Cover Image

Magnetic resonance spectroscopy as a decision tool in multimodality treatment design for localised prostate cancer

Giuseppe Sasso, Aleksandra Zapotoczna, David Pryor, John Simpson
  • Giuseppe Sasso
    Department of Radiation Oncology, ‘‘Centre Medical de Forcilles’’ PSPH Hospital, Ferolles-Attilly; Faculty of Medicine, Health and Molecular Sciences, James Cook University, Townsville, France | peppe.sasso@gmail.com
  • Aleksandra Zapotoczna
    Department of Medical Physics, Townsville Teaching Hospital, Townsville, Australia
  • David Pryor
    Department of Radiation Oncology, Princess Alexandra Hospital, Brisbane, Australia
  • John Simpson
    Department of Medical Physics, Auckland Radiation Oncology, Auckland, New Zealand

Abstract

Predicting the outcome of individual prostate adenocarcinoma can be challenging, especially for patients affected by intermediate or high risk, but localised disease. Natural histories of prostate cancers with similar stage and prognostic factors can differ significantly; and an ongoing debate surrounds the optimal treatment choice for men diagnosed with non-metastatic prostate cancer. A variety of effective therapeutic options are available to be used as a sole modality, or in combination, including surgery, external beam radiotherapy, brachytherapy, and endocrine manipulation. Although these treatments have been used routinely for more than 15 years, there is a paucity of data from randomised trials comparing their results. In addition, most treatment techniques have changed dramatically in the last two decades due to the ongoing healthcare technological revolution. The rapid proliferation of new and expensive therapeutic options (i.e. adaptive radiotherapy, focal ablation, etc.) promises to minimise treatment related side effects and improve local control, however, there is no uniform consensus. Treatment choice is based on the available prognostic factors and life expectancy, along with patient preference, toxicity profiles, the individual institution’s (and clinician’s) experience and resource availability. Unfortunately, our prognostic tools are still limited, as is our ability to precisely predict which subset of patients might benefit from more aggressive therapeutic combinations. Therefore, a significant number of patients receive unnecessary and expensive treatments, whilst others are denied highly technological procedures because of associated resource limitation. This paper aims to analyse the current evidence, cost-effectiveness and controversies, surrounding the nonsurgical treatment of localised prostate cancer, with a focus on radiation and endocrine therapies, and to discuss the role of magnetic resonance spectroscopy, as a decision tool for multimodality treatment design and prediction of response.

Keywords

Cost-effectiveness - Magnetic resonance spectroscopy - Prostate cancer - Multimodality treatment

Full Text

FULL TEXT
Submitted: 2011-12-14 12:17:59
Published: 2011-12-14 00:00:00
Search for citations in Google Scholar
Related articles: Google Scholar
Abstract views:
391

Views:
FULL TEXT
140

Article Metrics

Metrics Loading ...

Metrics powered by PLOS ALM


Copyright (c) 2011 Giuseppe Sasso, Aleksandra Zapotoczna, David Pryor, John Simpson

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
 
© PAGEPress 2008-2017     -     PAGEPress is a registered trademark property of PAGEPress srl, Italy.     -     VAT: IT02125780185