Brachytherapy for Patients With Prostate Cancer : American Society of Clinical Oncology/Cancer Care Ontario Joint Guideline Update
Cet article présente une mise à jour des recommandations du "Cancer Care Ontario", complétées et adoptées par l'"American Society of Clinical Oncology", concernant l'utilisation de la curiethérapie pour traiter un cancer de la prostate
Purpose : To jointly update the Cancer Care Ontario guideline on brachytherapy for patients with prostate cancer to account for new evidence.
Methods : An Update Panel conducted a targeted systematic literature review and identified more recent randomized controlled trials comparing dose-escalated external beam radiation therapy (EBRT) with brachytherapy in men with prostate cancer.
Results : Five randomized controlled trials provided the evidence for this update.
Recommendations : For patients with low-risk prostate cancer who require or choose active treatment, low–dose rate brachytherapy (LDR) alone, EBRT alone, and/or radical prostatectomy (RP) should be offered to eligible patients. For patients with intermediate-risk prostate cancer choosing EBRT with or without androgen-deprivation therapy, brachytherapy boost (LDR or high–dose rate [HDR]) should be offered to eligible patients. For low-intermediate risk prostate cancer (Gleason 7, prostate-specific antigen < 10 ng/mL or Gleason 6, prostate-specific antigen, 10 to 20 ng/mL), LDR brachytherapy alone may be offered as monotherapy. For patients with high-risk prostate cancer receiving EBRT and androgen-deprivation therapy, brachytherapy boost (LDR or HDR) should be offered to eligible patients. Iodine-125 and palladium-103 are each reasonable isotope options for patients receiving LDR brachytherapy; no recommendation can be made for or against using cesium-131 or HDR monotherapy. Patients should be encouraged to participate in clinical trials to test novel or targeted approaches to this disease.
Journal of Clinical Oncology , article en libre accès, 2016