Implementation of Germline Testing for Prostate Cancer: Philadelphia Prostate Cancer Consensus Conference 2019.

Purpose: Germline testing (GT) is a central feature of prostate cancer (PCA) treatment, management, and hereditary cancer assessment. Critical needs include optimized multigene testing strategies that incorporate evolving genetic data, consistency in GT indications and management, and alternate genetic evaluation models that address the rising demand for genetic services.

Methods: A multidisciplinary consensus conference that included experts, stakeholders, and national organization leaders was convened in response to current practice challenges and to develop a genetic implementation framework.

Patient Reported Outcomes in NRG Oncology RTOG 0938, Evaluating Two Ultrahypofractionated Regimens for Prostate Cancer.

Purpose: There is considerable interest in very short (ultrahypofractionated) radiation therapy regimens to treat prostate cancer based on potential radiobiological advantages, patient convenience, and resource allocation benefits. Our objective is to demonstrate that detectable changes in health-related quality of life measured by the bowel and urinary domains of the Expanded Prostate Cancer Index Composite (EPIC-50) were not substantially worse than baseline scores.

Methods And Materials: NRG Oncology's RTOG 0938 is a nonblinded randomized phase 2 study of National Comprehensive Cancer Network low-risk prostate cancer in which each arm is compared with a historical control.

Evaluation of planned treatment breaks during radiation therapy for anal cancer: update of RTOG 92-08.

Purpose: Radiation Therapy Oncology Group (RTOG) 92-08 began as a single arm, Phase II trial for patients with anal cancer consisting of radiation (RT) + 5-flourouracil + mitomycin-C with a mandatory 2-week break and was amended after completion to evaluate the same treatment regimen without a treatment break. Long-term efficacy and late toxicity reporting are the specific aims of this study.

Methods And Materials: Survivals were estimated with the Kaplan-Meier method.

Psychoeducational group intervention for wives of men with prostate cancer.

Objective: The effects of a 6-week psychoeducational group intervention on the distress, coping, personal growth, and marital communication of wives of men diagnosed with prostate cancer were evaluated using a randomized clinical trial.

Methods: Sixty wives completed measures prior to random assignment to either the psychoeducational group intervention or a no-treatment control group, and 1 month after completion of the group.

Results: No differences with regard to wives' general distress or cancer-specific distress were noted.

Free prostate-specific antigen improves prostate cancer detection in a high-risk population of men with a normal total PSA and digitalrectal examination.

Objectives: Uncertainty exists regarding optimal prostate cancer screening parameters for high-risk populations. The purpose of this study is to report the use of percent free prostate-specific antigen (PSA) as an indication for biopsy in men at increased risk for developing prostate cancer who have a normal digital rectal examination (DRE) and total PSA level between 2 and 4 ng/mL.

Methods: African-American men and men with at least one first-degree relative with prostate cancer are eligible for enrollment into the Prostate Cancer Risk Assessment Program (PRAP) at our institution.

Impact of target volume coverage with Radiation Therapy Oncology Group (RTOG) 98-05 guidelines for transrectal ultrasound guided permanent Iodine-125 prostate implants.

Purpose: Despite the wide use of permanent prostate implants for the treatment of early stage prostate cancer, there is no consensus for optimal pre-implant planning guidelines that results in maximal post-implant target coverage. The purpose of this study was to compare post-implant target volume coverage and dosimetry between patients treated before and after Radiation Therapy Oncology Group (RTOG) 98-05 guidelines were adopted using several dosimetric endpoints.

Materials And Methods: Ten consecutively treated patients before the adoption of the RTOG 98-05 planning guidelines were compared with ten consecutively treated patients after implementation of the guidelines.

Validation of a treatment policy for patients with prostate specific antigen failure after three-dimensional conformal prostate radiation therapy.

Background: The objective of this report was to present an outcomes validation for the Fox Chase Cancer Center (FCCC) management policy for patients who demonstrate prostate specific antigen (PSA) failure after receiving three-dimensional conformal radiation therapy (3DCRT).

Methods: Eligible patients included 248 men with T1-T3N0M0 prostate carcinoma who demonstrated PSA failure (according to the American Society for Therapeutic Radiology and Oncology definition) after completing definitive 3DCRT alone or with androgen deprivation (AD) therapy between May 1989 and November 1997. The primary endpoint evaluated was freedom from distant metastasis (FDM).

Late morbidity profiles in prostate cancer patients treated to 79-84 Gy by a simple four-field coplanar beam arrangement.

Purpose: To describe the frequency and magnitude of late GI and GU morbidity in prostate cancer patients treated to high dose levels with a simple three-dimensional conformal technique.

Methods And Materials: A total of 156 intermediate- and high-risk patients were treated between January 1, 1992 and February 28, 1999 with a simple four-field three-dimensional conformal technique to 79-84 Gy. All patients were treated with a four-field conformal technique; the prostate received 82 Gy and the seminal vesicles and periprostatic tissue 46 Gy.

Biochemical failure rates in prostate cancer patients predicted to have biologically insignificant tumors treated with three-dimensional conformal radiation therapy.

Purpose: It has been suggested that patients with prostate cancer meeting the following criteria have pathologically determined potentially biologically insignificant (PBI) tumor and therefore should be considered for observation: clinical stage T1c, PSA density <0.1 ng/mL per gram, absence of Gleason pattern 4 or 5, three or fewer biopsy cores positive for tumor, and tumor involvement of no more than 50% of any core. We compared the biochemical control rates in men meeting the above criteria to those of all low-risk patients (clinical T1c, PSA View Article and Find Full Text PDF

Advantages of using noncoplanar vs. axial beam arrangements when treating prostate cancer with intensity-modulated radiation therapy and the step-and-shoot delivery method.

Purpose: The focus of this work was to compare noncoplanar beam arrangements used for intensity-modulated radiation therapy (IMRT) step-and-shoot delivery to several axial beam arrangements used in the treatment of clinically localized prostate cancer.

Methods And Materials: A 5-field coronal crossfire beam arrangement was developed for IMRT with the objective of improving upon the rectal and bladder dose-volume histograms obtained using 5-, 7-, and 9-field axial beam arrangements. Additionally, a modified 7-field crossfire technique was developed yielding improved dose distributions.

Relationship between prostate volume, prostate-specific antigen nadir, and biochemical control.

Purpose: In patients treated with definitive three-dimensional conformal radiotherapy (3D-CRT) for localized prostatic adenocarcinoma, we sought to evaluate the relationship between pretreatment prostate gland volume and posttreatment prostate-specific antigen (PSA) nadir, as well as the relationship of prostate volume and PSA nadir with biochemical control (bNED). Two subgroups were studied: favorable (PSA <10 ng/mL, Gleason score 2-6, and T1-T2A) and unfavorable (one or more: PSA >/=10 ng/mL, Gleason score 7-10, T2B-T3).

Materials And Methods: A total of 655 men (n = 271 favorable and 384 unfavorable) were treated with 3D-CRT alone between May 1989 and November 1997.