A Short Review on Advanced Radiotherapy Techniques for Prostate Cancer

Abstract

Prostate cancer is the second-leading cause of cancer-related death among males in the United States. The three most prevalent contemporary methods surgery, radiation therapy (RT), and followup-were not compared in two treatment trials that examined treatment efficacy [1, 2]. The most frequent non-skin cancer in males is prostate cancer (PCa), with an estimated 161,360 cases and 26,730 fatalities in the United States in 2017 [3]. Surgery, RT, and androgen deprivation therapy are all possible treatments for localized PCa (Figure 1) [4]. Using intensity modulated radiation treatment, new developments in RT planning and delivery have made it possible to provide a highly uniform radiation dose distribution (IMRT). With cure rates comparable to those of radical prostatectomy, external beam radiation treatment (EBRT) is regarded as the standard treatment for organ confined PCa. Nevertheless, it has been shown that cutting-edge systemic radiation treatments significantly improve patient outcomes and survival in cases of metastatic sickness. RT has traditionally been employed primarily for palliation in metastatic disease. Three broad categories may be used for category RT, which is used for both local and advanced disease: X-ray equipment (a linear accelerator) is used in EBRT to generate high-energy photons that are directed at cancer cells outside the body.Brachytherapy and targeted radionuclide therapy, which employs radionuclides connected to drugs that target cancer to irradiate tumor cells and administer radioactive seeds inside. As PCa is α/β lower than nearby healthy tissue, hypofractionation employs a higher dosage of radiation, reducing the number of fractions and the total amount of time needed for therapy, providing a therapeutic benefit in terms of tumor management and toxicity, increasing patient comfort, and reducing costs [5]. The expanding use of severe hypofractionation has been made possible by recent technological developments in radiation treatment, including intensity-modulated radiation therapy (IMRT), image-guided radiation therapy (IGRT), and stereotactic radiation therapy (SBRT) in several local PCa therapy settings. PCa diagnosis and treatment have dramatically increased as a result of the widespread use of PSA testing. Unfortunately, due to the loss of weight or spread at the time of diagnosis, many men do not benefit from treatments. Sexual, urinary, and bowel function may be adversely affected by prostate cancer therapy [6–11]. The success of two treatment studies was assessed, but they did not compare the three most popular contemporary approaches—surgery, RT, and follow-up [1, 2, and 12]. Additionally, recent developments in RT technology, such as IGRT, IMRT, and SBRT, have gradually made it possible to use extreme hypofractionation (defined) in a variety of local PCa treatment scenarios. SBRT, also known as stereotaxic ablative radiotherapy (SABR), has shown in prospective randomized trials comparable biochemical control and morbidity to traditional fractionated regimens [13,14]. SBRT can also deliver higher doses in hypofractionated regimens.