Search Our Scientific Publications & Authors

Radiat Oncol 2019 Mar 15;14(1):47. Epub 2019 Mar 15.

Dapartment of Radiotherapy and Radio-Oncology, LKH Salzburg University Clinics, Paracelsus Medical University, Müllner Hauptstraße 48, 5020, Salzburg, Austria.

Background: Rectal spacers are used to limit dose to the anterior rectal wall in high dose external beam radiation therapy of the prostate and have been shown to reduce radiation induced toxicity. Here we report the complication rate and toxicity of the implantation procedure in a large cohort of patients who have either received a gel- or balloon-type spacer.

Methods: In total, 403 patients received rectal spacing, 264 with balloon, 139 with gel. Read More

Brachytherapy 2019 Mar 9. Epub 2019 Mar 9.

Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA.

Purpose: Retrospective data suggest less benefit from androgen deprivation therapy (ADT) in the setting of dose-escalated definitive radiation for prostate cancer, especially when a combination of external beam radiotherapy (EBRT) and brachytherapy approaches are used. This study aimed to test the hypothesis that patients with prostate cancer with intermediate- or high-risk disease undergoing extreme dose escalation with a brachytherapy boost are less likely to receive ADT.

Methods And Materials: Data from the National Cancer Database were extracted for men aged 40-90 years diagnosed with node-negative, non-metastatic prostate cancer from 2004 to 2015. Read More

Rep Pract Oncol Radiother 2019 Mar-Apr;24(2):204-207. Epub 2019 Feb 22.

Gifu University, School of Medicine, Department of Radiology, Japan.

Aim And Background: The change in the prostate size for radiotherapy has not yet been elucidated. The coverage of radiation dose is affected by changes in the prostate size. We evaluated the changes in the prostate, rectum, and bladder wall sizes during IMRT of fraction 2 Gy/day using MRI. Read More

Eur Urol 2019 Mar 8. Epub 2019 Mar 8.

Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address:

Background: Evidence supporting the efficacy of stereotactic body radiotherapy (SBRT) for localized prostate cancer is accumulating, but comparative studies of patient-reported quality of life (QOL) following SBRT versus conventionally fractionated external beam radiotherapy (EBRT) or active surveillance (AS) are limited.

Objective: To compare QOL of patients pursuing SBRT and EBRT versus AS.

Design, Setting, And Participants: A population-based cohort of 680 men with newly diagnosed localized prostate cancer was prospectively enrolled from 2011 to 2013. Read More

Int J Radiat Oncol Biol Phys 2019 Mar 7. Epub 2019 Mar 7.

Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh School of Medicine, Pittsburgh, PA.

Purpose: There is limited long-term data on outcome and side effects of Cs-131 prostate brachytherapy, and minimal patient-reported data on rectal bleeding with any isotope. We aimed to describe the incidence, prevalence, and predictors of late patient-reported rectal bleeding following Cs-131 brachytherapy.

Materials And Methods: We reviewed a prospectively collected database of 620 men treated with Cs-131 prostate brachytherapy. Read More

World J Urol 2019 Mar 8. Epub 2019 Mar 8.

Radiation Oncology Princess Alexandra Raymond Terrace (ROPART), 31 Raymond Terrace, South Brisbane, QLD, Australia.

Purpose: Although the clinical significance of a diagnosis of prostate cancer for some men is debated, for many men it leads to significant morbidity and mortality. Radical treatment of clinically localized prostate cancer has been shown to improve survival in men with intermediate or high-risk disease. There is no high level evidence to support the superiority of radical prostatectomy, with or without adjuvant or salvage external beam radiotherapy in comparison to definitive radiotherapy with or without androgen deprivation, and the choice should be individualized. Read More

Hell J Nucl Med 2019 Mar 5. Epub 2019 Mar 5.

Department of Nuclear Medicine and PET/CT, Evangelismos General Hospital, Ypsilantou 45-47, PC 106 76, Athens, Greece.

Prostate cancer (PCa) is the most common solid cancer affecting men worldwide. Serum prostate-specific antigen (PSA) is at present the most commonly used biomarker for PCa screening, as well as a reliable marker of disease recurrence after initial treatment. Bone metastases (BM) are present in advanced stages of the disease. Read More

Am J Mens Health 2019 Mar-Apr;13(2):1557988319835326

1 Department of Clinical Pharmacy, University of California, San Francisco, CA, USA.

Prostate cancer (PCa) is the leading cancer in men in the United States. This study evaluated direct costs of treating urinary problems after PCa treatments and determined predictors of long-term costs for urinary problems. Data from the Cancer of Prostate Strategic Urologic Research Endeavor registry was analyzed for this study. Read More

Clin Transl Radiat Oncol 2019 Feb 15;15:113-117. Epub 2019 Feb 15.

Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology Trondheim, Norway.

•Modern IGRT has given new insight regarding organ motion in radiotherapy.•Rectal volume variation may increase the risk of biochemical and local failure.•Rectal volume decreased significantly during eight weeks of radiotherapy. Read More

Front Oncol 2019 15;9:71. Epub 2019 Feb 15.

Academic Department of Radiation Oncology, Centre Oscar Lambret, Lille, France.

To report the preliminary results of salvage re-irradiation in the prostatic bed after radical prostatectomy and salvage external beam radiation therapy (EBRT) using robotic stereotactic body radiation therapy (SBRT) with Cyberknife® for local recurrence of prostate cancer. Retrospective monocentric analysis was performed on patients treated with SBRT for isolated macroscopic recurrence in the prostatic bed. All patients had radical prostatectomy and salvage or adjuvant EBRT. Read More

Front Oncol 2019 15;9:70. Epub 2019 Feb 15.

Department of Radiation Oncology, Unicancer-Georges-Francois Leclerc Cancer Center, Dijon, France.

External beam radiation therapy (EBRT) can cure localized prostate cancer (PCa) by sterilizing cancer cells in the prostate gland and surrounding tissues at risk of microscopic dissemination. We hypothesized that pelvic EBRT for localized PCa might have an unexpected prophylactic impact on the occurrence of pelvic bone metastases. We reviewed the data of 332 metastatic PCa patients. Read More

Cancers (Basel) 2019 Feb 25;11(2). Epub 2019 Feb 25.

CRUK/MRC Oxford Institute for Radiation Oncology, University of Oxford, Oxford OX37DQ, UK.

Compared to external beam radiotherapy, targeted radionuclide therapy (TRT) allows for systemic radiation treatment of metastatic lesions. Published work on recent strategies to improve patient management and response to TRT through individualising patient treatment, modifying treatment pharmacokinetics and increasing anticancer potency are discussed in this review, with a special focus on the application of clinically evaluated radiolabelled ligands and peptides in the treatment of neuroendocrine and prostate cancers. Read More

PLoS One 2019 28;14(2):e0213002. Epub 2019 Feb 28.

Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia.

Background And Purpose: In prostate cancer treatment with external beam radiation therapy (EBRT), prostate motion and internal changes in tissue distribution can lead to a decrease in plan quality. In most currently used planning methods, the uncertainties due to prostate motion are compensated by irradiating a larger treatment volume. However, this could cause underdosage of the treatment volume and overdosage of the organs at risk (OARs). Read More

Phys Med Biol 2019 Feb 28. Epub 2019 Feb 28.

1Département de Radio-Oncologie et CR CHU de Québec, Université Laval, 11 Côte du Palais, QC, Quebec, CANADA.

Stochastic frontier analysis is used as a novel knowledge-based technique in order to develop a predictive model of dosimetric features from signicant geometric parameters describing a patient morphology. 406 patients treated with VMAT for prostate cancer were analyzed retrospectively. Cases were divided into three prescription-based groups. Read More

Eur J Cancer Care (Engl) 2019 Feb 27:e13028. Epub 2019 Feb 27.

Freemasons Foundation Centre for Men's Health, The University of Adelaide, Adelaide, South Australia, Australia.

Purpose: This study aims to describe: (a) the proportion of prostate cancer patients satisfied with treatment, (b) how satisfaction changes after treatment, and (c) predictors of patient satisfaction including demographic, symptom-related and treatment variables.

Method: Self-reported quality of life and satisfaction questionnaire (UCLA Expanded Prostate Cancer Index Composite [EPIC] 26), and demographics were obtained from the South Australian Prostate Cancer Clinical Outcomes Collaborative (SA-PCCOC) database. Responses were obtained pre-treatment (radical prostatectomy or external beam radiation therapy) and 6, 12 and 24 months post-treatment, for patients diagnosed between 2009 and 2013. Read More

World J Urol 2019 Feb 21. Epub 2019 Feb 21.

Department of Urology, Sorbonne Université, GRC n5, ONCOTYPE-URO, AP-HP, Hôpital Pitié-Salpêtrière, 83 bvd hospital, 75013, Paris, France.

Introduction: Despite no consensus on the optimal management of recurrent prostate cancer after primary radiation or HIFU therapy, salvage prostatectomy (sRP) is reserved for only 3% of patients because of technical challenges and frequent post-operative complications. We assessed outcomes after sRP in a series of patients with localized PCa and that had received radiation therapy or HIFU as a first-line treatment.

Materials And Methods: Data from nine French referral centers on patients treated with sRP between 2005 and 2017 were collected. Read More

Ann Nucl Med 2019 Feb 18. Epub 2019 Feb 18.

Department of Urology, School of Medicine, Hacettepe University, Sihhiye, Ankara, 06100, Turkey.

Objective: To demonstrate the effect of clinicopathological factors on Ga-PSMA-11 PET/CT positivity at the time of biochemical recurrence (BCR) of localized prostate cancer (PCa) following definitive therapy.

Methods: We retrospectively reviewed our institutional database for PCa patients who had BCR and subsequently underwent Ga-PSMA-11 PET/CT between April 2014 and February 2018. A total of 51 patients who were metastasis-free before PSMA imaging and previously treated with definitive therapy (radical prostatectomy or external beam radiotherapy) for localized disease (pT1c-T3b pN0-1 cM0) were included. Read More

J Med Imaging Radiat Sci 2019 Mar 8;50(1):82-86. Epub 2018 Nov 8.

The Austin Hospital, Heidelberg, Australia; Ringwood Private Hospital, Ringwood East, Australia; University of Melbourne, Melbourne, Australia.

Introduction: This is a retrospective study conducted to report the tumor control and late toxicity outcomes of patients with intermediate-risk prostate cancer undergoing combination external beam radiation therapy and low dose rate brachytherapy (LDR-PB).

Methods And Materials: Thirty-one patients received 45 Gray (Gy) of external beam radiation therapy to the prostate and seminal vesicles, together with a brachytherapy boost via a transperineal prostate implant of I (108 Gy). In addition, some patients received 6 months of androgen deprivation therapy depending on physician preference. Read More

J Eng Sci Med Diagn Ther 2018 Nov 6;1(4). Epub 2018 Aug 6.

Department of Radiology, Boston Medical Center & Boston University School of Medicine, 820 Harrison Ave., Boston, MA 02118.

This paper presents the design evolution, fabrication, and testing of a novel patient and organ-specific, 3D printed phantom for external beam radiation therapy of prostate cancer. In contrast to those found in current practice, this phantom can be used to plan and validate treatment tailored to an individual patient. It contains a model of the prostate gland with a dominant intraprostatic lesion, seminal vesicles, urethra, ejaculatory duct, neurovascular bundles, rectal wall, and penile bulb generated from a series of combined T2-weighted/dynamic contrast-enhanced magnetic resonance images. Read More

Cancer Treat Res Commun 2019 Feb 10;19:100119. Epub 2019 Feb 10.

Florida Physician Specialists, Jacksonville, FL, USA.

Background: Prior randomized studies have shown a survival benefit using combined androgen deprivation therapy (ADT) and radiation therapy for intermediate-risk prostate cancer. However, these studies either used low doses of radiation (66.6 Gy to isocenter) or imaged guidance was not available. Read More

J Urol 2019 Mar;201(3):528-534

Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California.

Purpose: The aim of this guideline is to present recommendations regarding moderately hypofractionated (240-340 cGy per fraction) and ultrahypofractionated (500 cGy or more per fraction) radiation therapy for localized prostate cancer.

Methods And Materials: The American Society for Radiation Oncology convened a task force to address 8 key questions on appropriate indications and dose-fractionation for moderately and ultrahypofractionated radiation therapy, as well as technical issues, including normal tissue dose constraints, treatment volumes, and use of image guided and intensity modulated radiation therapy. Recommendations were based on a systematic literature review and created using a predefined consensus-building methodology and Society-approved tools for grading evidence quality and recommendation strength. Read More

J Urol 2019 Feb 5:101097JU0000000000000110. Epub 2019 Feb 5.

Departments of Radiation Oncology, Pathology and Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center , New York , New York.

Purpose: We determined the prognostic importance of a positive posttreatment biopsy after prostate radiotherapy.

Materials And Methods: A total of 382 patients underwent a posttreatment biopsy after external beam radiotherapy of clinically localized prostate cancer. Posttreatment biopsies were classified as positive (prostatic adenocarcinoma without typical radiation induced changes), negative (no evidence of carcinoma) or adenocarcinoma with a severe treatment effect. Read More

Int Braz J Urol 2019 Jan 25;45. Epub 2019 Jan 25.

Departamento de Radioterapia, Hospital Sirio-Libanês, São Paulo, SP, Brasil.

Objectives: Brachytherapy (BT) with iodine-125 seeds placement is a consolidated treatment for prostate cancer. The objective of this study was to assess the clinical outcomes in patients with prostate cancer who underwent low-dose-rate (LDR) -BT alone in a single Brazilian institution.

Materials And Methods: Patients treated with iodine-125 BT were retrospectively assessed after at least 5 years of follow-up. Read More

JAMA Netw Open 2019 Feb 1;2(2):e188006. Epub 2019 Feb 1.

Department of Radiation Oncology, University of California, Los Angeles.

Importance: Stereotactic body radiotherapy harnesses improvements in technology to allow the completion of a course of external beam radiotherapy treatment for prostate cancer in the span of 4 to 5 treatment sessions. Although mounting short-term data support this approach, long-term outcomes have been sparsely reported.

Objective: To assess long-term outcomes after stereotactic body radiotherapy for low-risk and intermediate-risk prostate cancer. Read More

Am J Clin Oncol 2019 Feb 4. Epub 2019 Feb 4.

Department of Radiation Oncology, Beaumont Hospital, Dearborn, MI.

Objectives: We applied an established prognostic model to high-risk prostate cancer (HRPC) patients treated with radiotherapy (RT) and evaluated the influence of clinical and treatment variables on treatment outcomes.

Methods: In total, 1075 HRPC patients undergoing definitive radiotherapy (RT) between 1995 and 2010 were retrospectively reviewed. Median follow-up was 62. Read More

J Oncol 2019 2;2019:8170428. Epub 2019 Jan 2.

Institute of Oncology, Davidoff Cancer Center, Rabin Medical Center, Petah Tikva, Israel.

Background: Until recently, dose intensified radiotherapy was the standard radiation method for localized prostate cancer. Multiple studies have demonstrated similar efficacy and tolerability with moderate hypofractionation. In recent years there has been an increasing focus placed on understanding the cost and value of cancer care. Read More

World J Urol 2019 Feb 1. Epub 2019 Feb 1.

CURAVID Radiology and Radiotherapy, Luebeck, Germany.

Purpose: To analyze outcomes and complication rates in an unselected cohort of men with unfavorable (NCCN intermediate and high-risk) PCa receiving combined-modality radiation treatment (CRT).

Methods: Patients received androgen deprivation therapy for 1 year and combined-modality radiation treatment (CRT) consisting of external-beam radiotherapy (EBRT, 59.4 Gy, 33 fractions) and J seed-brachytherapy (S-BT, 100 Gy). Read More

JAMA Netw Open 2019 Feb 1;2(2):e187765. Epub 2019 Feb 1.

Department of Biostatistics, University of Michigan, Ann Arbor.

Importance: Whether surgery or radiotherapy is the preferred treatment for patients with localized prostate cancer continues to be debated, and randomized clinical trials cannot yet fully address this question. Furthermore, there may be heterogeneity in responses, and the optimal treatment for a patient will depend on his clinical and tumor characteristics.

Objectives: To use a unified statistical approach to compare the association of surgery and radiotherapy with both metastatic clinical failure (CF) and survival in localized prostate cancer and to develop an online calculator for individualized, treatment-specific outcome prediction. Read More

PLoS One 2019 25;14(1):e0210514. Epub 2019 Jan 25.

Radiation Department, CLCC Eugène Marquis,Rennes, France.

Objectives: No study has reported clinical results of external-beam radiotherapy specifically for T3b prostate cancer. The possibility of escalating the dose to the involved seminal vesicles (ISV) while respecting the dose constraints in the organs at risk is thus so far not clearly demonstrated. The objective of the study was to analyze the dose distribution and the clinical outcome in a large series of patients who received IMRT for T3b prostate cancer. Read More

Int Braz J Urol 2018 10 30;45. Epub 2018 Oct 30.

Department of Radiation Medicine, Oregon Health and Science University, Portland, OR, U.S.A.

Introduction: Several recent randomized clinical trials have evaluated hypofractionated regimens against conventionally fractionated EBRT and shown similar effectiveness with conflicting toxicity results. The current view regarding hypofractionation compared to conventional EBRT among North American genitourinary experts for management of prostate cancer has not been investigated.

Materials And Methods: A survey was distributed to 88 practicing North American GU physicians serving on decision - making committees of cooperative group research organizations. Read More

Eur Urol 2019 Jan 19. Epub 2019 Jan 19.

Department of Radiation Oncology, University of Michigan, Ann Arbor, MI, USA.

Eur Urol 2019 Jan 19. Epub 2019 Jan 19.

Division of Urological Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address:

World J Urol 2019 Jan 21. Epub 2019 Jan 21.

Department of Urology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.

Purpose: To compare oncological, functional, and toxicity outcomes of patients with radiation-recurrent prostate cancer (PCa) after external beam radiation therapy (EBRT) or brachytherapy (BT) treated with salvage high-intensity focused ultrasound (S-HIFU) or salvage radical prostatectomy (S-RP).

Methods: This retrospective study compared 52 patients with radiation-recurrent PCa after EBRT or BT treated with S-HIFU (n = 27) or S-RP (n = 25) between 1998 and 2016. We estimated overall survival (OS), cancer-specific survival (CSS), and metastasis-free survival (MFS) at 5 years. Read More

Brachytherapy 2019 Jan 14. Epub 2019 Jan 14.

Department of Radiation Oncology, UPMC Hillman Cancer Center, Pittsburgh, PA.

Purpose: The purpose of this study was to study the correlation between intraoperative and postimplant dosimetry. We investigated the correlation between prostate (V) and urethra (D, D) dose limits, and whether it is possible to increase prostate D and V in intraoperative planning without violating postimplant urethra and rectum dose limits.

Methods And Materials: Seventy-nine patients who underwent real-time ultrasound-guided prostate implants using intraoperative planning from 2013 to 2017 were analyzed. Read More

Health Qual Life Outcomes 2019 Jan 14;17(1):11. Epub 2019 Jan 14.

Hospital Universitari de Bellvitge, l'Hospitalet de Llobregat, Barcelona, Spain.

Background: The purpose of this study is to describe Health-Related Quality of Life (HRQoL) of localized prostate cancer patients in an Active Surveillance (AS) program, and to compare them with those undergoing radical prostatectomy (RP), external-beam radiotherapy (XRT) and brachytherapy (BT).

Methods: Multi-institutional pooled cross-sectional analysis on patients in an AS protocol: < 75 years old; pathologically confirmed LPC (maximum of three positive cylinders); Gleason score < 3 + 4; clinical stage T1a-T2b; and PSA < 15 ng/ml. Exclusion criteria for this study were: less than 6 months in AS, termination of AS protocol, or incomplete data. Read More

Brachytherapy 2019 Jan 9. Epub 2019 Jan 9.

Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston, MA; Harvard Medical School, Boston, MA.

Purpose: External beam radiation therapy (EBRT) with low-dose-rate (LDR) brachytherapy boost has been associated with improved biochemical progression-free survival and overall survival (OS) compared with dose-escalated EBRT (DE-EBRT) alone for unfavorable-risk prostate cancer. However, it is not known whether high-dose-rate (HDR) boost provides a similar benefit. We compare HDR boost against LDR boost and DE-EBRT with respect to OS. Read More

Oncology 2019 Jan 9:1-9. Epub 2019 Jan 9.

Purpose: Cancer-related fatigue is one of the most debilitating side effects of cancer and cancer therapy. We aimed to investigate co-occurring symptoms associated with persistent fatigue in men receiving external beam radiation therapy (EBRT) for nonmetastatic prostate cancer.

Methods: A sample of 47 men with prostate cancer scheduled to receive radiotherapy (RT) were followed at baseline and 1 year after RT. Read More

Urol Oncol 2019 Jan 2. Epub 2019 Jan 2.

Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL.

Purpose: Controversy surrounds the benefit of pelvic lymph node irradiation (PLN-RT) in localized prostate cancer (CaP). Our objective was to determine the practice patterns and predictors of PLN-RT in a national cohort.

Materials And Methods: The National Cancer Data Base (2005-2015) was leveraged to obtain men diagnosed with nonmetastatic CaP treated with external beam radiotherapy (n = 197,378). Read More

BMC Urol 2019 Jan 5;19(1). Epub 2019 Jan 5.

Faculty of Medicine, Department of Biostatistics, Cukurova University, Adana, Turkey.

Background: Optimal treatment of high-risk prostate cancer remains controversial. We aimed to compare treatment outcomes of prostate cancer patients treated with definitive external-beam radiotherapy (ExRT) or radical prostatectomy (RP).

Methods: The records of 120 high-risk clinical stage T2b-T4 N0 M0 prostate cancer patients treated with definitive ExRT or RP were reviewed. Read More

Anticancer Res 2019 Jan;39(1):477-486

Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan

Background/aim: To evaluate the treatment outcomes, toxicity and health-related quality of life (HRQOL) in prostate cancer (PCa) patients who underwent single-fraction high-dose-rate brachytherapy (single-fraction HDR-BT) with external beam radiotherapy (EBRT).

Materials And Methods: From April 2014 to October 2017, treatment outcomes and toxicity of 85 patients who underwent single-fraction HDR-BT of 13 Gy, followed by 46 Gy EBRT in 23 fractions, were examined. HRQOL of 53 patients was evaluated using the Expanded Prostate Cancer Index Composite (EPIC), International Prostate Symptom Score (IPSS)/QOL index, International Index of Erectile Function 5 (IIEF-5), and 36-Item Short Form Survey (SF-36) scores through one year. Read More

J Appl Clin Med Phys 2019 Jan 26;20(1):194-199. Epub 2018 Dec 26.

Department of Mechanical, Industrial and Manufacturing Engineering, University of Toledo, Toledo, OH, USA.

An effective radiotherapy treatment entails maximizing radiation dose to the tumor while sparing the surrounding and normal tissues. With the advent of SBRT with extreme hypo-fractionation in treating tumors including prostate where ablative dose is delivered in smaller number of fractions, rectum remains a dose-limiting organ and at the risk of rectal toxicity or secondary cancer. The same limitation of rectal toxicity exists for high-dose rate (HDR) treatments of cervical, endometrial, or prostate cancer when creating even a short distance between the anterior rectal wall and field of radiation is ideal in delivering ablative dose to the target. Read More

Health Phys 2019 Feb;116(2):189-204

Department of Medical Physics, University of Wisconsin-Madison, 1005 Wisconsin Institutes for Medical Research, 1111 Highland Avenue, Madison, WI 53705.

Radiation protection in brachytherapy entails protecting members of the public, radiation professionals, and the patient from unnecessary radiation, as well as making sure that the radiation used in the patient's treatment is placed correctly with the correct dose distribution. Protecting members of the public from radiation emanating from brachytherapy sources implanted in a patient was an issue several decades ago, but with modern brachytherapy, the problem has mostly disappeared. The most frequent treatments are either low-dose-rate permanent implants for prostate cancer, or high-dose-rate procedures for gynecological, breast, or skin cancers. Read More

J Magn Reson Imaging 2018 Dec 25. Epub 2018 Dec 25.

Department of Radiation Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands.

Background: Post-radiotherapy locally recurrent prostate cancer (PCa) patients are candidates for focal salvage treatment. Multiparametric MRI (mp-MRI) is attractive for tumor localization. However, radiotherapy-induced tissue changes complicate image interpretation. Read More

Prostate 2019 Apr 26;79(5):506-514. Epub 2018 Dec 26.

Department of Urology, Kitasato University School of Medicine, Sagamihara, Japan.

Background: Systemic Therapy in Advancing or Metastatic Prostate Cancer: Evaluation of Drug Efficacy (STAMPEDE) trial showed the survival benefit for prostate radiotherapy in newly diagnosed prostate cancer patients with a low metastatic burden. The result raises the next question whether additional radiotherapy to metastatic sites could improve the survival in those with a low metastatic burden.

Methods: We evaluated the efficacy and safety of prostate-directed radiotherapy (PDRT) with or without metastasis-directed radiotherapy (MDRT) in newly diagnosed oligometastatic patients who underwent combination of high-dose-rate prostate brachytherapy, external beam radiotherapy, and androgen deprivation therapy. Read More

J Urol 2019 01;201(1):120-128

Division of Urology, Department of Surgery, University of Maryland Medical Center, Baltimore, Maryland.

Purpose: The optimal primary treatment of localized high grade prostate cancer in younger men remains controversial. The objective of this project was to compare the impact of initial radical prostatectomy vs radiation therapy on survival outcomes in young men less than 60 years old with high grade prostate cancer.

Materials And Methods: We retrospectively analyzed the records of men younger than 60 years in the SEER (Surveillance, Epidemiology and End Results) database who underwent initial surgery or radiation therapy of high grade (Gleason score 8 or greater) localized (N0M0 TNM stage) prostate cancer from 2004 to 2012. Read More

Ther Adv Urol 2018 Dec 11;10(12):359-364. Epub 2018 Oct 11.

The Christie NHS Foundation Trust, Manchester, UK.

Background: Changes in prostate cancer apparent diffusion coefficient (ADC) derived from diffusion-weighted magnetic resonance imaging (MRI) provide a noninvasive method for assessing radiotherapy response. This may be attenuated by neoadjuvant hormone therapy (NA-HT). We investigate ADC values measured before, during and after external beam radiotherapy (EBRT) following NA-HT. Read More

Eur Urol 2019 Mar 17;75(3):464-476. Epub 2018 Dec 17.

Division of Urology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada; Institute for Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada. Electronic address:

Context: Radiotherapy used for treating localized prostate cancer is effective at prolonging cancer-specific and overall survival. Still, acute and late pelvic toxicities are a concern, with gastrointestinal (GI) and genitourinary (GU) sequelae being most common as well as other pelvic complications.

Objective: To present a critical review of the literature regarding the incidence and risk factors of pelvic toxicity following primary radiotherapy for prostate cancer and to provide a narrative review regarding its management. Read More

Cancer 2019 Mar 18;125(6):952-962. Epub 2018 Dec 18.

Department of Urology, Brigham and Women's Hospital, Boston, Massachusetts.

Background: Active surveillance (AS) is a viable management option for approximately 50% of men who are newly diagnosed with prostate cancer. To the authors' knowledge, no direct comparisons between the different variants of AS protocols have been conducted to date. The authors developed a microsimulation decision model to evaluate which of 3 alternative AS protocols is optimal for men with low-risk prostate cancer, and compared each of these with immediate treatment. Read More

Eur Urol 2019 01 24;75(1):35-41. Epub 2018 Oct 24.

Harvard Medical School, Boston, MA, USA; Department of Radiation Oncology, Dana-Farber/Brigham and Women's Cancer Center, Boston, MA, USA. Electronic address:

Background: While the addition of androgen deprivation therapy (ADT) to external beam radiation therapy (EBRT) is known to improve overall survival (OS) in Gleason 8-10 (Grade Group 4-5) prostate cancer (PCa), it has been hypothesized that Gleason 9-10 disease, which is less differentiated than Gleason 8 disease, may be less sensitive to ADT.

Objective: To examine the association between ADT and OS for Gleason 8 versus Gleason 9-10 PCa.

Design, Setting, And Participants: A retrospective cohort study of 20 139 men from the National Cancer Database with localized or locally advanced, Gleason 8-10 PCa who received EBRT. Read More