What are the possible hormonal complications of conventional external beam radiotherapy (EBRT) for prostate cancer?

1. Brame RS, Zaider M, Zakian KL, Koutcher JA, Shukla-Dave A, Reuter VE, et al. Regarding the focal treatment of prostate cancer: inference of the Gleason grade from magnetic resonance spectroscopic imaging. Int J Radiat Oncol Biol Phys. 2009 May 1. 74(1):110-4. [Medline]. [Full Text].

2. Bylund KC, Bayouth JE, Smith MC, Hass AC, Bhatia SK, Buatti JM. Analysis of interfraction prostate motion using megavoltage cone beam computed tomography. Int J Radiat Oncol Biol Phys. 2008 Nov 1. 72(3):949-56. [Medline].

3. Grimm P, Billiet I, Bostwick D, Dicker AP, Frank S, Immerzeel J, et al. Comparative analysis of prostate-specific antigen free survival outcomes for patients with low, intermediate and high risk prostate cancer treatment by radical therapy. Results from the Prostate Cancer Results Study Group. BJU Int. 2012 Feb. 109 Suppl 1:22-9. [Medline].

4. BAGSHAW MA, KAPLAN HS, SAGERMAN RH. LINEAR ACCELERATOR SUPERVOLTAGE RADIOTHERAPY. VII. CARCINOMA OF THE PROSTATE. Radiology. 1965 Jul. 85:121-9. [Medline].

5. Agency for Healthcare Research and Quality. Comparative Effectiveness of Therapies for Clinically Localized Prostate Cancer. AHRQ: Agency for Healthcare Research and Quality. [Full Text].

6. Mulcahy N. AUA and ASTRO Issue Joint Guidelines for Postsurgery Radiotherapy. Medscape Medical News. May 10 2013. Available at http://www.medscape.com/viewarticle/803942. Accessed: May 23 2013.

7. Thompson IM, Valicenti R, Albertsen PC. Adjuvant and Salvage Radiotherapy after Prostatectomy: ASTRO/AUA Guideline. American Urological Association. Available at http://www.auanet.org/education/guidelines/radiation-after-prostatectomy.cfm. Accessed: May 23 2013.

8. Small W Jr, Woloschak GE. Radiation Toxicity. Small W Jr, Woloschak GE, eds. A Practical Guide. Springer; 2006. Vol 128:

9. Paulson DF. Randomized series of treatment with surgery versus radiation for prostate adenocarcinoma. NCI Monogr. 1988. 127-31. [Medline].

10. Wallis CJ, Saskin R, Choo R, Herschorn S, Kodama RT, Satkunasivam R, et al. Surgery Versus Radiotherapy for Clinically-localized Prostate Cancer: A Systematic Review and Meta-analysis. Eur Urol. 2015 Nov 30. [Medline].

11. Bagshaw MA, Cox RS, Ramback JE. Radiation therapy for localized prostate cancer. Justification by long-term follow-up. Urol Clin North Am. 1990 Nov. 17(4):787-802. [Medline].

12. Perez CA, Michalski J, Mansur D. Clinical assessment of outcome of prostate cancer (TCP, NTCP). Rays. 2005 Apr-Jun. 30(2):109-20. [Medline].

13. Roach M 3rd, DeSilvio M, Lawton C, Uhl V, Machtay M, Seider MJ, et al. Phase III trial comparing whole-pelvic versus prostate-only radiotherapy and neoadjuvant versus adjuvant combined androgen suppression: Radiation Therapy Oncology Group 9413. J Clin Oncol. 2003 May 15. 21(10):1904-11. [Medline].

14. Pollack A, Zagars GK, Smith LG, Lee JJ, von Eschenbach AC, Antolak JA, et al. Preliminary results of a randomized radiotherapy dose-escalation study comparing 70 Gy with 78 Gy for prostate cancer. J Clin Oncol. 2000 Dec 1. 18(23):3904-11. [Medline].

15. Zietman AL, DeSilvio ML, Slater JD, Rossi CJ Jr, Miller DW, Adams JA, et al. Comparison of conventional-dose vs high-dose conformal radiation therapy in clinically localized adenocarcinoma of the prostate: a randomized controlled trial. JAMA. 2005 Sep 14. 294(10):1233-9. [Medline].

16. Kalbasi A, Li J, Berman A, Swisher-McClure S, Smaldone M, Uzzo RG, et al. Dose-Escalated Irradiation and Overall Survival in Men With Nonmetastatic Prostate Cancer. JAMA Oncol. 2015 Jul 16. [Medline].

17. Nelson R. Radiation Ups Survival in Prostate Cancer, but Not Low Risk. Medscape Medical News. Available at http://www.medscape.com/viewarticle/848615#vp_2. July 24, 2015; Accessed: September 15, 2015.

18. Touijer KA, Karnes RJ, Passoni N, Sjoberg DD, Assel M, Fossati N, et al. Survival Outcomes of Men with Lymph Node-positive Prostate Cancer After Radical Prostatectomy: A Comparative Analysis of Different Postoperative Management Strategies. Eur Urol. 2017 Oct 14. [Medline].

19. Planas J, Celma A, Placer J, et al. Hormonal changes after localized prostate cancer treatment. Comparison between external beam radiation therapy and radical prostatectomy. Actas Urol Esp. 2016 Nov. 40 (9):549-55. [Medline].

20. Zelefsky MJ, Yamada Y, Fuks Z, Zhang Z, Hunt M, Cahlon O, et al. Long-term results of conformal radiotherapy for prostate cancer: impact of dose escalation on biochemical tumor control and distant metastases-free survival outcomes. Int J Radiat Oncol Biol Phys. 2008 Jul 15. 71(4):1028-33. [Medline].

21. Pinkawa M, Pursch-Lee M, Asadpour B, Gagel B, Piroth MD, Klotz J, et al. Image-guided radiotherapy for prostate cancer. Implementation of ultrasound-based prostate localization for the analysis of inter- and intrafraction organ motion. Strahlenther Onkol. 2008 Dec. 184(12):679-85. [Medline].

22. Noel C, Parikh PJ, Roy M, Kupelian P, Mahadevan A, Weinstein G, et al. Prediction of intrafraction prostate motion: accuracy of pre- and post-treatment imaging and intermittent imaging. Int J Radiat Oncol Biol Phys. 2009 Mar 1. 73(3):692-8. [Medline].

23. Langen KM, Willoughby TR, Meeks SL, Santhanam A, Cunningham A, Levine L, et al. Observations on real-time prostate gland motion using electromagnetic tracking. Int J Radiat Oncol Biol Phys. 2008 Jul 15. 71(4):1084-90. [Medline].

24. Slater JD, Rossi CJ Jr, Yonemoto LT, Bush DA, Jabola BR, Levy RP, et al. Proton therapy for prostate cancer: the initial Loma Linda University experience. Int J Radiat Oncol Biol Phys. 2004 Jun 1. 59(2):348-52. [Medline].

25. Kagan AR, Schulz RJ. Proton-beam therapy for prostate cancer. Cancer J. 2010 Sep-Oct. 16(5):405-9. [Medline].

26. Gardner BG, Zietman AL, Shipley WU, Skowronski UE, McManus P. Late normal tissue sequelae in the second decade after high dose radiation therapy with combined photons and conformal protons for locally advanced prostate cancer. J Urol. 2002 Jan. 167(1):123-6. [Medline].

27. Kupelian PA, Lee C, Langen KM, Zeidan OA, Mañon RR, Willoughby TR, et al. Evaluation of image-guidance strategies in the treatment of localized prostate cancer. Int J Radiat Oncol Biol Phys. 2008 Mar 15. 70(4):1151-7. [Medline].

28. King CR, Lehmann J, Adler JR, Hai J. CyberKnife radiotherapy for localized prostate cancer: rationale and technical feasibility. Technol Cancer Res Treat. 2003 Feb. 2(1):25-30. [Medline].

29. Laverdière J, Gomez JL, Cusan L, Suburu ER, Diamond P, Lemay M, et al. Beneficial effect of combination hormonal therapy administered prior and following external beam radiation therapy in localized prostate cancer. Int J Radiat Oncol Biol Phys. 1997 Jan 15. 37(2):247-52. [Medline].

30. McGowan D, Hunt D, Jones C, et al. Effect of short-term endocrine therapy prior to and during radiation therapy on overall survival in patients with T1b-T2b adenocarcinoma of the prostate and PSA equal to or less than 20. Available at http://www.asco.org/ASCOv2/Meetings/Abstracts?&vmview=abst_detail_view&confID=73&abstractID=30652.

31. Lee BH, Kibel AS, Ciezki JP, Klein EA, Reddy CA, Yu C, et al. Are Biochemical Recurrence Outcomes Similar After Radical Prostatectomy and Radiation Therapy? Analysis of Prostate Cancer-Specific Mortality by Nomogram-predicted Risks of Biochemical Recurrence. Eur Urol. 2014 Oct 4. [Medline].

32. Dearnaley D, et al. Conventional versus hypofractionated high-dose intensity-modulated radiotherapy for prostate cancer: 5-year outcomes of the randomised, non-inferiority, phase 3 CHHiP trial. Lancet Oncol. 2016 Aug;17(8):1047-60. doi: 10.1016/S1470-2045(16)30102-4. Epub 2016 Jun 20.

33. Incrocci L, et al. Hypofractionated versus conventionally fractionated radiotherapy for patients with localised prostate cancer (HYPRO): final efficacy results from a randomised, multicentre, open-label, phase 3 trial. Lancet Oncol. 2016 Aug;17(8):1061-9. doi: 10.1016/S1470- 2045(16)30070-5. Epub 2016 Jun 20.

34. Wilkins A, Mossop H, Syndikus I, et al. Hypofractionated radiotherapy versus conventionally fractionated radiotherapy for patients with intermediate-risk localised prostate cancer: 2-year patient-reported outcomes of the randomised, non-inferiority, phase 3 CHHiP trial. Lancet Oncol. 2015 Dec;16(16):1605-16. doi: 10.1016/S1470-2045(15)00280-6. Epub 2015 Oct 28.

35. Yu JB, Cramer LD, Herrin J, Soulos PR, Potosky AL, Gross CP. Stereotactic Body Radiation Therapy Versus Intensity-Modulated Radiation Therapy for Prostate Cancer: Comparison of Toxicity. J Clin Oncol. 2014 Apr 20;32(12):1195-201.

36. EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent Mottet, Nicolas et al. European Urology , Volume 71 , Issue 4 , 618 - 629, 2017.

37. The Natural History and Predictors of Outcome Following Biochemical Relapse in the Dose Escalation Era for Prostate Cancer Patients Undergoing Definitive External Beam Radiotherapy Zumsteg, Zachary S. et al. European Urology , Volume 67 , Issue 6 , 1009 - 1016, 2015.

38. Harrison P. New Guidelines Highlight Hypofractionation for Prostate Cancer. Medscape Medical News. Available at https://www.medscape.com/viewarticle/903481. October 16, 2018; Accessed: November 29, 2018.

39. [Guideline] Morgan SC, Hoffman K, Loblaw DA, Buyyounouski MK, Patton C, Barocas D, et al. Hypofractionated Radiation Therapy for Localized Prostate Cancer: An ASTRO, ASCO, and AUA Evidence-Based Guideline. J Clin Oncol. 2018 Oct 11. JCO1801097. [Medline]. [Full Text].

Isamettin Andrew Aral, MD, MS Radiation Oncologist, ProHEALTH Radiation Oncology

Isamettin Andrew Aral, MD, MS is a member of the following medical societies: American College of Radiology, American Medical Association, American Society for Radiation Oncology

Disclosure: Nothing to disclose.

Ciril Godec, MD Chairman, Professor, Department of Urology, Long Island College Hospital, State University of New York at Brooklyn

Disclosure: Nothing to disclose.

Fazal Hussain, MD, MPH Associate Professor, Alfaisal University College of Medicine, Saudi Arabia

Fazal Hussain, MD, MPH is a member of the following medical societies: Aerospace Medical Association, American Academy of Pharmaceutical Physicians, American College of Radiation Oncology, American College of Radiology, American Public Health Association, American Society for Radiation Oncology, Association of Military Surgeons of the US, International College of Surgeons, New York State Radiological Society, Radiation Research Society, Royal Society for Public Health, Society of Clinical Research Associates

Disclosure: Nothing to disclose.

Edward David Kim, MD, FACS Professor of Surgery, Division of Urology, University of Tennessee Graduate School of Medicine; Consulting Staff, University of Tennessee Medical Center

Edward David Kim, MD, FACS is a member of the following medical societies: American College of Surgeons, American Society for Reproductive Medicine, American Society of Andrology, American Urological Association, Sexual Medicine Society of North America, Tennessee Medical Association

Disclosure: Serve(d) as a speaker or a member of a speakers bureau for: Endo, Avadel.

Hassan Aziz, MD, FRCR Clinical Professor, Department of Radiation Oncology, Downstate Medical Center and Long Island College Hospital, State University of New York at Downstate Medical Center

Hassan Aziz, MD, FRCR is a member of the following medical societies: American College of Radiology, American Society for Radiation Oncology

Disclosure: Nothing to disclose.

Michael Grasso III, MD Director of Endourology, Lenox Hill Hospital; Professor and Vice Chairman, Department of Urology, New York Medical College

Michael Grasso III, MD is a member of the following medical societies: American Medical Association, American Urological Association, Endourological Society, Medical Society of the State of New York, National Kidney Foundation, Société Internationale d'Urologie (International Society of Urology), and Society of Laparoendoscopic Surgeons

Disclosure: Karl Storz Endoscopy Consulting fee Consulting; Boston Scientific Consulting fee Consulting; Cook Urologic Consulting fee Consulting

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Reference Salary Employment

Dan Theodorescu, MD, PhD Paul A Bunn Professor of Cancer Research, Professor of Surgery and Pharmacology, Director, University of Colorado Comprehensive Cancer Center

Dan Theodorescu, MD, PhD is a member of the following medical societies: American Cancer Society, American College of Surgeons, American Urological Association, Medical Society of Virginia, Society for Basic Urologic Research, and Society of Urologic Oncology

Disclosure: Key Genomics Ownership interest Co-Founder-50% Stock Ownership