Can we deliver randomized trials of focal therapy in prostate cancer? Journal Article
| Authors: | Ahmed, H. U.; Berge, V.; Bottomley, D.; Cross, W.; Heer, R.; Kaplan, R.; Leslie, T.; Parker, C.; Relton, C.; Stephens, R.; Sydes, M. R.; Turnbull, L.; Van Der Meulen, J.; Vickers, A.; Wilt, T.; Emberton, M. |
| Article Title: | Can we deliver randomized trials of focal therapy in prostate cancer? |
| Abstract: | Tissue-preserving focal therapies, such as brachytherapy, cryotherapy, high-intensity focused ultrasound and photodynamic therapy, aim to target individual cancer lesions rather than the whole prostate. These treatments have emerged as potential interventions for localized prostate cancer to reduce treatment-related adverse-effects associated with whole-gland treatments, such as radical prostatectomy and radiotherapy. In this article, the Prostate Cancer RCT Consensus Group propose that a novel cohort-embedded randomized controlled trial (RCT) would provide a means to study men with clinically significant localized disease, which we defined on the basis of PSA level (15 ng/ml or 20 ng/ml), Gleason grade (Gleason pattern 4 + 4 or 4 + 3) and stage (cT2cN0M0). This RCT should recruit men who stand to benefit from treatment, with the control arm being whole-gland surgery or radiotherapy. Composite outcomes measuring rates of local and systemic salvage therapies at 3-5 years might best constitute the basis of the primary outcome on which to change practice. © 2014 Macmillan Publishers Limited. All rights reserved. |
| Keywords: | cancer survival; treatment response; overall survival; review; cancer radiotherapy; cancer staging; nuclear magnetic resonance imaging; prostate specific antigen; quality of life; cancer screening; prostate cancer; prostatectomy; high intensity focused ultrasound; patient safety; brachytherapy; electroporation; clinical effectiveness; photodynamic therapy; transrectal ultrasonography; radiofrequency; cryosurgery; randomized controlled trial (topic); tumor ablation; phototherapy; human; priority journal |
| Journal Title: | Nature Reviews Clinical Oncology |
| Volume: | 11 |
| Issue: | 8 |
| ISSN: | 1759-4774 |
| Publisher: | Nature Publishing Group |
| Date Published: | 2014-08-01 |
| Start Page: | 482 |
| End Page: | 491 |
| Language: | English |
| DOI: | 10.1038/nrclinonc.2014.44 |
| PROVIDER: | scopus |
| PUBMED: | 24751803 |
| DOI/URL: | |
| Notes: | Export Date: 2 September 2014 -- Source: Scopus |
