ACR Appropriateness Criteria® External Beam Radiation Therapy Treatment Planning for Clinically Localized Prostate Cancer EVIDENCE TABLE Reference
Study Type
1.
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin. 2015;65(1):5-29.
2.
Cooperberg MR, Broering JM, Carroll Review/Other-Tx PR. Time trends and local variation in primary treatment of localized prostate cancer. J Clin Oncol. 2010;28(7):11171123.
* See Last Page for Key
Review/Other-Tx
Patients/ Events N/A
Study Objective (Purpose of Study) To provide the expected numbers of new cancer cases and deaths in 2015 nationally and for each state, as well as a comprehensive overview of cancer incidence, mortality, and survival rates and trends using the most current population-based data. The article also estimates the total number of deaths averted nationally during the past 2 decades and by state in 2011 as a result of the continual decline in cancer death rates and present actual number of deaths reported in 2011 by age for the 10 leading causes of death and for the 5 leading causes of cancer death.
11,892 men at 36 sites
To determine trends over time in treatment of cancers at varying levels of progression risk, and to characterize and quantify variation in primary treatment at the level of the clinical practice site.
2016 Review
Study Results Cancer death rates have been continuously declining for the past 2 decades. Overall, the risk of dying from cancer decreased by 22% between 1991 and 2011. Regionally, progress has been most rapid for residents of the Northeast, among whom death rates have declined by 25% to 30%, and slowest in the South, where rates declined by about 15%. Further reductions in cancer death rates can be accelerated by applying existing cancer control knowledge across all segments of the population, with an emphasis on those in the lowest socioeconomic bracket and other disadvantaged populations. Among 11,892 men analyzed, 6.8% elected surveillance, 49.9% prostatectomy, 11.6% EBRT, 13.3% brachytherapy, 4.0% cryoablation, and 14.4% androgen deprivation monotherapy. Prostate cancer risk drives treatment selection, but the data suggest both overtreatment of low-risk disease and undertreatment of high-risk disease. The former trend appears to be improving over time, while the latter is worsening. Treatment varies with age, comorbidity, and socioeconomic status. However, treatment patterns vary markedly across clinical sites, and this variation is not explained by case-mix variability or known patient factors. Practice site explains a proportion of this variation ranging from 13% for androgen deprivation monotherapy to 74% for cryoablation.
Study Quality 4
4
Showalter/Zaorsky Page 1
ACR Appropriateness Criteria® External Beam Radiation Therapy Treatment Planning for Clinically Localized Prostate Cancer EVIDENCE TABLE Reference
Study Type
3.
Aizer AA, Yu JB, Colberg JW, McKeon AM, Decker RH, Peschel RE. Radical prostatectomy vs. intensity-modulated radiation therapy in the management of localized prostate adenocarcinoma. Radiother Oncol. 2009;93(2):185-191.
Observational-Tx
4.
Klein EA, Ciezki J, Kupelian PA, Mahadevan A. Outcomes for intermediate risk prostate cancer: are there advantages for surgery, external radiation, or brachytherapy? Urol Oncol. 2009;27(1):67-71.
Review/Other-Tx
* See Last Page for Key
Patients/ Events 556 patients RP (n=204) or IMRT (n=352)
Study Objective (Purpose of Study) To determine whether RP or IMRT to ≥72 Gy, plus hormonal therapy if indicated, results in improved BDFS in localized prostate adenocarcinoma.
N/A
To review recent results from an institutional database and prospective quality of life study comparing cancer-related and quality of life outcomes among different treatment modalities for intermediate risk prostate cancer.
2016 Review
Study Results IMRT patients had more advanced disease at baseline (P5 mm) in the post-enema group (31%) was significantly lower than in the pre-leaflet (62%, P
