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Kwok JK, Martell K, Sia M, Bhindi B, Abedin T, Lu S, Quon HC. Local Prostate Radiation Therapy and Symptomatic Local Events in De Novo Metastatic Prostate Cancer. Pract Radiat Oncol 2023; 13:e61-e67. [PMID: 36064183 DOI: 10.1016/j.prro.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 07/29/2022] [Accepted: 08/17/2022] [Indexed: 01/10/2023]
Abstract
PURPOSE Local prostate radiation therapy (LPRT) for low-burden metastatic prostate cancer (mPCa) improves overall survival and is the standard of care. The role of LPRT in reducing symptomatic local events (SLE) remains unclear. We aimed to identify SLE risk factors and to evaluate the association between LPRT and SLE in mPCa. METHODS AND MATERIALS We conducted a retrospective, population-based cohort study of patients initially diagnosed with mPCa between 2005 and 2016 in a cancer registry. Patient, tumor, and treatment characteristics were obtained from chart review and the cancer registry. The coprimary endpoints were genitourinary (GU) and gastrointestinal (GI) SLE, identified by physician billing claims between 2004 and 2017 for diagnostic or therapeutic procedures potentially related to GU and GI SLE. The effect of LPRT on SLE was evaluated using both recurrent event (Andersen-Gill model) and time-to-first-event sequential landmark analyses. Risk factors for SLE were assessed by multivariable Cox regression. LPRT was defined as ≥40 Gy within 1 year of diagnosis. Metastatic burden was defined per the STAMPEDE trial. RESULTS Of 1363 patients, 46 (3.4%) received LPRT. Median follow-up was 27.3 and 28.9 months in the control and LPRT groups, respectively. LPRT was associated with less recurrent GU SLE (hazard ratio [HR], 0.34; 95% confidence interval [CI], 0.17-0.67; P = .002), upper tract obstruction (HR, 0.20; 95% CI, 0.05-0.84; P = .03), and cystoscopy (HR, 0.38; 95% CI, 0.15-0.96; P = .04). Metastatic burden was not associated with SLE. CONCLUSIONS LPRT in mPCa was associated with less recurrent GU SLE, specifically for upper tract obstruction and cystoscopy.
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Affiliation(s)
- Jaime Kirsten Kwok
- Tom Baker Cancer Centre, Calgary, Alberta, Canada; Division of Radiation Oncology, Department of Oncology, University of Calgary, Calgary, Alberta, Canada
| | - Kevin Martell
- Tom Baker Cancer Centre, Calgary, Alberta, Canada; Division of Radiation Oncology, Department of Oncology, University of Calgary, Calgary, Alberta, Canada
| | - Michael Sia
- Tom Baker Cancer Centre, Calgary, Alberta, Canada; Division of Radiation Oncology, Department of Oncology, University of Calgary, Calgary, Alberta, Canada
| | - Bimal Bhindi
- Division of Urology, Department of Surgery, University of Calgary and Southern Alberta Institute of Urology, Calgary, Alberta, Canada
| | | | - Shuang Lu
- Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada
| | - Harvey Charles Quon
- Tom Baker Cancer Centre, Calgary, Alberta, Canada; Division of Radiation Oncology, Department of Oncology, University of Calgary, Calgary, Alberta, Canada.
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Poon DMC, Chan CK, Chan TW, Cheung FY, Ho LY, Kwong PWK, Lee EKC, Leung AKC, Leung SYL, So HS, Tam PC, Ma WK. Hong Kong Urological Association-Hong Kong Society of Uro-Oncology consensus statements on the management of advanced prostate cancer-2019 Updates. Asia Pac J Clin Oncol 2021; 17 Suppl 3:12-26. [PMID: 33860645 DOI: 10.1111/ajco.13580] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND To update the Hong Kong Urological Association-Hong Kong Society of Uro-Oncology consensus statements on the management of advanced prostate cancer, the same panelists as in the previous consensus panel held a series of meetings to discuss updated clinical evidence and experiences. METHODS The previous consensus statements were retained, deleted, or revised, and new statements were added. At the final meeting, all statements were reviewed and amended as appropriate, followed by panel voting. RESULTS There were significant changes and additions to the previous consensus statements, primarily driven by the advances in androgen receptor signaling inhibitors, treatment sequencing in metastatic castration-resistant prostate cancer, and increasing recognition of oligometastatic prostate cancer since the introduction of prostate-specific membrane antigen positron emission tomography. In this update, a total of 59 consensus statements were accepted and established. CONCLUSIONS The consensus panel updated consensus statements on the management of advanced prostate cancer, aiming to allow physicians in the region to keep abreast of the recent evidence on optimal clinical practices.
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Affiliation(s)
- Darren Ming-Chun Poon
- Comprehensive Oncology Centre, Hong Kong Sanatorium and Hospital, Happy Valley, Hong Kong.,Department of Clinical Oncology, The Chinese University of Hong Kong, New Territories, Hong Kong
| | - Chi-Kwok Chan
- Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, New Territories, Hong Kong
| | - Tim-Wai Chan
- Department of Clinical Oncology, Queen Elizabeth Hospital, Kowloon, Hong Kong
| | | | - Lap-Yin Ho
- Asia Clinic, Tsim Sha Tsui, Kowloon, Hong Kong
| | | | - Eric Ka-Chai Lee
- Department of Clinical Oncology, Tuen Mun Hospital, New Territories, Hong Kong
| | | | | | - Hing-Shing So
- Division of Urology, Department of Surgery, United Christian Hospital, Kowloon, Hong Kong
| | - Po-Chor Tam
- Department of Surgery, Queen Mary Hospital, University of Hong Kong, Hong Kong Island, Hong Kong
| | - Wai-Kit Ma
- Department of Surgery, Princess Margaret Hospital, New Territories, Hong Kong
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3
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Bhanvadia RR, Khouri RK, Ashbrook C, Woldu SL, Margulis V, Raj GV, Bagrodia A. Safety, Efficacy, and Impact on Quality of Life of Palliative Robotic Cystectomy for Advanced Prostate Cancer. Clin Genitourin Cancer 2020; 19:e129-e134. [PMID: 33246846 DOI: 10.1016/j.clgc.2020.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 09/13/2020] [Accepted: 09/29/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Raj R Bhanvadia
- Department of Urology, University of Texas Southwestern, Dallas, TX
| | - Roger K Khouri
- Department of Urology, University of Texas Southwestern, Dallas, TX
| | - Caleb Ashbrook
- Department of Urology, University of Texas Southwestern, Dallas, TX
| | - Solomon L Woldu
- Department of Urology, University of Texas Southwestern, Dallas, TX
| | - Vitaly Margulis
- Department of Urology, University of Texas Southwestern, Dallas, TX
| | - Ganesh V Raj
- Department of Urology, University of Texas Southwestern, Dallas, TX
| | - Aditya Bagrodia
- Department of Urology, University of Texas Southwestern, Dallas, TX.
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Mai L, Li Y, Yang P, Zhang Z, Wu J, Zhou F, Liu Y, He L. Successful management of prostate cancer with bulky pelvic lymph node metastases after rapid development of castration-resistant prostate cancer: a case report with review of the literature. Transl Androl Urol 2020; 9:1428-1436. [PMID: 32676427 PMCID: PMC7354291 DOI: 10.21037/tau-20-725] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The rapid development of castration-resistant prostate cancer (CRPC) is a poor prognostic sign for loco-regionally advanced prostate cancer. Non-metastatic CRPC (nmCRPC) with bulky regional lymph node metastases is extremely rare and difficult to treat clinically without reported case. We present a case of a 72-year-old man with locally advanced prostate cancer with bulky lymph node metastases (53 mm × 77 mm × 67 mm), developing nmCRPC after 9-month ADT treatment. Immunohistochemistry (IHC) tests found partially positive MUC1 and negative BRCA1 expression in the initial biopsy specimens. Next-generation sequence analysis on the blood specimen after CRPC predicted a good tolerance to docetaxel. According to the multidisciplinary team recommendations, he was administrated docetaxel 75 mg/m2 on day 1 every 21 days for 6 cycles, and subsequently radiotherapy, with the delivery of a total dose of 67.5, 60-65 and 47.5 Gy in 25 fractions to the prostate, the enlarged lymph nodes and the whole pelvis respectively. Over a follow-up of 50 months, his disease has achieved good local control and he is alive without evidence of distant metastases or late adverse events. This case highlights individualized and multimodal therapy of intensification of systemic therapy and timely application of radiotherapy in such rare condition.
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Affiliation(s)
- Lixin Mai
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Yonghong Li
- Department of Urology Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Ping Yang
- Department of Pathology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Zitong Zhang
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Jianhua Wu
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Fangjian Zhou
- Department of Urology Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Yang Liu
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
| | - Liru He
- Department of Radiation Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou 510060, China
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Fujita N, Hatakeyama S, Momota M, Tobisawa Y, Yoneyama T, Yamamoto H, Imai A, Ito H, Yoneyama T, Hashimoto Y, Yoshikawa K, Mariya Y, Ohyama C. Safety and Feasibility of Radiation Therapy to the Primary Tumor in Patients With Metastatic Castration-resistant Prostate Cancer. Clin Genitourin Cancer 2020; 18:e523-e530. [PMID: 32278839 DOI: 10.1016/j.clgc.2020.03.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/05/2020] [Accepted: 03/10/2020] [Indexed: 01/15/2023]
Abstract
INTRODUCTION The objective of this study was to evaluate the safety and feasibility of radiation therapy (RT) to the primary tumor in patients with metastatic castration-resistant prostate cancer (mCRPC). PATIENTS AND METHODS This retrospective study included 105 patients with mCRPC who were treated between April 2004 and May 2019. We divided the patients into 2 groups: patients treated with RT to the primary tumor after they developed CRPC (RT group) and without (non-RT group). The primary purpose was safety assessed using the Common Terminology Criteria for Adverse Events. The secondary purpose included prostate-specific antigen (PSA) response, cancer-specific survival (CSS), and overall survival (OS). Background-adjusted multivariate analyses, with the inverse probability of treatment weighting (IPTW) method, were performed to evaluate impact of RT on CSS and OS. RESULTS The median age at CRPC diagnosis was 75 years, and the median follow-up period after CRPC diagnosis was 21 months. The adverse events rates related to RT in any grade and grade ≥ 3 were 55% and 23%, respectively. Nine (29%) patients achieved ≥ 30% PSA decline with RT. In multivariate analyses with the IPTW method, the CSS and OS in the RT group were significantly longer than those in the non-RT group. In subgroup analyses with the IPTW method, RT was significantly associated with improved OS in patients aged ≥ 75 years and patients with initial PSA ≥ 500 ng/mL, cT4, Gleason score ≥ 8, and high-volume metastatic burden. CONCLUSIONS RT to the primary tumor is safe and feasible, and it has potential benefits on oncologic outcomes in patients with mCRPC.
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Affiliation(s)
- Naoki Fujita
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Shingo Hatakeyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
| | - Masaki Momota
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Yuki Tobisawa
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Tohru Yoneyama
- Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hayato Yamamoto
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Atsushi Imai
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hiroyuki Ito
- Department of Urology, Aomori Rosai Hospital, Hachinohe, Japan
| | - Takahiro Yoneyama
- Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Yasuhiro Hashimoto
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | | | - Yasushi Mariya
- Department of Radiology, Mutsu General Hospital, Mutsu, Japan
| | - Chikara Ohyama
- Department of Urology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; Department of Advanced Transplant and Regenerative Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
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Management of non-metastatic castrate-resistant prostate cancer: A systematic review. Cancer Treat Rev 2018; 70:223-231. [DOI: 10.1016/j.ctrv.2018.09.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 09/19/2018] [Accepted: 09/20/2018] [Indexed: 01/13/2023]
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Consensus on management of castration-resistant prostate cancer on behalf of the Urological Tumours Working Group (URONCOR) of the Spanish Society of Radiation Oncology. Clin Transl Oncol 2018; 21:420-432. [PMID: 30293231 DOI: 10.1007/s12094-018-1940-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Accepted: 09/02/2018] [Indexed: 12/19/2022]
Abstract
BACKGROUND The knowledge in the field of castration-resistant prostate cancer (CRPC) is developing rapidly, with emerging new therapies and advances in imaging. Nonetheless, in multiple areas there is still a lack of or very limited evidence, and clear guidance from clinicians regarding optimal strategy is required. METHODS A modified Delphi method, with 116 relevant questions divided into 7 different CRPC management topics, was used to develop a consensus statement by the URONCOR group. RESULTS A strong consensus or unanimity was reached on 93% of the proposed questions. The seven topics addressed were: CRPC definition, symptomatic patients, diagnosis of metastasis, CRPC progression, M0 management, M1 management and sequencing therapy, and treatment monitoring. CONCLUSIONS The recommendations based on the radiation oncology experts' opinions are intended to provide cancer specialists with expert guidance and to standardise CRPC patient management in Spain, facilitating decision-making in different clinically relevant issues regarding CRPC patients.
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Aizawa R, Takayama K, Nakamura K, Inoue T, Kobayashi T, Akamatsu S, Yamasaki T, Ogawa O, Mizowaki T. Long-term outcomes of definitive external-beam radiotherapy for non-metastatic castration-resistant prostate cancer. Int J Clin Oncol 2018; 23:749-756. [DOI: 10.1007/s10147-018-1265-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 03/10/2018] [Indexed: 10/17/2022]
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9
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Beauval JB, Loriot Y, Hennequin C, Rozet F, Barthelemy P, Borchiellini D, Schlürmann Constans F, Gross E, Maillet D, Pasticier G, Pignot G, Timsit MO, Vincendeau S, Ploussard G, Sargos P. Loco-regional treatment for castration-resistant prostate cancer: Is there any rationale? A critical review from the AFU-GETUG. Crit Rev Oncol Hematol 2017; 122:144-149. [PMID: 29458782 DOI: 10.1016/j.critrevonc.2017.12.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 12/13/2017] [Accepted: 12/15/2017] [Indexed: 11/17/2022] Open
Abstract
Emerging evidence from population-based and retrospective series suggests a potential improvement of clinical outcomes in metastatic prostate cancer. Moreover, metastasis-directed treatment has shown encouraging results in this setting. There is an increasing interest in exploring the potential of local therapies in advanced prostate cancer, but this has rarely been specifically addressed in the castration-resistant state, whether non-metastatic or metastatic. A review of relevant articles was performed on the oncologic benefit of local treatment of the primary tumor or metastasis-targeted treatment in castration-resistant prostate cancer patients. The main goal of this strategy is to delay introduction of a new systemic agent to maintain quality of life and potentially to limit resistance. Further investigation is required to provide high-level evidence for the oncologic benefit of this treatment modality.
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Affiliation(s)
| | - Yohann Loriot
- Medical oncology department, Gustave Roussy, Université Paris-Saclay, Paris, France.
| | | | - François Rozet
- Department of Urology, Institut Mutualiste Montsouris, Paris, France.
| | - Philippe Barthelemy
- Medical Oncology Department, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
| | | | | | - Emmanuel Gross
- Ramsay Générale de Santé, Hôpital Privé Clairval, Marseille, France.
| | - Denis Maillet
- Medical Oncology Department, Centre Hospitalier Lyon-Sud, Institut de Cancérologie des Hospices Civils de Lyon (IC-HCL), CITOHL, F-69310, Pierre-Bénite, France.
| | | | - Géraldine Pignot
- Oncologic surgery department 2, Institut Paoli-Calmettes, Marseille, France.
| | - Marc-Olivier Timsit
- Department of Urology, Hôpital européen Georges-Pompidou (HEGP), Assistance Publique-Hôpitaux de Paris (APHP), Paris, France; Paris-Descartes University, Paris, France.
| | | | - Guillaume Ploussard
- Department of Urology, Clinique St Jean du Languedoc, Toulouse, France; Institut Universitaire du Cancer, Toulouse, France.
| | - Paul Sargos
- Department of Radiation therapy, Institut Bergonié, Bordeaux, France.
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Kuusk T, Pulliainen K, Vaarala MH. External beam radiation for the treatment of castration-resistant prostate cancer following primary hormonal therapy with androgen ablation: Analysis and outcome of 21 patients. Mol Clin Oncol 2017; 6:428-432. [PMID: 28451427 PMCID: PMC5403359 DOI: 10.3892/mco.2017.1156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 11/25/2016] [Indexed: 11/05/2022] Open
Abstract
Patients who undergo early androgen-deprivation therapy for prostate cancer may eventually develop castration-resistant prostate cancer. However, no optimal treatment for non-metastasized castration-resistant prostate cancer has yet been established. In the present retrospective, single-institutional study, the radiotherapy (RT) outcomes were evaluated in patients who underwent androgen-deprivation therapy for non-metastatic prostate cancer and subsequently developed castration-resistant disease. Following a thorough chart review, the data of 21 patients with castration-resistant prostate cancer who were treated between 2000 and 2010 with external beam radiation therapy (EBRT) at a prostate radiation dose of >45 Gy were evaluated. Of the 21 patients, 16 (76%) developed biochemical recurrence after RT, with a mean time to biochemical recurrence of 17 months. A total of 18 patients succumbed to the disease during follow-up, with a mean survival of 3 years after RT. A radiation dose of >66 Gy was associated with a longer time to biochemical recurrence after RT (P=0.011) and a longer survival, compared with a dose of ≤66 Gy (P=0.028). The mean overall survival time after RT was 42 months and did not depend on the primary hormonal treatment. Prostate-specific survival time was negatively associated with the Gleason score at diagnosis. The prostate-specific antigen (PSA) concentration prior to RT was a prognostic factor for biochemical recurrence of prostate cancer after RT, as well as for prostate cancer-specific survival. Finally, the multivariate analysis revealed that age, PSA concentration prior to RT and a high Gleason score were independent prognostic factors for prostate cancer-specific survival. Overall, our study findings demonstrated that disease progression was common after EBRT for castration-resistant prostate cancer and that survival was limited. However, young patients and those with low-risk disease at the time of diagnosis may benefit from RT.
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Affiliation(s)
- Teele Kuusk
- Division of Operative Care and Medical Research Center Oulu, Oulu University Hospital, 90220 Oulu, Finland
| | - Kristiina Pulliainen
- Division of Operative Care and Medical Research Center Oulu, Oulu University Hospital, 90220 Oulu, Finland
| | - Markku H. Vaarala
- Division of Operative Care and Medical Research Center Oulu, Oulu University Hospital, 90220 Oulu, Finland
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Palliative Radical (Cysto-)prostatectomy for Locally Advanced, Symptomatic Castration-resistant Prostate Cancer. Eur Urol Focus 2016; 2:478-479. [DOI: 10.1016/j.euf.2016.08.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 08/17/2016] [Indexed: 12/11/2022]
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12
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Jena R. Prostate Cancer Virtual Special Issue. Clin Oncol (R Coll Radiol) 2015; 28:163-4. [PMID: 26726168 DOI: 10.1016/j.clon.2015.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 12/10/2015] [Indexed: 11/18/2022]
Affiliation(s)
- R Jena
- Department of Oncology, University of Cambridge, Addenbrookes Hospital, Cambridge, UK.
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Cameron MG, Kersten C, Vistad I, van Helvoirt R, Weyde K, Undseth C, Mjaaland I, Skovlund E, Fosså SD, Guren MG. Palliative pelvic radiotherapy for symptomatic incurable prostate cancer – A prospective multicenter study. Radiother Oncol 2015; 115:314-20. [DOI: 10.1016/j.radonc.2015.05.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2015] [Revised: 05/20/2015] [Accepted: 05/22/2015] [Indexed: 11/12/2022]
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