Advances in Prostate Cancer Radiotherapy

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Therapy".

Deadline for manuscript submissions: closed (20 July 2023) | Viewed by 4837

Special Issue Editors


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Guest Editor
Department of Radiation Medicine, Medstar Georgetown University Hospital, Washington, DC 20007, USA
Interests: prostate cancer; radiation therapy

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Guest Editor
Department of Radiation Oncology, The Valley Health Hospital, Ridgewood, NJ 07450, USA
Interests: prostate cancer; SBRT

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Guest Editor
Department of Radiation Oncology, Wellstar Kennestone Hospital, Marietta, GA 30060, USA
Interests: prostate cancer; radiotherapy; SBRT

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Guest Editor
Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
Interests: prostate cancer; radiotherapy; SBRT

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Guest Editor
Department of Radiation Oncology, Perlmutter Cancer Center, New York University Langone Hospital—Long Island, New York, NY 10023, USA
Interests: prostate cancer; radiotherapy
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Department of Radiation Oncology, Perlmutter Cancer Center, New York University Langone Hospital—Long Island, New York, NY 10023, USA
Interests: prostate cancer; SBRT
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Since the advent of routine PSA screening, the majority of prostate cancers are diagnosed when confined to the prostate and may be treated with curative intent. Non-operative treatment using radiation therapy has been well established as a primary definitive treatment modality due to its equivalence in terms of efficacy as compared to radical prostatectomy. Over the past several decades, radiation technology has made significant advances in treatment delivery through the use of inverse planning and enhanced stereotactic image guidance. This has resulted in greater treatment precision and more favorable outcomes due to tumor dose escalation, as well as decreased treatment-related morbidity. During this time, stereotactic body radiotherapy (SBRT) or ultrahypofractionated treatment courses have emerged as safe and effective alternatives to longer conventional courses of radiation treatment. This Special Issue will focus on the evolving role of SBRT in the treatment of prostate cancer, including the influence of biological imaging, dose escalation, image guidance, and modulation of androgen signaling.

Dr. Sean P. Collins
Dr. Thomas Kole
Dr. Olusola Obayomi-Davies
Dr. Nima Aghdam
Dr. Jonathan W. Lischalk
Dr. Michael C. Repka
Guest Editors

Manuscript Submission Information

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Keywords

  • prostate cancer
  • radiotherapy
  • biological imaging
  • dose escalation
  • image guidance
  • androgen signaling

Published Papers (3 papers)

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Research

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13 pages, 420 KiB  
Article
Radiobiological Meta-Analysis of the Response of Prostate Cancer to Different Fractionations: Evaluation of the Linear–Quadratic Response at Large Doses and the Effect of Risk and ADT
by Juan Pardo-Montero, Isabel González-Crespo, Antonio Gómez-Caamaño and Araceli Gago-Arias
Cancers 2023, 15(14), 3659; https://doi.org/10.3390/cancers15143659 - 18 Jul 2023
Cited by 1 | Viewed by 924
Abstract
The purpose of this work was to investigate the response of prostate cancer to different radiotherapy schedules, including hypofractionation, to evaluate potential departures from the linear–quadratic (LQ) response, to obtain the best-fitting parameters for low-(LR), intermediate-(IR), and high-risk (HR) prostate cancer and to [...] Read more.
The purpose of this work was to investigate the response of prostate cancer to different radiotherapy schedules, including hypofractionation, to evaluate potential departures from the linear–quadratic (LQ) response, to obtain the best-fitting parameters for low-(LR), intermediate-(IR), and high-risk (HR) prostate cancer and to investigate the effect of ADT on the radiobiological response. We constructed a dataset of the dose–response containing 87 entries/16,536 patients (35/5181 LR, 32/8146 IR, 20/3209 HR), with doses per fraction ranging from 1.8 to 10 Gy. These data were fit to tumour control probability models based on the LQ model, linear–quadratic–linear (LQL) model, and a modification of the LQ (LQmod) model accounting for increasing radiosensitivity at large doses. Fits were performed with the maximum likelihood expectation methodology, and the Akaike information criterion (AIC) was used to compare the models. The AIC showed that the LQ model was superior to the LQL and LQmod models for all risks, except for IR, where the LQL model outperformed the other models. The analysis showed a low α/β for all risks: 2.0 Gy for LR (95% confidence interval: 1.7–2.3), 3.4 Gy for IR (3.0–4.0), and 2.8 Gy for HR (1.4–4.2). The best fits did not show proliferation for LR and showed moderate proliferation for IR/HR. The addition of ADT was consistent with a suppression of proliferation. In conclusion, the LQ model described the response of prostate cancer better than the alternative models. Only for IR, the LQL model outperformed the LQ model, pointing out a possible saturation of radiation damage with increasing dose. This study confirmed a low α/β for all risks. Full article
(This article belongs to the Special Issue Advances in Prostate Cancer Radiotherapy)
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11 pages, 2222 KiB  
Article
Genomic Prostate Score: A New Tool to Assess Prognosis and Optimize Radiation Therapy Volumes and ADT in Intermediate-Risk Prostate Cancer
by Yazid Belkacemi, Kamel Debbi, Gabriele Coraggio, Jérome Bendavid, Maya Nourieh, Nhu Hanh To, Mohamed Aziz Cherif, Carolina Saldana, Alexandre Ingels, Alexandre De La Taille and Gokoulakrichenane Loganadane
Cancers 2023, 15(3), 945; https://doi.org/10.3390/cancers15030945 - 02 Feb 2023
Cited by 1 | Viewed by 1522
Abstract
Genomic classifiers such as the Genomic Prostate Score (GPS) could help to personalize treatment for men with intermediate-risk prostate cancer (I-PCa). In this study, we aimed to evaluate the ability of the GPS to change therapeutic decision making in I-PCa. Only patients in [...] Read more.
Genomic classifiers such as the Genomic Prostate Score (GPS) could help to personalize treatment for men with intermediate-risk prostate cancer (I-PCa). In this study, we aimed to evaluate the ability of the GPS to change therapeutic decision making in I-PCa. Only patients in the intermediate NCCN risk group with Gleason score 3 + 4 were considered. The primary objective was to assess the impact of the GPS on risk stratification: NCCN clinical and genomic risk versus NCCN clinical risk stratification alone. We also analyzed the predictive role of the GPS for locally advanced disease (≥pT3+) and the potential change in treatment strategy. Thirty patients were tested for their GPS between November 2018 and March 2020, with the median age being 70 (45–79). Twenty-three patients had a clinical T1 stage. Eighteen patients were classified as favorable intermediate risk (FIR) based on the NCCN criteria. The median GPS score was 39 (17–70). Among the 23 patients who underwent a radical prostatectomy, Gleason score 3 + 4 was found in 18 patients. There was a significant correlation between the GPS and the percentage of a Gleason grade 4 or higher pattern in the surgical sample: correlation coefficient r = 0.56; 95% CI = 0.2–0.8; p = 0.005. In this study, the GPS combined with NCCN clinical risk factors resulted in significant changes in risk group. Full article
(This article belongs to the Special Issue Advances in Prostate Cancer Radiotherapy)
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Review

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14 pages, 1148 KiB  
Review
MRI-Guided Radiation Therapy for Prostate Cancer: The Next Frontier in Ultrahypofractionation
by Cecil M. Benitez, Michael L. Steinberg, Minsong Cao, X. Sharon Qi, James M. Lamb, Amar U. Kishan and Luca F. Valle
Cancers 2023, 15(18), 4657; https://doi.org/10.3390/cancers15184657 - 21 Sep 2023
Cited by 1 | Viewed by 1553
Abstract
Technological advances in MRI-guided radiation therapy (MRIgRT) have improved real-time visualization of the prostate and its surrounding structures over CT-guided radiation therapy. Seminal studies have demonstrated safe dose escalation achieved through ultrahypofractionation with MRIgRT due to planning target volume (PTV) margin reduction and [...] Read more.
Technological advances in MRI-guided radiation therapy (MRIgRT) have improved real-time visualization of the prostate and its surrounding structures over CT-guided radiation therapy. Seminal studies have demonstrated safe dose escalation achieved through ultrahypofractionation with MRIgRT due to planning target volume (PTV) margin reduction and treatment gating. On-table adaptation with MRI-based technologies can also incorporate real-time changes in target shape and volume and can reduce high doses of radiation to sensitive surrounding structures that may move into the treatment field. Ongoing clinical trials seek to refine ultrahypofractionated radiotherapy treatments for prostate cancer using MRIgRT. Though these studies have the potential to demonstrate improved biochemical control and reduced side effects, limitations concerning patient treatment times and operational workflows may preclude wide adoption of this technology outside of centers of excellence. In this review, we discuss the advantages and limitations of MRIgRT for prostate cancer, as well as clinical trials testing the efficacy and toxicity of ultrafractionation in patients with localized or post-prostatectomy recurrent prostate cancer. Full article
(This article belongs to the Special Issue Advances in Prostate Cancer Radiotherapy)
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