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  1. Article ; Online: Stereotactic Ablative Body Radiotherapy for Intermediate- or High-Risk Prostate Cancer.

    Loblaw, Andrew

    Cancer journal (Sudbury, Mass.)

    2020  Volume 26, Issue 1, Page(s) 38–42

    Abstract: Stereotactic ablative radiotherapy (SABR) is a relatively novel form of high precision radiotherapy. For low- and intermediate risk patients, ultrahypofractionation (UHF - more than 5 Gy per day) has been compared to conventionally fractionated or ... ...

    Abstract Stereotactic ablative radiotherapy (SABR) is a relatively novel form of high precision radiotherapy. For low- and intermediate risk patients, ultrahypofractionation (UHF - more than 5 Gy per day) has been compared to conventionally fractionated or moderately hypofractionated radiotherapy in two large randomized studies. A third smaller randomized study examined the question of the optimal frequency of treatments. The results of these studies will be reviewed. SABR for high risk prostate cancer has been shown to be feasible and is well tolerated with careful planning and setup techniques. However, there is currently insufficient data supporting its use for high-risk patients to offer SABR outside of a clinical trial. SABR costs less to the radiotherapydepartments and, the patient, as well as increasing system capacity. Therefore, it has the potential to be widely adopted in the next few years.
    MeSH term(s) Cost-Benefit Analysis ; Disease-Free Survival ; Dose-Response Relationship, Radiation ; Evidence-Based Medicine/economics ; Evidence-Based Medicine/methods ; Evidence-Based Medicine/trends ; Humans ; Male ; Prostate/diagnostic imaging ; Prostate/radiation effects ; Prostatic Neoplasms/diagnosis ; Prostatic Neoplasms/mortality ; Prostatic Neoplasms/radiotherapy ; Radiation Dose Hypofractionation ; Radiation Oncology/economics ; Radiation Oncology/methods ; Radiation Oncology/trends ; Radiosurgery/adverse effects ; Radiosurgery/economics ; Radiosurgery/methods ; Radiosurgery/trends ; Radiotherapy Planning, Computer-Assisted ; Randomized Controlled Trials as Topic ; Risk Assessment/statistics & numerical data
    Language English
    Publishing date 2020-02-12
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2018400-1
    ISSN 1540-336X ; 1528-9117 ; 1081-4442
    ISSN (online) 1540-336X
    ISSN 1528-9117 ; 1081-4442
    DOI 10.1097/PPO.0000000000000425
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: The march toward single-fraction stereotactic body radiotherapy for localized prostate cancer-Quo Vadimus?

    Ong, Wee Loon / Loblaw, Andrew

    World journal of urology

    2023  Volume 41, Issue 12, Page(s) 3485–3491

    Abstract: Purpose: Stereotactic body radiotherapy (SBRT) is an emerging treatment option for localized prostate cancer. There is increasing interest to reduce the number of fractions for prostate SBRT.: Methods: We provide a narrative review and summary of ... ...

    Abstract Purpose: Stereotactic body radiotherapy (SBRT) is an emerging treatment option for localized prostate cancer. There is increasing interest to reduce the number of fractions for prostate SBRT.
    Methods: We provide a narrative review and summary of prospective trials of different fractionation schedules for prostate SBRT, focusing on efficacy, toxicities, and quality of life outcomes.
    Results: There are two randomized phase 3 trials comparing standard external beam radiotherapy with ultra-hypofractionated radiotherapy. HYPO-RT-PC compared 78 Gy in 39 fractions vs 42.7 Gy in 7 fractions (3D-CRT or IMRT) showing non-inferiority in 5-year biochemical recurrence-free survival and equivalent tolerability. PACE-B trial compared 78 Gy in 39-fraction or 62 Gy in 20-fraction vs 36.25 Gy in 5-fraction prostate SBRT, with no significant differences in toxicity outcomes at 2 years. Five-year efficacy data for PACE-B are expected in 2024. Five-fraction prostate SBRT is currently the most common and well-established fractionation schedule with multiple prospective phase 2 trials published to date. There is more limited data on 1-4 fraction prostate SBRT. All fractionation schedules had acceptable toxicity outcomes. Experience from a high-dose-rate brachytherapy randomized trial showed inferior efficacy with single-fraction compared to two-fraction brachytherapy. Hence, caution should be applied in adopting single-fraction prostate SBRT.
    Conclusion: Two-fraction SBRT is likely the shortest fractionation schedule that maintains the therapeutic ratio. Several randomized trials currently recruiting will likely provide us with more definite answers about whether two-fraction prostate SBRT should become a standard-of-care option. Enrollment of eligible patients into these trials should be encouraged.
    MeSH term(s) Male ; Humans ; Radiosurgery ; Quality of Life ; Prospective Studies ; Prostatic Neoplasms/radiotherapy ; Prostatic Neoplasms/surgery ; Dose Fractionation, Radiation
    Language English
    Publishing date 2023-11-03
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 380333-8
    ISSN 1433-8726 ; 0724-4983
    ISSN (online) 1433-8726
    ISSN 0724-4983
    DOI 10.1007/s00345-023-04663-x
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: In Reply to Yamazaki et al.

    Musunuru, Hima Bindu / Loblaw, Andrew

    International journal of radiation oncology, biology, physics

    2022  Volume 113, Issue 1, Page(s) 230–231

    Language English
    Publishing date 2022-04-12
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 197614-x
    ISSN 1879-355X ; 0360-3016
    ISSN (online) 1879-355X
    ISSN 0360-3016
    DOI 10.1016/j.ijrobp.2022.01.013
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Stereotactic Body Radiotherapy: Hitting Harder, Faster, and Smarter in High-Risk Prostate Cancer.

    Correa, Rohann J M / Loblaw, Andrew

    Frontiers in oncology

    2022  Volume 12, Page(s) 889132

    Abstract: Stereotactic body radiotherapy (SBRT) is a technologically sophisticated form of radiotherapy that holds significant potential to effectively treat high-risk prostate cancer (HRPC). Prostate SBRT has been the subject of intense investigation in the ... ...

    Abstract Stereotactic body radiotherapy (SBRT) is a technologically sophisticated form of radiotherapy that holds significant potential to effectively treat high-risk prostate cancer (HRPC). Prostate SBRT has been the subject of intense investigation in the context of low- and intermediate-risk disease, but less so for HRPC. However, emerging data are demonstrating its potential to safely and efficiently delivery curative doses of radiotherapy, both to the prostate and elective lymph nodes. SBRT theoretically hits harder through radiobiological dose escalation facilitated by ultra-hypofractionation (UHRT), faster with only five treatment fractions, and smarter by using targeted, focal dose escalation to maximally ablate the dominant intraprostatic lesion (while maximally protecting normal tissues). To achieve this, advanced imaging modalities like magnetic resonance imaging and prostate specific membrane antigen positron emmission tomography (PSMA-PET) are leveraged in combination with cutting-edge radiotherapy planning and delivery technology. In this focused narrative review, we discuss key evidence and upcoming clinical trials evaluating SBRT for HRPC with a focus on dose escalation, elective nodal irradiation, and focal boost.
    Language English
    Publishing date 2022-07-07
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2649216-7
    ISSN 2234-943X
    ISSN 2234-943X
    DOI 10.3389/fonc.2022.889132
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Response to comment to "Dosimetric correlates of toxicities and quality of life following two-fraction stereotactic ablative radiotherapy (SABR) for prostate cancer".

    Ong, Wee Loon / Zhang, Liying / Loblaw, Andrew

    Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

    2023  Volume 189, Page(s) 109918

    MeSH term(s) Male ; Humans ; Quality of Life ; Prostatic Neoplasms/radiotherapy ; Prostatic Neoplasms/surgery ; Radiosurgery/adverse effects ; Radiometry
    Language English
    Publishing date 2023-09-28
    Publishing country Ireland
    Document type Letter
    ZDB-ID 605646-5
    ISSN 1879-0887 ; 0167-8140
    ISSN (online) 1879-0887
    ISSN 0167-8140
    DOI 10.1016/j.radonc.2023.109918
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article: Is it time to end lone-wolf medicine?

    Loblaw, Andrew

    Canadian Urological Association journal = Journal de l'Association des urologues du Canada

    2016  Volume 10, Issue 9-10, Page(s) 319–320

    Language English
    Publishing date 2016-10-19
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 2431403-1
    ISSN 1911-6470
    ISSN 1911-6470
    DOI 10.5489/cuaj.4163
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Can a FLAME forge a stronger SABRe? Let's await the evidence for focal boost with Stereotactic Ablative Radiotherapy.

    Correa, Rohann J M / Morton, Gerard / Loblaw, Andrew

    Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology

    2022  Volume 174, Page(s) 173–174

    MeSH term(s) Humans ; Radiosurgery
    Language English
    Publishing date 2022-07-08
    Publishing country Ireland
    Document type Letter ; Comment
    ZDB-ID 605646-5
    ISSN 1879-0887 ; 0167-8140
    ISSN (online) 1879-0887
    ISSN 0167-8140
    DOI 10.1016/j.radonc.2022.06.019
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: The use of virtual reality hypnosis for prostate cancer patients during transperineal biopsy/gold seed implantation: A needs assessment study.

    Wong, Jane / McGuffin, Merrylee / Smith, Mackenzie / Loblaw, Dr Andrew

    Journal of medical imaging and radiation sciences

    2023  Volume 54, Issue 3, Page(s) 429–435

    Abstract: Background: Patients having radiation therapy treatment to the prostate may require invasive preparation procedures under local anesthesia (LA), such as the insertion of gold seeds into the prostate or targeted biopsies. These procedures can induce pain ...

    Abstract Background: Patients having radiation therapy treatment to the prostate may require invasive preparation procedures under local anesthesia (LA), such as the insertion of gold seeds into the prostate or targeted biopsies. These procedures can induce pain and anxiety for some patients. Virtual Reality Hypnosis (VRH) is the combination of a 360-degree video display with audio and mental guides for relaxation and distraction during medical procedures. The objective of this research was to assess the level of patient interest in the use of VRH during gold seed insertion and biopsy, and to identify a subset of patients that would be most likely to benefit from the use of VRH.
    Methods: This single arm, prospective pilot study included patients who were receiving biopsy and/or gold seed insertion using a 2-step LA procedure. Participants were asked to complete a questionnaire about their level of knowledge and interest in VRH before and after their procedure. At the same time, pain and anxiety levels were collected before and after the procedure, as well as during each LA step and at the mid-seed drop/biopsy core extraction. A visual analogue scale for pain and the National Comprehensive Cancer Network's Distress Thermometer were used to verbally rate pain and distress respectively. Descriptive statistics and Pearson's correlation coefficient were calculated for all variables of interest.
    Results: 24 patients were recruited and 1 had their procedure cancelled, so a total of 23 patients completed this study. 74% of patients (n=23) agreed to try VRH before their procedures, whereas 65% of patients (n=23) were willing to try VRH after the procedure. Pain scores were highest at deep LA injection (mean= 5.48, SD= 2.56) and distress scores were also highest at deep LA injection (mean= 4.28, SD= 2.92). After the procedure, 83% of participants with pain scores above the mean at deep LA injection and 80% with anxiety scores above the mean at deep LA injection agreed that they would be willing to try VRH.
    Conclusions: Patients with higher pain and distress scores had more interest in trying VRH with the standard LA for gold seed insertion/biopsy procedures. Patients with a history of lower pain tolerance or who express having experienced high levels of pain during previous biopsies will be the target population for using VRH in future trials to determine feasibility and effectiveness.
    MeSH term(s) Male ; Humans ; Prostate ; Prospective Studies ; Gold ; Needs Assessment ; Pilot Projects ; Pain ; Prostatic Neoplasms/radiotherapy ; Prostatic Neoplasms/pathology ; Biopsy ; Hypnosis/methods ; Virtual Reality
    Chemical Substances Gold (7440-57-5)
    Language English
    Publishing date 2023-06-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2426513-5
    ISSN 1876-7982 ; 1939-8654
    ISSN (online) 1876-7982
    ISSN 1939-8654
    DOI 10.1016/j.jmir.2023.05.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: The value of randomised trials for prostate cancer management.

    Loblaw, Andrew

    The Lancet. Oncology

    2014  Volume 15, Issue 4, Page(s) 374–375

    MeSH term(s) Dose Fractionation ; Humans ; Male ; Prostatic Neoplasms/radiotherapy ; Radiotherapy, Conformal
    Language English
    Publishing date 2014-04
    Publishing country England
    Document type Comment ; Journal Article
    ZDB-ID 2049730-1
    ISSN 1474-5488 ; 1470-2045
    ISSN (online) 1474-5488
    ISSN 1470-2045
    DOI 10.1016/S1470-2045(14)70081-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Urethra contouring on computed tomography urethrogram versus magnetic resonance imaging for stereotactic body radiotherapy in prostate cancer

    Wee Loon Ong / M. Allan Hupman / Melanie Davidson / Mark Ruschin / Jay Detsky / Stanley Liu / Danny Vesprini / Andrew Loblaw

    Clinical and Translational Radiation Oncology, Vol 45, Iss , Pp 100722- (2024)

    2024  

    Abstract: Accurate urethra contouring is critical in prostate SBRT. We compared urethra contouring on CT-urethrogram and T2-weighted MRI. The dice similarity coefficient, Jaccard index, Hausdorff distance and mean distance to agreement were evaluated. All four ... ...

    Abstract Accurate urethra contouring is critical in prostate SBRT. We compared urethra contouring on CT-urethrogram and T2-weighted MRI. The dice similarity coefficient, Jaccard index, Hausdorff distance and mean distance to agreement were evaluated. All four metrics indicate better agreement and less variability in urethra contouring on CT-urethrogram, compared to T2-weighted MRI.
    Keywords Prostate SBRT ; Urethra contour ; Urethrogram ; MRI sequences ; Medical physics. Medical radiology. Nuclear medicine ; R895-920 ; Neoplasms. Tumors. Oncology. Including cancer and carcinogens ; RC254-282
    Language English
    Publishing date 2024-03-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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