Mindless or mindful? Radiation oncologists' perspectives on the evolution of prostate cancer treatment

Alan Pollack, Eric M. Horwitz, Benjamin Movsas, Alexandra L. Hanlon

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

The evolution of radiation therapy treatment for prostate cancer has been striking over the last 10 years. Advances in brachytherapy (BT), external beam radiotherapy (EBRT), and the combination of EBRT + BT have led to improved biochemical and clinical results. This article describes these advances in the context of the treatment decision process. Key to this process is the assignment of patient risk, which is based on the results of conventional radiation dose and techniques. Using the 1992 AJCC palpation staging system, Gleason score, and pretreatment prostate-specific antigen, two different risk assessment algorithms were compared. Both gave comparable approximations of risk, although the single factor high-risk model was superior in differentiating those patients with the highest probability of failing treatment after radiotherapy. Such criteria are the foundation for treatment selection. Objective findings support BT alone or EBRT alone for low-risk patients, high-dose EBRT or EBRT + BT for intermediate-risk patients, and EBRT + androgen deprivation for high-risk patients. In summary, advances in radiation oncology have led to significant gains in prostate cancer control. Clinical prognostic factor-based patient selection is central to the optimization of outcome.

Original languageEnglish
Pages (from-to)337-349
Number of pages13
JournalUrologic Clinics of North America
Volume30
Issue number2
DOIs
StatePublished - May 1 2003
Externally publishedYes

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Prostatic Neoplasms
Radiotherapy
Brachytherapy
Therapeutics
Radiation Oncology
Radiation Oncologists
Neoplasm Grading
Palpation
Prostate-Specific Antigen
Patient Selection
Androgens
Radiation

ASJC Scopus subject areas

  • Urology

Cite this

Mindless or mindful? Radiation oncologists' perspectives on the evolution of prostate cancer treatment. / Pollack, Alan; Horwitz, Eric M.; Movsas, Benjamin; Hanlon, Alexandra L.

In: Urologic Clinics of North America, Vol. 30, No. 2, 01.05.2003, p. 337-349.

Research output: Contribution to journalArticle

Pollack, Alan ; Horwitz, Eric M. ; Movsas, Benjamin ; Hanlon, Alexandra L. / Mindless or mindful? Radiation oncologists' perspectives on the evolution of prostate cancer treatment. In: Urologic Clinics of North America. 2003 ; Vol. 30, No. 2. pp. 337-349.
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