Thursday, September 24, 2015

Scanning the Horizon: Advances in Radiation Treatment for Prostate Cancer - Page 3

“Only when you need to deliver a big radiobiological punch — like when the disease is aggressive — do you go with HDR, typically not for early-stage prostate cancer,” says Dorin Todor, director of the brachytherapy program at Virginia Commonwealth University’s Massey Cancer Center in Richmond. “I think this is where brachytherapy combined with EBRT really shines.

These rules of thumb may be changing, though. According to Todor, “There are ongoing clinical trials trying to prove the equivalence between LDR treatments and one large fraction of HDR for early-stage prostate cancer. Both have the advantage of being a ‘one-stop shop,’ but during HDR, radiation is delivered for only 10 to 15 minutes, as opposed to months or years.”

Radiation can also be delivered directly to bone metastases via radiopharmaceuticals — drugs that contain radioactive elements — in patients with advanced prostate cancer. These drugs are a particularly useful approach when multiple areas of bone are involved. They can shrink painful lesions and improve quality of life with less exposure to normal tissue.

In May 2013, the U.S. Food and Drug Administration approved Xofigo (radium-223) to treat bone metastases, and a study published in July 2013 in The New England Journal of Medicine showed that those receiving Xofigo had improved median overall survival (14.9 months) compared with those on placebo (11.3 months).

Although there are many radiation treatment options, with the guidelines continuing to evolve, Levy is pleased that he chose HDR brachytherapy for his localized tumor.

“I didn’t want to take any chances,” he says. “Two days of treatment meant that I would likely not have any problems down the road.”

Contribution by Yaribeth Galvez club memberships white coat

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