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[Stereotactic radiotherapy for prostate cancer].

L Quero1, C Hennequin1

  • 1Service de cancérologie-radiothérapie, hôpital Saint-Louis, 1, avenue Claude-Vellefeaux, 75475 Paris, France; Université Paris-Diderot Paris VII, 1, avenue Claude-Vellefeaux, 75475 Paris, France.

Cancer Radiotherapie : Journal De La Societe Francaise De Radiotherapie Oncologique
|June 25, 2014
PubMed
Summary

Stereotactic radiotherapy shows promise for prostate cancer treatment, with acute toxicity comparable to conventional methods. Further research is needed to fully assess long-term efficacy and late toxicity in diverse patient groups.

Keywords:
Cancer de prostateProstate cancerRadiothérapie stéréotaxiqueStereotactic radiotherapy

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Area of Science:

  • Oncology
  • Radiation Oncology
  • Urologic Oncology

Background:

  • Stereotactic radiotherapy (SRT) is an emerging treatment modality for prostate cancer.
  • Current evidence primarily consists of retrospective series and limited prospective phase II trials.
  • Patient cohorts are often small with short follow-up periods.

Purpose of the Study:

  • To evaluate the efficacy and toxicity of stereotactic radiotherapy in prostate cancer management.
  • To compare SRT outcomes with conventional radiotherapy based on available data.
  • To identify areas requiring further investigation, particularly for intermediate and high-risk groups.

Main Methods:

  • Review of retrospective series and prospective phase II trials involving stereotactic radiotherapy for prostate cancer.
  • Analysis of treatment protocols, typically involving 33-38 Gy in 4-5 fractions.
  • Assessment of reported acute and late toxicity, as well as biochemical control rates.

Main Results:

  • Acute toxicity appears similar to conventional radiotherapy.
  • Late toxicity data is limited due to short follow-up; radiation-induced proctitis rates seem low.
  • Urinary toxicity evaluation is inconsistent, with some series reporting high rates of grade 3+ complications.
  • Biochemical controls in favorable-risk patients (D'Amico criteria) are comparable to conventional irradiation, but long-term data is pending.
  • Data for intermediate and high-risk prostate cancer patients treated with SRT is immature.

Conclusions:

  • Stereotactic radiotherapy may significantly alter prostate cancer management.
  • Ongoing phase III trials are crucial to validate preliminary findings and establish definitive conclusions on efficacy and safety.
  • Further long-term data is necessary to fully understand the role of SRT, especially in higher-risk prostate cancer populations.