline values were done for IPSS and EPIC scores.

    Thirty patients were accrued to the study. Median prostate-specific antigen was 8,7 (range 4.1-17.5). T stages were T1c = 65%, T2a = 21%, and T2b = 14%. Twenty-seven percent of patients had a Gleason score of 6 and 73% had a Gleason score of 7. IPSS categories at baseline, 1, 3, 6, 12, and 24 months were mild (81%, 43%, 58%, 62%, 76%, 64%), moderate (19%, 32%, 29%, 30%, 20%, 29%), and severe (0%, 25%, 13%, 7%, 4%, 6%), respectively. There was a significant decrease in EPIC sexual summary scores at 1, 3, 6, and 12 months of 0 points (p < 0.001), 17 points (p = 0.01), 18 points (p = 0.02), and 17 points (p = 0.01), respectively.

    This is the first report of this cohort of patients treated with two-fraction HDR monotherapy. This regimen shows rates of toxicity and health-related quality of life that appear acceptable as compared to other treatment modalities. These results are also comparable with other reports with similar treatment regimens.
    First Forum post: https://www.cancerforums.net/threads/54437-Early-toxicity-amp-QOL-results-of-HD-brachy-as-monotherapy-for-low-amp-intermediate-risk

  7. #7
    Effect of Standard vs Dose-Escalated Radiation Therapy for Patients With Intermediate-Risk Prostate Cancer: The NRG Oncology RTOG 0126 Randomized Clinical Trial [2018]



    Optimizing radiation therapy techniques for localized prostate cancer can affect patient outcomes. Dose escalation improves biochemical control, but no prior trials were powered to detect overall survival (OS) differences.

    To determine whether radiation dose escalation to 79.2 Gy compared with 70.2 Gy would improve OS and other outcomes in prostate cancer.

    The NRG Oncology/RTOG 0126 randomized clinical trial randomized 1532 patients from 104 North American Radiation Therapy Oncology Group institutions March 2002 through August 2008. Men with stage cT1b to T2b, Gleason score 2 to 6, and prostate-specific antigen (PSA) level of 10 or greater and less than 20 or Gleason score of 7 and PSA less than 15 received 3-dimensional conformal radiation therapy or intensity-modulated radiation therapy to 79.2 Gy in 44 fractions or 70.2 Gy in 39 fractions.

    Time to OS measured from randomization to death due to any cause. American Society for Therapeutic Radiology and Oncology (ASTRO)/Phoenix definitions were used for biochemical failure. Acute (≤90 days of treatment start) and late radiation therapy toxic effects (>90 days) were graded using the National Cancer Institute Common Toxicity Criteria, version 2.0, and the RTOG/European Organisation for the Research and Treatment of Cancer Late Radiation Morbidity Scoring Scheme, respectively.

    With a median follow-up of 8.4 (range, 0.02-13.0) years in 1499 patients (median [range] age, 71 [33-87] years; 70% had PSA <10 ng/mL, 84% Gleason score of 7, 57% T1 disease), there was no difference in OS between the 751 men in the 79.2-Gy arm and the 748 men in the 70.2-Gy arm. The 8-year rates of OS were 76% with 79.2 Gy and 75% with 70.2 Gy (hazard ratio [HR], 1.00; 95% CI, 0.83-1.20; P = .98 ). The 8-year cumulative rates of distant metastases were 4% for the 79.2-Gy arm and 6% for the 70.2-Gy arm (HR, 0.65; 95% CI, 0.42-1.01; P = .05). The ASTRO and Phoenix biochemical failure rates at 5 and 8 years were 31% and 20% with 79.2 Gy and 47% and 35% with 70.2 Gy, respectively (both P < .001; ASTRO: HR, 0.59; 95% CI, 0.50-0.70; Phoenix: HR, 0.54; 95% CI, 0.44-0.65). The high-dose arm had a lower rate of salvage therapy use. The 5-year rates of late grade 2 or greater gastrointestinal and/or genitourinary toxic effects were 21% and 12% with 79.2 Gy and 15% and 7% with 70.2 Gy (P = .006 [HR, 1.39; 95% CI, 1.10-1.77] and P = .003 [HR, 1.59; 95% CI, 1.17-2.16], respectively).

    Despite improvements in biochemical failure and distant metastases, dose escalation did not improve OS. High doses caused more late toxic effects but lower rates of salvage therapy.

  8. #8
    Long-term outcomes following proton therapy for prostate cancer in young men with a focus on sexual health [2018]



    We investigated long-term outcomes for men ≤60 years old treated with proton therapy (PT).

    Of 254 men ≤60 years old were treated with proton therapy alone for prostate cancer. Risk stratification included 56% with low-, 42% with intermediate- and 2% with high-risk disease. Patients received 76-82 Gy at 2 Gy/fraction or 70-72.5 Gy at 2.5 Gy/fraction. Before treatment and every 6-12 months for 5 years, patients were evaluated by a physician, answered health-related quality of life surveys, including the EPIC, IIEF and IPSS, and had PSA evaluated.

    Median follow-up for the cohort was 7.1 years; 7-year biochemical-free survival was 97.8%. Eight men (one high-risk; five intermediate-risk and two low-risk) experienced biochemical progression, including one who died of disease 9 years after treatment. Potency (erections firm enough for sexual intercourse) was 90% at baseline and declined to 72% at the first-year follow-up, but declined to only 67% at 5 years. Only 2% of patients developed urinary incontinence requiring pads. The bowel habits mean score declined from a baseline of 96 to 88 at 1 year, which improved over the following years to 93 at 5 years.

    Young men with prostate cancer continue to have excellent results with respect to 7-year biochemical control and 5-year erectile function, without clinically significant urinary incontinence 5 years after proton therapy. Comparative effectiveness studies of proton therapy with surgery and IMRT are needed.
    First Forum post: https://www.cancerforums.net/threads/54216-Long-term-outcomes-after-proton-therapy-in-young-men-with-a-focus-on-sexual-health

  9. #9
    Online advertising and marketing claims by providers of proton beam therapy: are they guideline-based?
    [2018, Full Text]


    (I don't know if the authors have a dog in the fight.)


    Cancer patients frequently search the Internet for treatment options, and hospital websites are seen as reliable sources of knowledge. Guidelines support the use of proton radiotherapy in specific disease sites or on clinical trials. This study aims to evaluate direct-to-consumer advertising content and claims made by proton therapy centre (PTC) websites worldwide.

    Operational PTC websites in English were identified through the Particle Therapy Co-Operative Group website. Data abstraction of website content was performed independently by two investigators. Eight international guidelines were consulted to determine guideline-based indications for proton radiotherapy. Univariate and multivariate logistic regression models were used to determine the characteristics of PTC websites that indicated proton radiotherapy offered greater disease control or cure rates.

    Forty-eight PTCs with 46 English websites were identified. 60·9% of PTC websites claimed proton therapy provided improved disease control or cure. U.S. websites listed more indications than international websites (15·5 ± 5·4 vs. 10·4 ± 5·8, p = 0·004). The most common disease sites advertised were prostate (87·0%), head and neck (87·0%) and pediatrics (82·6%), all of which were indicated in least one international guideline. Several disease sites advertised were not present in any consensus guidelines, including pancreatobiliary (52·2%), breast (50·0%), and esophageal (43·5%) cancers. Multivariate analysis found increasing number of disease sites and claiming their centre was a local or regional leader in proton radiotherapy was associated with indicating proton radiotherapy offers greater disease control or cure.

    Information from PTC websites often differs from recommendations found in international consensus guidelines. As online marketing information may have significant influence on patient decision-making, alignment of such information with accepted guidelines and consensus opinion should be adopted by PTC providers.
    [Emphasis mine]

  10. #10
    Comparative Toxicities and Cost of Intensity-Modulated Radiotherapy, Proton Radiation, and Stereotactic Body Radiotherapy Among Younger Men With Prostate Cancer [2018]



    To compare the toxicities and cost of proton radiation and stereotactic body radiotherapy (SBRT) with intensity-modulated radiotherapy (IMRT) for prostate cancer among men younger than 65 years of age with private insurance.

    Using the MarketScan Commercial Claims and Encounters database, we identified men who received radiation for prostate cancer between 2008 and 2015. Patients undergoing proton therapy and SBRT were propensity score–matched to IMRT patients on the basis of clinical and sociodemographic factors. Proportional hazards models compared the cumulative incidence of urinary, bowel, and erectile dysfunction toxicities by treatment. Cost from a payer’s perspective was calculated from claims and adjusted to 2015 dollars.

    A total of 693 proton therapy patients were matched to 3,465 IMRT patients. Proton therapy patients had a lower risk of composite urinary toxicity (33% v 42% at 2 years; P < .001) and erectile dysfunction (21% v 28% at 2 years; P < .001), but a higher risk of bowel toxicity (20% v 15% at 2 years; P = .02). Mean radiation cost was $115,501 for proton therapy patients and $59,012 for IMRT patients (P < .001). A total of 310 SBRT patients were matched to 3,100 IMRT patients. There were no significant differences in composite urinary, bowel, or erectile dysfunction toxicities between SBRT and IMRT patients (P > .05), although a higher risk of urinary fistula was noted with SBRT (1% v 0.1% at 2 years; P = .009). Mean radiation cost for SBRT was $49,504 and $57,244 for IMRT (P < .001).

    Among younger men with prostate cancer, proton radiation was associated with significant reductions in urinary toxicity but increased bowel toxicity at nearly twice the cost of IMRT. SBRT and IMRT were associated with similar toxicity profiles; SBRT was modestly less expensive than IMRT.
    [Emphasis mine]


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