EBRT stands for External Beam Radiation Therapy. It is a form of radiation treatment for prostate cancer that is often considered equivalent to surgery in terms of patient outcomes.
Key aspects of EBRT detailed in the sources include:
Techniques and Procedure
- Preferred Methods: Modern techniques such as 3D conformational radiation therapy or IMRT (intensity modulated radiation therapy) are preferred over standard techniques.
- Duration: A typical treatment course lasts approximately 8 to 9 weeks.
- Targeting: Depending on the risk level, EBRT may target only the prostate or include irradiation of the pelvic lymph nodes.
Clinical Applications
- Risk-Based Treatment:
- Low-Risk: EBRT can be used alone without pelvic node irradiation or hormonal therapy.
- Intermediate and High-Risk: It is frequently combined with Androgen Deprivation Therapy (ADT) for 4 months to 3 years to improve survival rates.
- Metastatic Disease: In cases of metastatic castrate-sensitive prostate cancer with a low metastatic burden, EBRT may be directed at the primary tumor.
- Palliative Care: EBRT is used to control bone pain and prevent fractures resulting from individual metastatic lesions.
Comparison to Surgery
- Benefits: EBRT is a primary option for patients who are not surgical candidates. Compared to surgery, it involves less bleeding, avoids the risks associated with anesthesia, and has a lower immediate risk of urinary incontinence and strictures.
- Disadvantages and Side Effects:
- Short-term: About 50% of patients experience temporary bowel or bladder symptoms during therapy.
- Long-term: Potential complications include radiation proctitis and sexual dysfunction. While erectile function may be preserved in the short term, the risk of erectile dysfunction increases over time.
- Late Effects: Some patients may experience late urinary or sexual dysfunction, such as urethral strictures or hematuria, 6 to 36 months after completing therapy.
Combination Therapy
Multiple clinical trials (such as RTOG and EORTC) have demonstrated that combining EBRT with ADT significantly improves overall survival and reduces the risk of disease progression compared to using radiation alone, particularly in intermediate and high-risk patients.
Synonyms
EBRT