GEC/ESTRO recommendations on high dose rate afterloading brachytherapy for localised prostate cancer: An update
TL;DR: HDRBT in prostate cancer can be practiced effectively and safely within the context of these guidelines with the main indication being for dose escalation with external beam.
About: This article is published in Radiotherapy and Oncology.The article was published on 2013-06-01 and is currently open access. It has received 234 citations till now. The article focuses on the topics: Brachytherapy.
Citations
More filters
Harvard University1, University of Sheffield2, University of Warwick3, Vita-Salute San Raffaele University4, University of Bern5, St James's University Hospital6, Katholieke Universiteit Leuven7, University of Aberdeen8, Aberdeen Royal Infirmary9, Cardiff University10, Netherlands Cancer Institute11, Erasmus University Rotterdam12
TL;DR: The 2016 EAU-STRO-IOG Prostate Cancer (PCa) Guidelines present updated information on the diagnosis, and treatment of clinically localised prostate cancer and reflect the multidisciplinary nature of PCa management.
2,767 citations
Cites background from "GEC/ESTRO recommendations on high d..."
...HDR brachytherapy as monotherapy has been pioneered in a small number of centres with low published toxicity and high biochemical control rates but currently mature data are not available on the optimal treatment schedule [88]....
[...]
Katholieke Universiteit Leuven1, University of Sheffield2, Charité3, Medical University of Vienna4, University of Bologna5, Vita-Salute San Raffaele University6, University of Manchester7, University of Lugano8, Netherlands Cancer Institute9, Monash University10, St James's University Hospital11, Erasmus University Medical Center12, University of Aberdeen13, Aberdeen Royal Infirmary14, Wrightington, Wigan and Leigh NHS Foundation Trust15, Cardiff University16, University of Amsterdam17, University of Lyon18, Utrecht University19, University of Liverpool20
TL;DR: The 2020 EAU-EANM-ESTRO-ESUR-SIOG guidelines on PCa guidelines summarise the most recent findings and advice for their use in clinical practice and include a strong recommendation to consider moderate hypofractionation in intermediate-risk patients.
1,369 citations
TL;DR: The ESTRO consensus on CT/MRI based CTV delineation for primary RT of localized prostate cancer, endorsed by a broad base of the radiation oncology community, is presented to improve consistency and reliability.
128 citations
TL;DR: Prospective reports comparing HDR-BT and LDR-BT to each other or to other treatment options (such as external beam radiotherapy (EBRT) or surgery) suggest similar outcomes.
Abstract: Brachytherapy (BT), using low-dose-rate (LDR) permanent seed implantation or high-dose-rate (HDR) temporary source implantation, is an acceptable treatment option for select patients with prostate cancer of any risk group. The benefits of HDR-BT over LDR-BT include the ability to use the same source for other cancers, lower operator dependence, and - typically - fewer acute irritative symptoms. By contrast, the benefits of LDR-BT include more favourable scheduling logistics, lower initial capital equipment costs, no need for a shielded room, completion in a single implant, and more robust data from clinical trials. Prospective reports comparing HDR-BT and LDR-BT to each other or to other treatment options (such as external beam radiotherapy (EBRT) or surgery) suggest similar outcomes. The 5-year freedom from biochemical failure rates for patients with low-risk, intermediate-risk, and high-risk disease are >85%, 69-97%, and 63-80%, respectively. Brachytherapy with EBRT (versus brachytherapy alone) is an appropriate approach in select patients with intermediate-risk and high-risk disease. The 10-year rates of overall survival, distant metastasis, and cancer-specific mortality are >85%, <10%, and <5%, respectively. Grade 3-4 toxicities associated with HDR-BT and LDR-BT are rare, at <4% in most series, and quality of life is improved in patients who receive brachytherapy compared with those who undergo surgery.
108 citations
TL;DR: MRI-guided prostate brachytherapy has significant potential to identify prostate subvolumes and dominant lesions to allow for dose administration reflecting the differential risk of recurrence.
96 citations
Cites methods from "GEC/ESTRO recommendations on high d..."
...This approach can be used for boosting the entire gland or subvolumes in combination with EBRT, as well as for HDR monotherapy.(29) Furthermore, multiparametric MRI has emerged as the standard imaging modality to evaluate recurrent disease inmenwith a rising prostate-specific antigen (PSA) level following prostate cancer treatment and has therefore also been explored for MRI-guided salvage brachytherapy....
[...]
References
More filters
TL;DR: The guidelines have been updated and level of evidence/grade of recommendation added to the text enables readers to better understand the quality of the data forming the basis of the recommendations.
3,209 citations
1,882 citations
TL;DR: It is expected that the therapeutic ratio including target coverage and sparing of organs at risk can be significantly improved, if radiation dose is prescribed to a 3D image-based CTV taking into account dose volume constraints for OAR.
1,398 citations
"GEC/ESTRO recommendations on high d..." refers background in this paper
...In this setting there is uncertainty in translating LDR constraints to an EQD2 and data from the experience in gynaecological brachytherapy should be considered also [47]....
[...]
TL;DR: Current evidence is insufficient to warrant widespread population-based screening by prostate-specific antigen (PSA) for PCa, and these EAU guidelines on PCa summarise the most recent findings and put them into clinical practice.
1,310 citations
TL;DR: The concept of integrating physical and biological conformality in multidimensional conformal radiotherapy (MD-CRT) is explored and the concept of "biological target volume" (BTV) is proposed and hypothesized that BTV can be derived from biological images and that their use may incrementally improve target delineation and dose delivery.
Abstract: Purpose: The goals of this study were to survey and summarize the advances in imaging that have potential applications in radiation oncology, and to explore the concept of integrating physical and biological conformality in multidimensional conformal radiotherapy (MD-CRT). Methods and Materials: The advances in three-dimensional conformal radiotherapy (3D-CRT) have greatly improved the physical conformality of treatment planning and delivery. The development of intensity-modulated radiotherapy (IMRT) has provided the “dose painting” or “dose sculpting” ability to further customize the delivered dose distribution. The improved capabilities of nuclear magnetic resonance imaging and spectroscopy, and of positron emission tomography, are beginning to provide physiological and functional information about the tumor and its surroundings. In addition, molecular imaging promises to reveal tumor biology at the genotype and phenotype level. These developments converge to provide significant opportunities for enhancing the success of radiotherapy. Results: The ability of IMRT to deliver nonuniform dose patterns by design brings to fore the question of how to “dose paint” and “dose sculpt”, leading to the suggestion that “biological” images may be of assistance. In contrast to the conventional radiological images that primarily provide anatomical information, biological images reveal metabolic, functional, physiological, genotypic, and phenotypic data. Important for radiotherapy, the new and noninvasive imaging methods may yield three-dimensional radiobiological information. Studies are urgently needed to identify genotypes and phenotypes that affect radiosensitivity, and to devise methods to image them noninvasively. Incremental to the concept of gross, clinical, and planning target volumes (GTV, CTV, and PTV), we propose the concept of “biological target volume” (BTV) and hypothesize that BTV can be derived from biological images and that their use may incrementally improve target delineation and dose delivery. We emphasize, however, that much basic research and clinical studies are needed before this potential can be realized. Conclusions: Whereas IMRT may have initiated the beginning of the end relative to physical conformality in radiotherapy, biological imaging may launch the beginning of a new era of biological conformality. In combination, these approaches constitute MD-CRT that may further improve the efficacy of cancer radiotherapy in the new millennium. © 2000 Elsevier Science Inc. Biological imaging, Conformal radiotherapy.
918 citations
"GEC/ESTRO recommendations on high d..." refers background in this paper
...Future developments of HDRBT will include the definition of biological subvolumes within the CTV selecting potential areas of radioresistance requiring higher doses [51]....
[...]