What is the efficacy of surgery vs radiotherapy in prostate cancer?
Best insight from top research papers
Surgery and radiotherapy are both common treatments for prostate cancer. Studies suggest that early salvage radiotherapy (eSRT) is as effective as adjuvant radiotherapy (ART) and potentially less toxic, making eSRT the standard of care . In metastatic disease, the role of radiation therapy (RT) in extending survival is less established, but localized RT in the presence of oligometastatic disease shows promise . Comparing robot-assisted Radical Prostatectomies (rRP) and robot-assisted stereotactic body radiotherapy (rSBRT) in France, rSBRT yielded more quality-adjusted life years, although rRP was more cost-saving . Whole pelvic radiotherapy (WPRT) significantly improves biochemical failure-free survival (BFFS) and progression-free survival (PFS) for localized prostate cancer compared to prostate-only radiotherapy (PORT), but increases gastrointestinal toxicity . Overall, the choice between surgery and radiotherapy depends on various factors, including the stage of the cancer and individual patient preferences.
Answers from top 5 papers
More filters
| Papers (5) | Insight |
|---|---|
| Not addressed in the paper. | |
| Robot-assisted stereotactic body radiotherapy (rSBRT) showed higher efficacy over 10 years compared to robot-assisted Radical Prostatectomy (rRP) in terms of quality-adjusted life years (QALYs). | |
6 Citations | Not addressed in the paper. |
4 Citations | Comparative assessment of online patient education materials suggests that radiotherapy videos on YouTube for prostate cancer have higher quality and less misinformation compared to surgery videos. |
| Postoperative radiotherapy, specifically early salvage radiotherapy (eSRT), is considered as effective as adjuvant radiotherapy (ART) in prostate cancer treatment, potentially offering lower toxicity. |
Related Questions
What type of radiotherapy is used in prostate cancer?5 answersRadiotherapy is an attractive treatment option for prostate cancer, and there have been significant advances in technology and imaging capabilities that have transformed radiotherapy for this disease. These advances have allowed for dose escalation and the adoption of hypofractionation, which is the delivery of higher doses of radiation in fewer treatment sessions. In addition, the integration of magnetic resonance imaging (MRI) and improved precision in dose delivery have enabled the targeting of intraprostatic tumor lesions that were previously not considered in conventional radiotherapy. There is ongoing research to assess the efficacy of ultra-hypofractionation compared to standard fractionation, and the role of partial gland dose escalation/tumor boosting is still evolving. Molecular imaging is also expected to play a crucial role in assessing the biology of the disease and personalizing radiotherapy treatment decisions.
What is the impact of prostate surgery on the quality of life of patients with prostate cancer?4 answersProstate surgery, specifically radical prostatectomy, has significant impacts on the quality of life of patients with prostate cancer. These impacts can be physical, emotional, and psychosocial in nature. Physical consequences include momentary inability to drive and erectile dysfunction. Emotional impacts include anxiety about the diagnosis and treatment, as well as depression. Psychosocial impacts include feelings of impotence, failure, and loss of status in society. In terms of specific outcomes, continence and biochemical remission are important parameters for patients' quality of life. Erectile function is difficult to maintain post-surgery and has less impact on quality of life. Complications and surgical margins have varying impacts on quality of life. The psychosocial domains of quality of life are more strongly affected than the physical domains. Mental and social wellbeing are significantly impacted, leading to uncertainty about the future and emotional repercussions on relationships. Overall, radical treatments have a considerable impact on the mental, social, and physical wellbeing of patients, highlighting the need for support and interventions to improve quality of life.
How effective is prostate cancer treatment in people of Black origin?5 answersProstate cancer treatment in people of Black origin has shown mixed effectiveness. Several studies have demonstrated that Black men who receive treatment experience a more pronounced decrease in prostate cancer-specific death, but there remains a large disparity in all-cause mortality. However, there is a higher risk of death resulting from comorbidities in Black men, given their higher rates of cardiovascular disease and diabetes, which are complicated by the use of androgen-deprivation therapy. Additionally, Black men have been found to have specific molecular characteristics in prostate cancer, which may impact the effectiveness of new hormonal therapies. Structural aspects, such as practice segregation and racial composition, have also been associated with disparities in treatment patterns, with Black patients receiving less definitive treatment compared to White patients. Overall, more research is needed to fully understand the effectiveness of prostate cancer treatment in people of Black origin and to develop interventions to mitigate disparities.
How different is prostate cancer in Whites and Blacks?4 answersProstate cancer in Whites and Blacks differs significantly. Black men have a higher incidence of prostate cancer and are more likely to die from the disease compared to White men. Racial disparities in prostate cancer exist at every stage of the cancer continuum. Genetic alterations and DNA methylation in prostate cancer vary between Blacks and Whites. Blacks have more genes with frequent alterations, while Whites have differentially methylated genes compared to Blacks. The burden of prostate cancer is disproportionately distributed across racial groups, with African Americans having a higher incidence and mortality rates. The cause of this disparity is multifactorial and influenced by social and environmental factors. Puberty may be a critical window of increased susceptibility to prostate carcinogenesis, contributing to the racial differences in prostate cancer burden. Screening policies may need to be more aggressive for Black men to address the higher risk of metastatic progression.
What are the dose and fraction used for prostate radiotherapy?5 answersExternal radiotherapy for prostate cancer can be delivered using different dose and fractionation regimens. The recommended technique is intensity-modulated radiotherapy combined with prostate image-guided radiotherapy, with a total dose of 74 to 80Gy delivered in standard fractionation of 2Gy per fraction. Moderate hypofractionation is also a standard of therapy, with a total dose of 60Gy delivered at a rate of 3Gy per fraction over 4 weeks. Extreme hypofractionation using stereotactic body radiotherapy can be considered as a therapeutic option, with a dose of 35 to 40Gy delivered in five fractions. Another study mentioned the use of high-dose per fraction radiotherapy delivered as stereotactic body radiotherapy, with a dose of 26 Gy delivered in two weekly fractions. These different dose and fractionation regimens aim to achieve effective treatment outcomes while minimizing toxicity and maintaining quality of life for patients with prostate cancer.
Roles of radiotherapy in the treatment of cancer?3 answersRadiotherapy plays various roles in the treatment of cancer. It is commonly used as an adjuvant treatment in combination with surgery, especially for solid tumors like breast cancer. It can also be used in the neoadjuvant setting in combination with chemotherapy for certain cancers such as rectal cancer. In some cases, radiotherapy can be the definitive treatment, avoiding the need for surgery and enabling organ preservation, such as in laryngeal cancer. Additionally, radiotherapy can provide excellent palliation for late-stage cancer, such as bone metastasis. Radiotherapy can be delivered at various energy levels and with different subatomic particles, using complex imaging techniques to improve precision and minimize damage to normal tissues. Furthermore, radiotherapy can be combined with immunotherapy to enhance the vulnerability of irradiated cells to the immune system. Exercise interventions following radiotherapy can help reduce side effects and improve patients' quality of life. Finally, radiotherapy can be harnessed to enhance the clinical efficacy of targeted anticancer agents by activating cytotoxic signaling pathways and abrogating cytoprotective mechanisms.