Prostate Flashcards
(11 cards)
Summarise the findings from PrOTECT
RT vs Surgery vs observation: Low to Int risk
RT+ADT and Prostatectomy no difference in mortality
Surgery has worse sexual dysfunction and urinary incontince
RT+ADT will lead to ED eventually
Active surveillance 55% all eventually need treatment in 10-15 years
RT has slightly worse GI effect, very mild faecal incontince
What is the SPPORT trial?
WPRT + ADT (6 months) + prostate bed RT
70Gy to prostate bed
54Gy to pelvis (optional)
GI and GU toxicity not worsened
Improved FFP compared to prostate bed alone without ADT
What are the prostate hypofractionation trials?
CHHiP (mostly int risk, 60Gy/20# non inferior)
PROFIT (int risk, 60Gy/20# non inferior, no ADT)
PCS 5 (for high risk, 68Gy/25# + 45Gy SIB WPRT, toxicity not worsen at 2 year, unable to show non-inferiority)
What is the trial for SBRT for low to int risk prostate cancer?
PACE B trial
SBRT 36.25Gy/5# to PTV, 40Gy to CTV SIB
No ADT
No SpaceOA
What is the trial for SBRT for low to int risk prostate cancer?
PACE B trial
SBRT 36.25Gy/5# to PTV, 40Gy to CTV SIB
No ADT
No SpaceOA
What are the trials for radiation to primary in metastatic setting?
PEACE-1
Docetaxel + ADT then RT + Abi improves survival
STOPCAP M1
Meta-analysis of STAMPEDE and HORRAD
< 5 bone Mets, RT to prostate improves survival
What is the comparative treatment study for low to intermediate prostate cancer?
CEASAR prospective study
Active surveillance vs IMRT (78Gy) no ADT, surgery or brachytherapy
Sexual function, Urinary incontinence, Urinary obstruction, Bowel function
5 yrs - EBRT all similar, RP worse SE, UI but better obstruction, Brachy SE similar, all worse
10 yrs (2024) - most differences attenuate, RP incontinence persists
Mostly GS 6, T1c
What is the difference between Protect study vs CEASAR?
Protect uses ADT with RT
CTV Margins for nodal mets?
Usually not required as they rarely has extraprostatic extension
