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Arab J Urol 2020 Aug 26;19(2):152-158. Epub 2020 Aug 26.

Division of Urology, Department of Surgery, American University of Beirut Medical Center (AUBMC), Beirut, Lebanon.

Objective: To report on the surgical, oncological and early functional outcomes of robot-assisted radical prostatectomy (RARP) at our tertiary care centre, as there is a scarcity of reports on outcomes of robotic surgery from the Middle East.

Patients And Methods: We reviewed the electronic health records for patients undergoing RARP between 2013 and 2019 at the American University of Beirut Medical Center. We collected patients' demographics and preoperative oncological factors including prostate-specific antigen (PSA), clinical oncological stage, and World Health Organization (WHO) grade. Read More

Eur J Nucl Med Mol Imaging 2021 Jun 6. Epub 2021 Jun 6.

Department of Radiology, University of Minnesota, Minneapolis, MN, USA.

Purpose: F-Fluciclovine PET imaging has been increasingly used in the restaging of prostate cancer patients with biochemical recurrence (BCR); however, its clinical utility in patients with low prostate-specific antigen (PSA) levels following primary radiation therapy has not been well-studied. This study aims to determine the detection rate and diagnostic accuracy of F-fluciclovine PET and the patterns of prostate cancer recurrence in patients with rising PSA after initial radiation therapy, particularly in patients with PSA levels below the accepted Phoenix definition of BCR (PSA nadir +2 ng/mL).

Methods: This retrospective study included patients from two tertiary institutions who underwent F-fluciclovine PET scans for elevated PSA level following initial external beam radiation therapy, brachytherapy, and/or proton therapy. Read More

Brachytherapy 2021 Jun 2. Epub 2021 Jun 2.

Department of Research and Evaluation, Kaiser Permanente, Pasadena, CA.

Purpose: To compare 10-year late complications of radical prostatectomy (RP) versus external-beam-radiation-therapy (EBRT) versus brachytherapy (BT).

Methods: Retrospective analysis was performed on 1503 intermediate-risk-prostate-cancer patients treated from 2004 to 2007, using univariate comparisons. Eight hundred and nineteen underwent RP, 574 EBRT, and 110 BT. Read More

Radiother Oncol 2021 Jun 2. Epub 2021 Jun 2.

Utrecht University, The Netherlands.

Background And Purpose: 1.5 Tesla magnetic resonance imaging radiotherapy linear accelerator (MR-Linac) is gaining interest for treatment of localized prostate cancer. Clinical evidence is lacking and it therefore remains uncertain whether MR-Linac is cost-effective. Read More

Cancers (Basel) 2021 May 31;13(11). Epub 2021 May 31.

Yonsei Cancer Center, Department of Radiation Oncology, Yonsei University College of Medicine, Seoul 03722, Korea.

Purpose: This nationwide multi-institutional study analyzed the patterns of care and outcomes of external beam radiotherapy (EBRT) in localized prostate cancer patients. We compared various risk classification tools and assessed the need for refinements in current radiotherapy (RT) schemes.

Methods And Materials: We included non-metastatic prostate cancer patients treated with primary EBRT from 2001 to 2015 in this study. Read More

Cancers (Basel) 2021 May 29;13(11). Epub 2021 May 29.

The D-Lab, Department of Precision Medicine, GROW-School for Oncology and Developmental Biology, Maastricht University, 6229 ER Maastricht, The Netherlands.

The aim of this study is to build a decision support system (DSS) to select radical prostatectomy (RP) or external beam radiotherapy (EBRT) for low- to intermediate-risk prostate cancer patients. We used an individual state-transition model based on predictive models for estimating tumor control and toxicity probabilities. We performed analyses on a synthetically generated dataset of 1000 patients with realistic clinical parameters, externally validated by comparison to randomized clinical trials, and set up an in silico clinical trial for elderly patients. Read More

Cancers (Basel) 2021 May 30;13(11). Epub 2021 May 30.

Radiation Oncology Department, University and Spedali Civili Hospital, 25123 Brescia, Italy.

Background And Purpose: Two previous "Patterns Of Practice" surveys (POP I and POP II), including more than 4000 patients affected by prostate cancer treated with radical external beam radiotherapy (EBRT) between 1980 and 2003, established a "benchmark" Italian data source for prostate cancer radiotherapy. This report (POP III) updates the previous studies.

Methods: Data on clinical management and outcome of 2525 prostate cancer patients treated by EBRT from 2004 to 2011 were collected and compared with POP II and, when feasible, also with POP I. Read More

Pharmaceutics 2021 May 7;13(5). Epub 2021 May 7.

Department of Radiology & Nuclear Medicine, Erasmus Medical Center, Erasmus University, 3015 GD Rotterdam, The Netherlands.

In recent years, radionuclide therapy (RT) and targeted radionuclide therapy (TRT) have gained great interest in cancer treatment. This is due to promising results obtained in both preclinical and clinical studies. However, a complete response is achieved in only a small percentage of patients that receive RT or TRT. Read More

Prostate 2021 May 31. Epub 2021 May 31.

Division of Urology, Cancer Prognostics and Health Outcomes Unit, University of Montréal Health Center, Montréal, Québec, Canada.

Background: We hypothesized that Gleason Grade Group (GGG) IV patients treated with radical prostatectomy (RP) or external beam radiotherapy (EBRT) exhibit different cancer-specific mortality (CSM) rates according to underlying Gleason patterns (GP): 4 + 4 versus 3 + 5 versus 5 + 3.

Materials And Methods: We identified all GGG IV patients treated with either RP or EBRT within the Surveillance, Epidemiology, and End Results 2004-2016 database. The effect of biopsy GP on CSM (3 + 5 vs. Read More

World J Urol 2021 May 30. Epub 2021 May 30.

Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Canada.

Purpose: To externally validate the STAR-CAP prognostic system for prostate cancer (PCa) and compare it to the CAPRA score to predict for biochemical recurrence (BCR) after radiation therapy (RTx).

Methods: We included patients treated with RTx between 2002 and 2021 for non-metastatic PCa at our institution. BCR was defined based on Phoenix criteria. Read More

Int J Urol 2021 May 28. Epub 2021 May 28.

Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Quebec, Canada.

Objective: To test whether radical prostatectomy might result in better survival than external beam radiation therapy in metastatic prostate cancer patients.

Methods: Newly diagnosed metastatic prostate cancer patients with M1a/b substages, treated with radical prostatectomy or external beam radiation therapy were abstracted from the Surveillance, Epidemiology and End Results database (2004-2016). Temporal trend analyses, propensity score matching, cumulative incidence plots, multivariate competing risks regression models and landmark analyses were used. Read More

J Appl Clin Med Phys 2021 May 27. Epub 2021 May 27.

Institut de Cancérologie de l'Ouest, Angers, France.

Purpose: To evaluate the Siemens solution generating Synthetic computed tomography (sCT) for magnetic resonance imaging (MRI)-only radiotherapy (RT).

Method: A retrospective study was conducted on 47 patients treated with external beam RT for brain or prostate cancer who underwent both MRI and CT for treatment planning. sCT images were generated from MRI using automatic bulk densities segmentation. Read More

J Med Case Rep 2021 May 26;15(1):296. Epub 2021 May 26.

Department of Radiation Oncology, Hiroshima University Hospital, 1-2-3 Kasumi Minami-ku Hiroshima-shi, Hiroshima, 734-8553, Japan.

Background: Few studies have assessed hydrogel spacer shrinkage during external-beam radiation therapy following brachytherapy for localized high-risk prostate cancer. This case presentation evaluated the changes in hydrogel spacer appearance by magnetic resonance imaging during external-beam radiation therapy after brachytherapy for prostate cancer and analyzed the effect of this shrinkage on the dose distribution in four cases.

Case Presentation: In all cases, we implanted I sources using a modified peripheral loading pattern for seed placement. Read More

Biomed Phys Eng Express 2021 Jun 2;7(4). Epub 2021 Jun 2.

Sunnybrook Health Sciences Centre, ON, Canada.

To investigate the feasibility of using a single MRI acquisition for fiducial marker identification and synthetic CT (sCT) generation towards MRI-only treatment planning for prostate external beam radiation therapy (EBRT).Seven prostate cancer patients undergoing EBRT, each with three implanted gold fiducial markers, participated in this study. In addition to the planning CT scan, all patients were scanned on a 3 T MR scanner with a 3D double-echo gradient echo (GRE) sequence. Read More

Urology 2021 May 22. Epub 2021 May 22.

University College Hospital, United Kingdom.

Objective: To evaluate the association between SpaceOAR and radiation dosing, toxicity and quality-of-life versus no spacer across all radiotherapy modalities for prostate cancer.

Methods: A systematic search of the Cochrane Central Register of Controlled Trials, MEDLINE, and Embase was performed from database inception through May 2020. Two reviewers independently screened titles/abstracts and full papers. Read More

J Contemp Brachytherapy 2021 Feb 18;13(1):91-94. Epub 2021 Feb 18.

Department of Brachytherapy for Prostate Cancer, Shiga University of Medical Science, Shiga, Japan.

Purpose: Prostate cancer with nodular bladder invasion (stage T4 prostate cancer) is an extremely difficult clinical entity to achieve complete cure. So far, there has been no clear report demonstrating complete cure of prostate cancer with nodular bladder invasion, stage T4 prostate cancer.

Case Presentation: In this case report, the author presents a 55-year-old man with a diagnosis of advanced prostate cancer invading into the bladder wall with pelvic lymph node metastasis (T4N1M0 disease). Read More

J Contemp Brachytherapy 2021 Feb 18;13(1):72-79. Epub 2021 Feb 18.

School of Physics, University of Sydney, Sydney, Australia.

Purpose: The purpose of this investigation was to examine differences in estimates of accumulated rectal dose when using deformable image registration (DIR) compared with rigid image registration (RIR) methods, and parameter addition methods for combined transrectal ultrasound (TRUS)-based high-dose-rate brachytherapy (HDR-BT) and external beam radiation therapy (EBRT) treatments of prostate cancer.

Material And Methods: In this retrospective study, data from 10 patients who had previously received HDR-BT in one 15 Gy fraction, followed by 46 Gy EBRT in twenty-three fractions were used. To estimate total combined dose to the rectum, dose accumulation using both DIR and RIR methods were compared with parameter addition methods, which assume the same region of rectal anatomy receives the maximum dose from both treatment modalities. Read More

J Contemp Brachytherapy 2021 Feb 18;13(1):1-11. Epub 2021 Feb 18.

Servicio de Oncología Radioterápica, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain.

Purpose: Brachytherapy (BT) and external beam radiation therapy (EBRT) are effective treatments for high-risk prostate cancer (PCa). However, the impact of these treatments on health-related quality of life (HRQL) remains unclear. In this study, we compared EBRT alone with EBRT plus a boost with high-dose rate (HDR)-BT to determine the impact on HRQL in patients with high-risk PCa. Read More

Prostate 2021 May 19. Epub 2021 May 19.

Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada.

Background: To test for rates of other cause mortality (OCM) and cancer-specific mortality (CSM) in elderly prostate cancer (PCa) patients treated with the combination of radical prostatectomy (RP) and external beam radiation therapy (EBRT) versus RP alone, since elderly PCa patients may be over-treated.

Methods: Within the Surveillance, Epidemiology and End Results database (2004-2016), cumulative incidence plots, after propensity score matching for cT-stage, cN-stage, prostate specific antigen, age and biopsy Gleason score, and multivariable competing risks regression models (socioeconomic status, pathological Gleason score) addressed OCM and CSM in patients (70-79, 70-74, and 75-79 years) treated with RP and EBRT versus RP alone.

Results: Of 18,126 eligible patients aged 70-79 years, 2520 (13. Read More

JAMA Netw Open 2021 May 3;4(5):e2111092. Epub 2021 May 3.

Department of Radiation Oncology, Dana-Farber Cancer Institute, Brigham and Women's Hospital, Boston, Massachusetts.

Importance: Increased prostate-specific antigen (PSA) levels after treatment (PSA failure) may have different associations with outcomes for men with locally advanced vs localized prostate cancer.

Objective: To evaluate whether the association between PSA failure and death may be different in locally advanced vs localized prostate cancer.

Design, Setting, And Participants: This multicenter cohort study included patients from 2 randomized clinical trials. Read More

Brachytherapy 2021 May 13. Epub 2021 May 13.

Department of Radiation Oncology, UPMC Hillman Cancer Center, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Electronic address:

Purpose: Baseline intraprostatic calcification (IC) has been shown to be associated with a higher rate of biochemical recurrence (BCR) in men treated with iodine-125 prostate brachytherapy (PB). We evaluated this association in a cohort of men treated with cesium-131 PB.

Methods And Materials: We retrospectively reviewed the charts of all low- and intermediate-risk prostate cancer patients treated with cesium-131 PB +/- external beam radiotherapy (EBRT) at our institution from 2/2011 to 7/2018. Read More

J Radiat Res 2021 May 17. Epub 2021 May 17.

Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.

Modern radiotherapy (RT) uses altered fractionation, long beam-on time and image-guided procedure. This study aimed to compare secondary cancer risk (SCR) associated with primary field, scatter/leakage radiations and image-guided procedure in prostate treatment using intensity-modulated RT (IMRT), CyberKnife stereotactic body RT (CK-SBRT) in relative to 3-dimensional conformal RT (3D-CRT). Prostate plans were generated for 3D-CRT, IMRT (39 fractions of 2 Gy), and CK-SBRT (five fractions of 7. Read More

Urol Oncol 2021 May 12. Epub 2021 May 12.

Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montreal Health Center, Montreal, Quebec, Canada.

Background: Race/ethnicity may predispose to higher active treatment rates in septuagenarian or older low risk prostate cancer (CaP) patients. We tested this hypothesis within a contemporary North American cohort.

Material And Methods: We relied on the Surveillance, Epidemiology and End Results (SEER) database 2010-2016. Read More

Eur Urol 2021 May 10. Epub 2021 May 10.

Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

The natural history of radiorecurrent high-risk prostate cancer (HRPCa) is not well-described. To better understand its clinical course, we evaluated rates of distant metastases (DM) and prostate cancer-specific mortality (PCSM) in a cohort of 978 men with radiorecurrent HRPCa who previously received either external beam radiation therapy (EBRT, n = 654, 67%) or EBRT + brachytherapy (EBRT + BT, n = 324, 33%) across 15 institutions from 1997 to 2015. In men who did not die, median follow-up after treatment was 8. Read More

World J Urol 2021 May 12. Epub 2021 May 12.

Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, QC, Canada.

Purpose: To assess the effect of race/ethnicity in cancer-specific mortality (CSM) adjusted for other-cause mortality (OCM) in metastatic prostate cancer patients (mPCa) treated with external beam radiotherapy (EBRT) to the prostate.

Methods: We relied on the Surveillance, Epidemiology, and End Results (SEER) database to identify Caucasian, African-American, Hispanic/Latino and Asian mPCa patients treated by EBRT between 2004 and 2016. Cumulative incidence plots displayed CSM after adjustment for OCM according to race/ethnicity. Read More

Int J Radiat Oncol Biol Phys 2021 May 8. Epub 2021 May 8.

School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia; Department of Radiation Oncology, Calvary Mater Newcastle, Waratah, Australia. Electronic address:

Purpose: Recent evidence shows the noninferiority of hypofractionated radiation therapy regimens compared with conventional regimens in the treatment of prostate cancer (PCa). Hypofractionation has benefits for both the patient and health care system, because of the shorter treatment duration. Despite this advantage, the uptake of hypofractionation can be slow. Read More

Anticancer Res 2021 May;41(5):2523-2531

Department of Radiation Oncology, Toyota Memorial Hospital, Toyota, Japan.

Background/aim: To compare five radiotherapy methods for prostate cancer.

Patients And Methods: During 2005-2018, the data of patients with non-metastatic prostate cancer were retrospectively analysed. Patients were treated with high-dose-rate brachytherapy (HDR-BT); low-dose-rate brachytherapy (LDR-BT); or external-beam radiotherapy (EBRT), including conventionally fractionated radiotherapy (CFRT), moderate-hypofractionated radiotherapy (MHRT), and ultra-hypofractionated radiotherapy (UHRT). Read More

Radiat Oncol 2021 May 5;16(1):85. Epub 2021 May 5.

Department of Radiation Oncology, University of Torino, Città della Salute e della Scienza Hospital, Turin, Italy.

Background: the aim of this study is to perform an external validation for the Candiolo nomogram, a predictive algorithm of biochemical and clinical recurrences in prostate cancer patients treated by radical Radiotherapy, published in 2016 on the journal "Radiation Oncology".

Methods: 561 patients, treated by Radiotherapy with curative intent between 2003 and 2012, were classified according to the five risk-classes of the Candiolo nomogram and the three risk-classes of the D'Amico classification for comparison. Patients were treated with a mean prostatic dose of 77. Read More

Prostate Cancer Prostatic Dis 2021 May 4. Epub 2021 May 4.

Department of Urology, The Jikei University School of Medicine, Tokyo, Japan.

Background: The prognostic significance of PSA bounce following definitive radiation therapy remains controversial. To develop a sense of current opinion in this area, we performed a systematic search of the literature based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.

Methods: In January 2021, we systematically searched PubMed, the Cochrane library, and Scopus for studies that compared patients who had localized prostate cancer with or without PSA bounce after definitive radiation therapy. Read More

Urol Oncol 2021 Apr 29. Epub 2021 Apr 29.

Harvard Medical School, Boston, MA; Division of Urologic Surgery, Beth Israel Deaconess Medical Center, Boston, MA. Electronic address:

Purpose: The comparative effectiveness of surgery and radiation therapy for high-grade, clinically localized prostate cancer remains a seminal, open question in urologic oncology, with no randomized controlled trials to inform management. We therefore emulated a hypothetical target clinical trial of radical prostatectomy (RP) versus external beam radiotherapy (EBRT) for high-grade, clinically localized prostate cancer.

Materials And Methods: We conducted observational analyses using the National Cancer Database from 2006-2015 to emulate a target clinical trial in men 55-69 years with cT1-3cN0cM0, PSA<20 ng/mL, Gleason 8 to 10 prostate adenocarcinoma treated with RP or 75 to 81 Gy EBRT with androgen deprivation therapy (EBRT+ADT). Read More