Subject Index. Androgen antiandrogen therapy, see Hormone ablation therapy, prostate cancer synthesis and metabolism 49
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1 OOOOOOOOOOOOOOOOOOOOOOOOOOOOOO Subject Index Androgen antiandrogen therapy, see Hormone ablation therapy, synthesis and metabolism 49 Bacillus Calmette-Guérin adjunct therapy with transurethral resection of bladder tumor , 153 Bladder cancer cost factors in treatment 142, 143 epidemiology 131 prospects for organ-sparing treatment , 143 radiation therapy efficacy adjuvant therapy rationale 157 external beam radiotherapy comparison with radical cystectomy study limitations 132 radical cystectomy adjuvant therapy studies 133, 134 complication rate 106 continent diversions 133 mortality 106 outcomes stage dependence 110, 111, 114, 115 superficial invasive disease pelvic lymph node involvement dissection 106 prognosis recurrence rate 133 radiochemotherapy adverse effects 126, 127, 142 concerns of organ-sparing approach 127, 128, distant metastases outcome 124 endpoints 120, 121 initial response 121, 122, 129 local control with preserved bladder 123 patient selection 119 post-transurethral resection of bladder 119, , prognostic factors 125, 127 quality of life 142 rationale 118, 119 salvage cystectomy 123, 124, 127 survival and bladder preservation 124, 125, 141, 142 treatment protocol 119, 120, , 141 staging, clinical vs pathological 107, 108, 131 superficial T1G3 cancer natural course prognosis
2 radiation treatment historical series 154, 155 intravesical therapy comparison 156, 157 rationale 154 University of Erlangen series 155, 156 transurethral resection of bladder bacillus Calmette-Guérin adjunct therapy for T1G3 cancer , 153 efficacy 118, 121, 147 treatment challenges 127, 128 Brachytherapy, adverse effects 172 external beam radiation combined with high-dose rate brachytherapy complications 180, 181 patient selection 179, 180 pelvic lymph node radiation transrectal ultrasound guidance 186 radioisotope sources 180 study design and outcomes 178, 179 goals 159 hormone ablation adjuvant therapy limitations 95, 96 interstitial brachytherapy with permanent seed implants morbidity 168, 169 patient selection 169 placement 166 tumor control 166, 167 iodine-125 permanent implants design differential dose-volume histogram 163, 164 dose-volume histogram dosimetric evaluation and reporting 163, 164 placement 162 quality of life outcomes 104 radioisotopes 172, 180 rationale 166 Carboplatin, radiochemotherapy of bladder cancer 122, 125 Chemotherapy, combination therapy 77 corticosteroids 73, 74 docetaxel 76 estramustine phosphate 75 mitomycin 74 mitoxantrone 74 paclitaxel 76 prostate-specific antigen as response marker 72, 73, 77 rationale 72 suramin 73 Chemoradiotherapy, see Bladder cancer Cisplatin, radiochemotherapy of bladder cancer 121, 125, 136, 139, 140 Clinical target volume, conformal threedimensional radiotherapy of prostate cancer 2, 3, 7 Computed tomography, bladder cancer staging 107, 108 Conformal three-dimensional radiotherapy, clinical target volume 2, 3, 7 goals 1 gross tumor volume 2, 17, 18, 20, 22 health-related quality of life 13, 14, 104 high-dose rate brachytherapy combination therapy complications 180, 181 patient selection 179, 180 pelvic lymph node radiation transrectal ultrasound guidance 186 radioisotope sources 180 study design and outcomes 178, 179 historical perspective 26, 171, 172 hormone ablation adjuvant therapy brachytherapy limitations 95, 96 cytoreduction 90 duration 95 early stage disease role 95 Subject Index 193
3 Computed tomography (continued) EORTC trial EORTC trial , 83 EORTC trial , 84 mechanisms and concerns 92 monoclonal antibody study 83, 84 post-radiation 58, 59 pre-radiation 60, 61 Quebec randomized trial 93 rationale 87, 89 RTOG trial 93, 94 synergistic cell killing 90, 91 target volume reduction 94 timing factors 81 hyperthermia with conformal radiotherapy advantages 173 phase II trial outcomes 174, 175 protocol 173, 174 thermosensitivity of tissue 172, 173 intensity modulated radiotherapy beam delivery 29, 30 definition 29 inverse planning 27 29, 178 outcomes 32, 33 planning target volume 6, 31, 32 planning target volume clinical trials, definition and dose prescription 19, 20, 22 definition 3, 4 imaging modalities 18, 22 inter-observer variability 18, 19 margins 5, 6, 17 organ motion 4, 5, 17 prognostic factors 1 radiation dose classification of patients and outcomes 10, 11 escalation studies MD Anderson randomized trial 11, 12 prescription guidelines 6, 7 retrospective studies 11, 12 rationale 25, 26 tumor control probability and radiation dose 87 Corticosteroids, treatment 73, 74 Cystectomy, see Bladder cancer Dethylstilbestrol, treatment 51 Docetaxel, treatment 76 Estramustine phosphate, treatment 75 Estrogens, treatment 51 5-Fluorouracil, radiochemotherapy of bladder cancer 121, 125, 136, 139 Health-related quality of life conformal three-dimensional radiotherapy for 13, 14 radical prostatectomy comparison of different prostate cancer treatment modality outcomes 99, 100, 104 impotence 103 patient education 104 urinary incontinence 100, 101, 103 Hormone ablation therapy, adjuvant and neoadjuvant therapy radiation therapy brachytherapy limitations 95, 96 cytoreduction 90 duration 95 early stage disease role 95 EORTC trial EORTC trial , 83 EORTC trial , 84 mechanisms and concerns 92 monoclonal antibody study 83, 84 post-radiation 58, 59 pre-radiation 60, 61 Quebec randomized trial 93 rationale 87, 89 RTOG trial 93, 94 synergistic cell killing 90, 91 target volume reduction 94 timing factors 81 Subject Index 194
4 radical prostatectomy postsurgery 57, 58 presurgery 59, 60 adverse effects 66 androgen dependence and independence of tumors 66, 67 early vs deferred therapy intermittent therapy continuous therapy comparison 56, 57 early studies 67, 68 phase II trials 68 phase III studies 69, 70 quality of life outcomes maximal androgen blockade 52, 54 monotherapy antiandrogens 52 estrogens 51 luteinizing-releasing hormone analogs 51 orchiectomy 50, 51, 61 survival 49, 66 palliative therapy 171 Hyperthermia with conformal radiotherapy, advantages 173 phase II trial outcomes 174, 175 protocol 173, 174 thermosensitivity of tissue 172, 173 Impotence, radical prostatectomy 103 Intensity modulated radiotherapy beam delivery 29, 30 definition 29 inverse planning 27 29, 178 outcomes 32, 33 planning target volume 6, 31, 32 KONRAD, inverse planning 29 Luteinizing-releasing hormone, prostate cancer treatment with analogs 51, 52, 59, 61, 82, 83 Lymph node radiation, combination therapy 47 patient selection 46, 47 pelvic lymph node radiation with highdose brachytherapy transrectal ultrasound guidance 186 prevalence of node involvement 43 rationale 43 retrospective analysis of pelvic node lymph irradiation biopsy-proven lymph node disease 45, 46 suspected lymph node disease 44 risk factors 43, 44 Magnetic resonance imaging bladder cancer staging 107, 108 clinical target volume 2, 3 planning target volume 18, 22 Mitomycin, treatment 74 Mitoxantrone, treatment 74 Paclitaxel, treatment 76 Pelvic lymph node, see Bladder cancer, Lymph node radiation, Planning target volume, conformal threedimensional radiotherapy of prostate cancer clinical trials, definition and dose prescription 19, 20, 22 definition 3, 4 imaging modalities 18, 22 intensity modulated radiotherapy 6 inter-observer variability 18, 19 margins 5, 6, 17 organ motion 4, 5, 17 Prostate cancer antiandrogen therapy, see Hormone ablation therapy, chemotherapy, see Chemotherapy, prostate cancer Subject Index 195
5 Prostate cancer (continued) epidemiology 171 prostatectomy, see Radical prostatectomy radiotherapy, see Brachytherapy, prostate cancer, Conformal three-dimensional radiotherapy,, Hyperthermia with conformal radiotherapy,, Intensity modulated radiotherapy, Lymph node radiation,, Radical prostatectomy Prostatectomy, see Radical prostatectomy Quality of life, see Health-related quality of life Radical cystectomy, see Bladder cancer Radical prostatectomy cancer recurrence rates 172, 177 health-related quality of life comparison of different treatment modality outcomes 99, 100, 104 impotence 103 patient education 104 urinary incontinence 100, 101, 103 historical perspective 99, 171 hormone ablation adjuvant therapy postsurgery 57, 58 presurgery 59, 60 radiation adjuvant therapy outcomes without radiotherapy 35 percutaneous radiotherapy 36 predictive criteria 38, 39 prostate-specific antigen elevation and outcomes 36 38, 40 side effects 39, 40 Suramin, treatment 73 Transurethral resection of bladder tumor, see Bladder cancer Urinary incontinence radical cystectomy 131 radical prostatectomy 100, 101, 103 Subject Index 196
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