What is the best way to radiate the prostate in 2016?

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• 作者：Dominic H. Moon ; M.D.^a ; Jason A. Efstathiou ; M.D. ; D.Phil.^b ; Ronald C. Chen ; M.D. ; M.P.H.^a ; ^c ; ^{ronald_chen@med.unc.edu}
• 关键词：Prostate cancer ; Radiation therapy ; Intensity-modulated radiation therapy (IMRT) ; Image-guided radiation therapy (IGRT) ; Proton therapy ; Hypofractionation ; Stereotactic body radiation therapy (SBRT) ; Brachytherapy
• 刊名：Urologic Oncology: Seminars and Original Investigations
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：35
• 期：2
• 页码：59-68
• 全文大小：281 K
• 卷排序：35

文摘

Intensity-modulated radiation therapy with image guidance is considered standard of care for definitive prostate cancer radiation therapy. Brachytherapy is used as monotherapy for lower-risk patients whereas its combination with external beam radiation therapy is used for higher-risk patients. Proton therapy has been shown to be safe and effective for the treatment of prostate cancer, but additional studies would be required to determine whether it leads to improvement in clinical outcomes compared to intensity-modulated radiation therapy. Hypofractionated radiation therapy delivers larger daily radiation dose, reducing the overall treatment time and possibly cost, and it has been shown to be noninferior to conventional fractionation. Stereotactic body radiation therapy is an extreme form of hypofractionation, delivering treatment in a total of 3 to 5 sessions, with growing evidence for its use in low- to intermediate-risk prostate cancer patients.