Prostate Cancer Research: Radiation therapy Archives

prostate cancer Radiation therapy; +137 new citations

137 new PubMed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

prostate cancer Radiation therapy

These PubMed results were generated on 2006/09/27

PubMed, a service of the National Library of Medicine, includes over 15 million citations for biomedical articles back to the 1950's. These citations are from MEDLINE and additional life science journals. PubMed includes links to many sites providing full text articles and other related resources.

Posted by blogposter at 06:01 PM | Permalink

prostate cancer Radiation therapy; +40 new citations

40 new PubMed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

prostate cancer Radiation therapy

These PubMed results were generated on 2006/08/21

PubMed, a service of the National Library of Medicine, includes over 15 million citations for biomedical articles back to the 1950's. These citations are from MEDLINE and additional life science journals. PubMed includes links to many sites providing full text articles and other related resources.

Posted by blogposter at 04:52 PM | Permalink

prostate cancer Radiation therapy; +178 new citations

178 new PubMed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

prostate cancer Radiation therapy

These PubMed results were generated on 2006/08/09

PubMed, a service of the National Library of Medicine, includes over 15 million citations for biomedical articles back to the 1950's. These citations are from MEDLINE and additional life science journals. PubMed includes links to many sites providing full text articles and other related resources.

Posted by blogposter at 12:43 PM | Permalink

prostate cancer Radiation therapy; +28 new citations

28 new PubMed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

prostate cancer Radiation therapy

These PubMed results were generated on 2006/06/13

PubMed, a service of the National Library of Medicine, includes over 15 million citations for biomedical articles back to the 1950's. These citations are from MEDLINE and additional life science journals. PubMed includes links to many sites providing full text articles and other related resources.

Posted by blogposter at 08:57 PM | Permalink

prostate cancer Radiation therapy; +31 new citations

31 new PubMed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

prostate cancer Radiation therapy

These PubMed results were generated on 2006/06/05

PubMed, a service of the National Library of Medicine, includes over 15 million citations for biomedical articles back to the 1950's. These citations are from MEDLINE and additional life science journals. PubMed includes links to many sites providing full text articles and other related resources.

Posted by blogposter at 03:44 PM | Permalink

Prognostic value of PSA nadir < or =4 ng/mL within 4 months of high-dose radiotherapy for locally advanced prostate cancer.

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Prognostic value of PSA nadir < or =4 ng/mL within 4 months of high-dose radiotherapy for locally advanced prostate cancer.

Int J Radiat Oncol Biol Phys. 2006 May 1;65(1):73-7

Authors: Nickers P, Albert A, Waltregny D, Deneufbourg JM

PURPOSE: To investigate early prostate-specific antigen (PSA) kinetics after high radiation doses of 85 Gy on locally advanced prostate cancer. METHODS AND MATERIALS: A total of 201 patients were prospectively and consecutively treated with external beam radiotherapy and a brachytherapy boost. Of the 201 patients, 104 received concomitant hormonal therapy on the decision of the referring urologist and were excluded, yielding a study population of 97 patients. The first posttreatment PSA analysis was performed not earlier than 1 month after treatment completion but within the first 4 months, and then every 4 months. Analysis of PSA kinetics included the PSA nadir (nPSA) at values of < or =4 ng/mL to < or =0.5 ng/mL. The nPSA at < or =4 ng/mL within 4 months (nPSA < or =4/4m) was the variable of interest. RESULTS: We established highly significant associations between an nPSA of < or =1 and < or =0.5 ng/mL and the nPSA < or =4/4m (p <0.0001). A hazard ratio of 0.33 (95% Confidence Interval (CI), 0.12-0.91) underlined the lower risk of recurrence related to nPSA < or =4/4m achievement (p = 0.033). Using time-dependent covariate models for patients who did not reach an nPSA < or =4/4m, an nPSA of < or =1 ng/mL remained without prognostic significance (p = 0.06). However, for patients who reached an nPSA < or =4/4m, an nPSA of < or =1 ng/mL did significantly improve the prognosis (p <0.001), but much later after treatment. The same analysis was repeated for nPSA < or =0.5 ng/mL with similar conclusions as when nPSA < or =4/4m was obtained (p <0.01). CONCLUSION: The nPSA < or =4/4m has been demonstrated to be a significant predictor of biochemical no evidence of disease after high radiation doses of 85 Gy. Its major advantage is that it was available earlier than the other nadirs.

PMID: 16503381 [PubMed - indexed for MEDLINE]

Posted by blogposter at 10:53 AM | Permalink

Positron emission tomography with C11-acetate for tumor detection and localization in patients with prostate-specific antigen relapse after radical prostatectomy.

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Positron emission tomography with C11-acetate for tumor detection and localization in patients with prostate-specific antigen relapse after radical prostatectomy.

Urology. 2006 May;67(5):996-1000

Authors: Sandblom G, Sörensen J, Lundin N, Häggman M, Malmström PU

OBJECTIVES: To evaluate positron emission tomography with C11-acetate as a method for detecting and localizing prostate cancer recurrence. No technique for localizing and detecting prostate cancer recurrence after biochemical relapse available today is sensitive enough to localize recurrence at a stage at which salvage radiotherapy is still curative. METHODS: Twenty patients (age 56 to 77 years) who had undergone radical prostatectomy and had an increasing prostate-specific antigen level measured on two consecutive occasions were included. In addition to the investigations usually performed when prostate cancer recurrence is suspected, they underwent positron emission tomography with C11-acetate as the marker. RESULTS: Pathologic uptake of acetate was seen in 15 (75%) of the 20 patients. In 8 of these patients, a solitary lesion was found (seven in the prostatic fossa and one at the regional lymph nodes). Multiple lesions were found in the remaining 7. False-positive uptake was seen in 3 men (15%). Additional investigations in these men revealed pathologic findings other than prostate cancer. CONCLUSIONS: Positron emission tomography with C11-acetate as marker is a promising method for early detection and localization of prostate cancer recurrence. False-positive uptake does occur.

PMID: 16698359 [PubMed - in process]

Posted by blogposter at 08:49 PM | Permalink

prostate cancer Radiation therapy; +40 new citations

40 new PubMed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

prostate cancer Radiation therapy

These PubMed results were generated on 2006/05/15

PubMed, a service of the National Library of Medicine, includes over 15 million citations for biomedical articles back to the 1950's. These citations are from MEDLINE and additional life science journals. PubMed includes links to many sites providing full text articles and other related resources.

Posted by blogposter at 04:17 PM | Permalink

Health outcomes in older men with localized prostate cancer: results from the Prostate Cancer Outcomes Study.

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Health outcomes in older men with localized prostate cancer: results from the Prostate Cancer Outcomes Study.

Am J Med. 2006 May;119(5):418-25

Authors: Hoffman RM, Barry MJ, Stanford JL, Hamilton AS, Hunt WC, Collins MM

PURPOSE: We compared health-related quality-of-life (HRQOL) outcomes and survival of men with localized prostate cancer who received aggressive treatment with those receiving conservative management. METHODS: We conducted a population-based cohort study of men aged 75 to 84 years when diagnosed with a clinically localized cancer in 1994 or 1995. We used medical record abstractions and patient surveys to obtain clinical and HRQOL data at diagnosis and 24-month follow-up. We used a propensity score method to adjust for baseline differences between men treated with radical prostatectomy or radiation therapy (n = 175) and men who received hormone therapy or no treatment (n = 290). Propensity scores were used in regression analyses comparing HRQOL outcomes between treatment groups. Overall and disease-specific survivals were estimated with multivariate proportional hazards models. RESULTS: At 24 months following diagnosis, aggressively treated men were more likely to report daily urinary leakage (odds ratio [OR] = 2.9, 95% confidence interval [CI] 1.2-7.0) and to be bothered by urinary problems (OR = 5.1, 95% CI, 1.3-9.1) and sexual problems (OR = 2.8, 95% CI, 1.2-6.3). The adjusted disease-specific mortality hazard ratio was 0.43 (95% CI, 0.15, 1.28), favoring aggressive treatment. However, the absolute 5-year disease-specific survival difference was only 6% (98% vs 92%). Over 80% of all deaths were from other causes. CONCLUSIONS: Aggressive treatment was associated with significant decreases in disease-specific HRQOL. However, men who were aggressively treated for localized cancer had a minimally reduced absolute risk of dying from prostate cancer. Physicians and older patients should consider these outcomes in making decisions about screening and treatment.

PMID: 16651054 [PubMed - in process]

Posted by blogposter at 11:41 AM | Permalink

prostate cancer Radiation therapy; +49 new citations

49 new PubMed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

prostate cancer Radiation therapy

These PubMed results were generated on 2006/05/02

PubMed, a service of the National Library of Medicine, includes over 15 million citations for biomedical articles back to the 1950's. These citations are from MEDLINE and additional life science journals. PubMed includes links to many sites providing full text articles and other related resources.

Posted by blogposter at 04:32 PM | Permalink

Integral radiation dose to normal structures with conformal external beam radiation.

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Integral radiation dose to normal structures with conformal external beam radiation.

Int J Radiat Oncol Biol Phys. 2006 Mar 1;64(3):962-7

Authors: Aoyama H, Westerly DC, Mackie TR, Olivera GH, Bentzen SM, Patel RR, Jaradat H, Tome WA, Ritter MA, Mehta MP

BACKGROUND: This study was designed to evaluate the integral dose (ID) received by normal tissue from intensity-modulated radiotherapy (IMRT) for prostate cancer. METHODS AND MATERIALS: Twenty-five radiation treatment plans including IMRT using a conventional linac with both 6 MV (6MV-IMRT) and 20 MV (20MV-IMRT), as well as three-dimensional conformal radiotherapy (3DCRT) using 6 MV (6MV-3DCRT) and 20 MV (20MV-3DCRT) and IMRT using tomotherapy (6MV) (Tomo-IMRT), were created for 5 patients with localized prostate cancer. The ID (mean dose x tissue volume) received by normal tissue (NTID) was calculated from dose-volume histograms. RESULTS: The 6MV-IMRT resulted in 5.0% lower NTID than 6MV-3DCRT; 20 MV beam plans resulted in 7.7%-11.2% lower NTID than 6MV-3DCRT. Tomo-IMRT NTID was comparable to 6MV-IMRT. Compared with 6MV-3DCRT, 6MV-IMRT reduced IDs to the rectal wall and penile bulb by 6.1% and 2.7%, respectively. Tomo-IMRT further reduced these IDs by 11.9% and 16.5%, respectively. The 20 MV did not reduce IDs to those structures. CONCLUSIONS: The difference in NTID between 3DCRT and IMRT is small. The 20 MV plans somewhat reduced NTID compared with 6 MV plans. The advantage of tomotherapy over conventional IMRT and 3DCRT for localized prostate cancer was demonstrated in regard to dose sparing of rectal wall and penile bulb while slightly decreasing NTID as compared with 6MV-3DCRT.

PMID: 16458781 [PubMed - indexed for MEDLINE]

Posted by blogposter at 05:57 PM | Permalink

prostate cancer Radiation therapy; +50 new citations

50 new PubMed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

prostate cancer Radiation therapy

These PubMed results were generated on 2006/04/13

PubMed, a service of the National Library of Medicine, includes over 15 million citations for biomedical articles back to the 1950's. These citations are from MEDLINE and additional life science journals. PubMed includes links to many sites providing full text articles and other related resources.

Posted by blogposter at 11:18 PM | Permalink

Patterns of practice in the management of prostate cancer: results from multidisciplinary surveys of clinicians in Australia and New Zealand in 1995 and 2000.

Patterns of practice in the management of prostate cancer: results from multidisciplinary surveys of clinicians in Australia and New Zealand in 1995 and 2000.
Related Articles Patterns of practice in the management of prostate cancer: results from multidisciplinary surveys of clinicians in Australia and New Zealand in 1995 and 2000. BJU Int. 2006 Mar 17; Authors: Chong CC, Austen L, Kneebone A, Lalak A, Jalaludin B OBJECTIVE To investigate and compare patterns of practice in prostate cancer management in Australia and New Zealand from 1995 to 2000, as there are insufficient randomized trials to guide clinicians in the management of prostate cancer. SUBJECTS AND METHODS This study represents the two largest published surveys of Australian and New Zealand clinicians dealing with prostate cancer. We sent structured questionnaires on the management of prostate cancer patients to 804 urologists, radiation oncologists and medical oncologists in Australia and New Zealand in December 2000. We compared responses to a similar survey of 579 specialist clinicians in 1995. RESULTS The response rates were 56% in 1995 and 62% in 2000. In the management of clinically localized disease, the proportion recommending surgery or radiotherapy remained relatively constant between 1995 and 2000, although there was an increase in the use of brachytherapy and adjuvant hormonal therapy, and a reduced tendency to treat pelvic nodes. In the treatment of locally advanced disease, there was an increased use of hormonal treatment and local radiotherapy, with a reduction in the use of total androgen blockade and orchidectomy. In managing positive margins after prostatectomy, there was a clear lack of consensus, with a wide variety of treatment options proposed. CONCLUSIONS Practice has changed in several areas in 2000 compared to 1995, but not all changes were influenced by the publication of randomized trials or evidence-based guidelines. PMID: 16542341 [PubMed - as supplied by publisher]

Posted by blogposter at 11:43 PM | Permalink

Genitourinary small cell carcinoma: a retrospective review of treatment and survival patterns at The Ottawa Hospital Regional Cancer Center.

Genitourinary small cell carcinoma: a retrospective review of treatment and survival patterns at The Ottawa Hospital Regional Cancer Center.
Genitourinary small cell carcinoma: a retrospective review of treatment and survival patterns at The Ottawa Hospital Regional Cancer Center. BJU Int. 2006 Apr;97(4):711-5 Authors: Asmis TR, Reaume MN, Dahrouge S, Malone S OBJECTIVE To review patients with genitourinary (GU) small cell carcinoma (SCC) treated at a regional cancer centre, as due to its rarity and aggressive nature, GU SCC remains a therapeutic challenge. PATIENTS AND METHODS The charts of patients managed at a regional cancer centre between 1991 and 2002 for any GU diagnosis were manually reviewed to identify GU SCC. Demographic, staging, treatment and outcome data were extracted. The Veterans Administration small cell lung cancer staging classification of 'limited' or 'extensive' disease was adapted for SCC of the prostate and bladder (with 'limited' defined as disease localized to the true and false pelvis, and 'extensive' as disease beyond the pelvis). RESULTS In all, 555, 858 and 5066 new cases of primary renal, bladder and prostate cancer, respectively, were identified. Of these patients, 22 had GU SCC (12 bladder and 10 prostate; there were no cases of SCC of the kidney). Eight of 12 patients with bladder SCC had limited disease; five of 12 are alive (all with limited disease at diagnosis), and the median survival was 19.8 months. Surviving patients received similar therapy, with transurethral resection of the bladder tumour, platinum-based chemotherapy, etoposide (4-6 cycles), and radical radiotherapy (56-60 Gy). Two of 10 patients with SCC of the prostate had limited-stage disease, but all 10 died, the median survival being 9.5 months. Survival by stage for both types combined was 59 months for limited disease and 8 months for extensive disease. CONCLUSIONS These results indicate that GU SCC is an aggressive cancer; limited-stage SCC of the bladder or prostate, when treated with platinum/etoposide chemotherapy and radical radiotherapy, has a more favourable outcome than that of extensive GU SCC. PMID: 16536759 [PubMed - in process]

Posted by blogposter at 10:09 AM | Permalink

Hyperglycemia and insulin resistance in men with prostate carcinoma who receive androgen-deprivation therapy.

Hyperglycemia and insulin resistance in men with prostate carcinoma who receive androgen-deprivation therapy.
Related Articles Hyperglycemia and insulin resistance in men with prostate carcinoma who receive androgen-deprivation therapy. Cancer. 2006 Feb 1;106(3):581-8 Authors: Basaria S, Muller DC, Carducci MA, Egan J, Dobs AS BACKGROUND: Prostate carcinoma (PCa) is one of the most common malignancies in men. Androgen-deprivation therapy (ADT) is used frequently in the treatment of recurrent and metastatic PCa, rendering these men hypogonadal. Because male hypogonadism is associated with an unfavorable metabolic profile, and men with PCa have high cardiovascular mortality, the authors evaluated the effects of long-term ADT on fasting glucose levels, insulin levels, and insulin resistance. METHODS: To evaluate the long-term effects of ADT on fasting glucose and insulin resistance in men with PCa who received ADT and to determine whether these metabolic alterations are a result of hypogonadism, the authors conducted a cross-sectional study at a university-based research institution in the United States. In total, 53 men were evaluated, including 18 men with PCa who received ADT for at least 12 months prior to the onset of the study (the ADT group), 17 age-matched men with nonmetastatic PCa who had undergone prostatectomy and/or received radiotherapy and who were not receiving ADT (the non-ADT group), and 18 age-matched controls (the control group). None of the men had a known history of diabetes mellitus. RESULTS: The mean age was similar in all 3 groups (P=0.33). Serum total testosterone levels (P<0.0001) and free testosterone levels (P<0.0001) were significantly lower in the ADT group compared with the other groups. Men in the ADT group had a higher BMI compared with the other groups (overall P=0.005). After adjustment for age and BMI, men in the ADT group had significantly higher fasting levels of the following parameters: 1) Glucose levels were 131.0+/-7.43 mg/dL in the ADT group compared with 103.0+/-7.42 mg/dL in the non-ADT group (P=0.01) and 99.0+/-7.58 mg/dL in the control group (P<0.01). 2) Insulin levels were 45.0+/-7.25 uU/mL in the ADT group compared with 24.0+/-7.24 uU/mL in the non-ADT group (P=0.05) and 19.0+/-7.39 uU/mL in the control group (P=0.02). 3) Leptin levels were 25.0+/-2.57 ng/mL in the ADT group compared with 12.0+/-2.56 ng/mL in the non-ADT group (P<0.01) and 6.0+/-2.62 ng/mL in the control group (P<0.01). 4) The homeostatic model assessment for insulin resistance (HOMAIR)=17.0+/-2.78 in the ADT group compared with HOMAIR=6.0+/-2.77 in the non-ADT group (P<0.01) and HOMAIR=5.0+/-2.83 in the control group (P=0.01). There was a significant negative correlation between total and free testosterone levels with fasting glucose, insulin, leptin, and HOMAIR. CONCLUSIONS: The current data suggested that men with PCa who are receiving long-term ADT are at risk for developing insulin resistance and hyperglycemia, thus leading to their increased risk of cardiovascular disease. This adverse metabolic profile developed independent of age and BMI and appeared to be a direct result of androgen deprivation. PMID: 16388523 [PubMed - indexed for MEDLINE]

Posted by blogposter at 12:37 PM | Permalink

prostate cancer Radiation therapy; +44 new citations

prostate cancer Radiation therapy; +44 new citations
44 new PubMed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results: prostate cancer Radiation therapy These PubMed results were generated on 2006/03/12PubMed, a service of the National Library of Medicine, includes over 15 million citations for biomedical articles back to the 1950's. These citations are from MEDLINE and additional life science journals. PubMed includes links to many sites providing full text articles and other related resources.

Posted by blogposter at 07:44 PM | Permalink

A comparison of three-field and four-field techniques in different clinical target volumes in prostate cancer irradiation using dose volume histograms: a prospective three-dimensional analysis.

A comparison of three-field and four-field techniques in different clinical target volumes in prostate cancer irradiation using dose volume histograms: a prospective three-dimensional analysis.
Related Articles A comparison of three-field and four-field techniques in different clinical target volumes in prostate cancer irradiation using dose volume histograms: a prospective three-dimensional analysis. Br J Radiol. 2006 Feb;79(938):148-57 Authors: Hille A, T ws N, Hess CF The purpose of the current study was to quantitatively assess differences between irradiation techniques on normal tissue exposure in different clinical target volumes (CTVs) in irradiation of prostate cancer. 14 patients with prostate cancer undergoing external beam radiotherapy were investigated. The prostate and prostate + proximal/entire seminal vesicles were delineated as CTVs. A three-field and two different four-field plans were generated and compared concerning rectum, bladder and femoral head dose-volume histograms (DVHs). The exposure of the rectum exposed to 40-60 Gy was significantly lower for all CTVs with the three-field technique compared with both four-field techniques. The exposure of the rectum to 70 Gy was significantly lower for all CTVs with the weighted four-field technique compared with the unweighted four-field and three-field techniques. The weighted four-field technique was worst in bladder dose sparing for the three CTVs. Comparing the three-field and the unweighted four-field technique for irradiation of the prostate and prostate + entire seminal vesicles, no technique provided a clear advantage or disadvantage in bladder dose sparing. For irradiation of the prostate + proximal seminal vesicles the unweighted four-field technique provided the best bladder dose sparing. Concerning the exposure of the femoral heads, the three-field technique was significantly worse for the three CTVs compared with both four-field techniques. No difference was found between the unweighted and the weighted four-field techniques. In conclusion, none of the studied techniques consistently proved superior in different CTVs in prostate cancer irradiation with respect to sparing all organs at risk. The absolute differences between the three techniques were small and the clinical relevance of these findings is uncertain. PMID: 16489196 [PubMed - in process]

Posted by blogposter at 08:29 PM | Permalink

[Advancement of treatment for prostate cancer.]

[Advancement of treatment for prostate cancer.]
Related Articles [Advancement of treatment for prostate cancer.] Gan To Kagaku Ryoho. 2006 Feb;33(2):178-82 Authors: Hara I The number of prostate cancer patients is rapidly increasing in Japan,as aging people are more common and the lifestyle is more westernized. Another reason is that prostate specific antigen(PSA) is prevalent and PSA test can detect organ-confined prostate cancer in the early stage. In the past, endocrine therapy was the main treatment modality since many prostate cancer patients were diagnosed in the advanced stage. However, endocrine therapy is not suitable for young patients with organ-confined prostate cancer. Surgery and radiation therapy are becoming standard therapy for these patients. Although retropubic radical prostatectomy is widely performed,urinary incontinence and sexual dysfunction are still problems. Other approaches such as laparoscopic rostatectomy, portless endoscopic prostatectomy and perineal prostatectomy are also performed. Radiation therapy is commonly used for organ-confined prostate cancer in Europe and the U.S.A. The advancement in computer technology has made it possible to accumulate enough radiation dose to target without damaging the surrounding organs(3 D conformal, intensity-modulated radiotherapy). Heavy ion particle radiotherapy is also attempted in some institutes.Moreover, brachytherapy can be another choice in radiation therapy. In Japan, only high-dose brachytherapy with (192)Ir has been performed. In July 2003,permanent seed brachytherapy with (121)I was legally approved in Japan, and more organ-confined prostate cancer patients are expected to undergo this treatment. There are several treatment modalities for organ-confined prostate cancer patients these days. Therefore, not only tumor grade and stage, but also patients'lifestyle and thought should be considered in determining treatment. PMID: 16484852 [PubMed - in process]

Posted by blogposter at 01:38 PM | Permalink

Rising prostate-specific antigen after primary prostate cancer therapy.

Rising prostate-specific antigen after primary prostate cancer therapy.
Related Articles Rising prostate-specific antigen after primary prostate cancer therapy. Nat Clin Pract Urol. 2005 Apr;2(4):174-82 Authors: Ward JF, Moul JW An estimated 20-40% of men experience a biochemical recurrence within 10 years of definitive prostate cancer treatment. No single prostate-specific antigen (PSA) value is invariably associated with clinical metastasis or cancer-specific survival; PSA kinetics might prove to be a more important predictor of eventual progression-free survival and cancer-specific survival than absolute PSA level alone. With only one-third of patients progressing from biochemical recurrence to clinical disease, therapeutic morbidity should not outpace risk of disease progression. Salvage radiation therapy following radical prostatectomy has widely variable long-term biochemical control rates (from 18 to 64% depending on the follow-up period). Early hormonal therapy delivered as castration or complete androgen blockade might delay clinical metastasis in patients with high-risk pathologic disease; however, the adverse effects and morbidity of long-term therapy must not be underestimated. Non-steroidal antiandrogens as monotherapy for early biochemical recurrence, particularly for younger men who wish to preserve their libido and sexual potency, have received considerable attention, but there are conflicting data on long-term outcomes. Because of their favorable adverse-effect profiles, non-traditional therapies that exert localized hormonal or cellular effects are receiving considerable attention for treatment of early, PSA-only recurrence. Data from animal models provide a rationale for the use of these therapies, but there is a lack of evidence to support prolongation of progression-free survival or cancer-specific survival. PMID: 16474760 [PubMed - in process]

Posted by blogposter at 01:42 PM | Permalink

Is pretreatment PSA velocity associated with prostate-cancer-specific mortality rate after radiotherapy?

Is pretreatment PSA velocity associated with prostate-cancer-specific mortality rate after radiotherapy?
Related Articles Is pretreatment PSA velocity associated with prostate-cancer-specific mortality rate after radiotherapy? Nat Clin Pract Urol. 2006 Jan;3(1):12-3 Authors: Pollack A PMID: 16474485 [PubMed - in process]

Posted by blogposter at 09:09 PM | Permalink

Locally advanced prostate cancer treated with radiotherapy and androgen deprivation.

Locally advanced prostate cancer treated with radiotherapy and androgen deprivation.
Related Articles Locally advanced prostate cancer treated with radiotherapy and androgen deprivation. Nat Clin Pract Urol. 2005 Jun;2(6):304-8 Authors: Kirby R Background A 60-year-old man, with a 2-year history of lower-urinary-tract symptoms (frequency and reduced flow) and perineal discomfort, presented with a serum PSA level of 42 ng/ml.Investigations Digital rectal examination, transrectal ultrasound, prostate biopsy (8 cores), prostate and pelvic MRI, renal ultrasound and bone scan.Diagnosis cT3b, N0, M0 prostate cancer (Gleason score 7 [4 + 3]).Management Hormonal down-staging with bicalutamide 150 mg/day for 3 months, then conformal radiotherapy (70 Gy over 7 weeks) with adjuvant bicalutamide 150 mg/day, to be continued until disease progression. Breast radiotherapy administered over a 5-day period at a dose of 15 Gy to reduce nonsteroidal antiandrogen-associated gynecomastia and breast pain. PMID: 16474813 [PubMed - in process]

Posted by blogposter at 02:48 PM | Permalink

Advances in radiotherapy for prostate cancer.

Advances in radiotherapy for prostate cancer.
Related Articles Advances in radiotherapy for prostate cancer. Br J Radiol. 2005;78 Spec No 2:S112-6 Authors: Ash D PMID: 16306633 [PubMed - indexed for MEDLINE]

Posted by blogposter at 08:10 PM | Permalink

Advances in radiotherapy for prostate cancer.

Advances in radiotherapy for prostate cancer.
Related Articles Advances in radiotherapy for prostate cancer. Br J Radiol. 2005;78 Spec No 2:S112-6 Authors: Ash D PMID: 16306633 [PubMed - indexed for MEDLINE]

Posted by blogposter at 01:32 PM | Permalink

Large deformation three-dimensional image registration in image-guided radiation therapy.

Large deformation three-dimensional image registration in image-guided radiation therapy.
Related Articles Large deformation three-dimensional image registration in image-guided radiation therapy. Phys Med Biol. 2005 Dec 21;50(24):5869-92 Authors: Foskey M, Davis B, Goyal L, Chang S, Chaney E, Strehl N, Tomei S, Rosenman J, Joshi S In this paper, we present and validate a framework, based on deformable image registration, for automatic processing of serial three-dimensional CT images used in image-guided radiation therapy. A major assumption in deformable image registration has been that, if two images are being registered, every point of one image corresponds appropriately to some point in the other. For intra-treatment images of the prostate, however, this assumption is violated by the variable presence of bowel gas. The framework presented here explicitly extends previous deformable image registration algorithms to accommodate such regions in the image for which no correspondence exists. We show how to use our registration technique as a tool for organ segmentation, and present a statistical analysis of this segmentation method, validating it by comparison with multiple human raters. We also show how the deformable registration technique can be used to determine the dosimetric effect of a given plan in the presence of non-rigid tissue motion. In addition to dose accumulation, we describe a method for estimating the biological effects of tissue motion using a linear-quadratic model. This work is described in the context of a prostate treatment protocol, but it is of general applicability. PMID: 16333161 [PubMed - indexed for MEDLINE]

Posted by blogposter at 04:09 PM | Permalink

Radiation sensitivity of human carcinoma cells transfected with small interfering RNA targeted against cyclooxygenase-2.

Radiation sensitivity of human carcinoma cells transfected with small interfering RNA targeted against cyclooxygenase-2.
Related Articles Radiation sensitivity of human carcinoma cells transfected with small interfering RNA targeted against cyclooxygenase-2. Clin Cancer Res. 2005 Oct 1;11(19 Pt 1):6980-6 Authors: Palayoor ST, Arayankalayil MJ, Shoaibi A, Coleman CN PURPOSE: Cyclooxygenase-2 (COX-2) is considered a potential target for cancer therapy, because COX-2 levels are elevated in the majority of human tumors compared with the normal tissues. COX-2 inhibitors inhibit tumor growth and enhance radiation response in vitro as well as in vivo. However, the precise role of COX-2 in radiation response is not clear. The purpose of the present study was to investigate the in vitro radiosensitivity of tumor cells as a function of COX-2 expression. EXPERIMENTAL DESIGN AND RESULTS: PC3 and HeLa cells express COX-2 protein constitutively. We silenced the COX-2 gene in these cells using small interfering RNA (siRNA). Transfection of PC3 cells with 100 nmol/L siRNA targeted against COX-2 resulted in reduction of COX-2 protein by 75% and inhibition of arachidonic acid-induced prostaglandin E2 synthesis by approximately 50% compared with the vehicle control. In HeLa cells, 100 nmol/L COX-2 siRNA inhibited COX-2 protein expression by 80%. Cell cycle analysis showed that transfection with COX-2 siRNA did not alter the cell cycle distribution. Radiosensitivity was determined by clonogenic cell survival assay. There was no significant difference in the radiosensitivity of cells in which COX-2 was silenced compared with the cells transfected vehicle or with negative control siRNAs (enhancement ratio = 1.1). CONCLUSIONS: These data indicate that the in vitro radiosensitivity of tumor cells is minimally dependent on the cellular COX-2 status. Given that a number of potential mechanisms are attributed to COX-2 inhibitors for radiosensitization, specific intervention of COX-2 by RNA interference could help elucidate the precise role of COX-2 in cancer therapy and to optimize strategies for COX-2 inhibition. PMID: 16203791 [PubMed - indexed for MEDLINE]

Posted by blogposter at 10:30 PM | Permalink

Influence of number of CAG repeats on local control in the RTOG 86-10 protocol.

Influence of number of CAG repeats on local control in the RTOG 86-10 protocol.
Related Articles Influence of number of CAG repeats on local control in the RTOG 86-10 protocol. Am J Clin Oncol. 2006 Feb;29(1):14-20 Authors: Abdel-Wahab M, Berkey BA, Krishan A, O'Brien T, Hammond E, Roach M, Lawton C, Pilepich M, Markoe A, Pollack A OBJECTIVES: The number of CAG repeats on the androgen receptor (AR) gene is inversely proportional to transcriptional activity. The purpose of this study was to determine if short-term androgen deprivation therapy (RT + HT) can improve outcome in patients with tumors with short CAG repeats (<19). MATERIALS AND METHODS: Prostate cancer patients were randomized to receive either radiotherapy (RT) alone or (RT + HT) in the RTOG 86-10 study. CAG repeats were measured in 94 tumor specimens (21%; test cohort) of the 456 (parent cohort) analyzable cases. AR flow cytometry measurements were done on 13 patients. The effect on local failure (LF), distant metastases (DM), prostate cancer survival (PSS), and overall survival (OS) was studied. RESULTS: Pretreatment characteristics and assigned treatment arm were not significantly different between the parent and test groups except for a significantly higher risk of death (P = 0.049) in the test group. The median CAG repeat was 19. There were no significant differences in stage, or Gleason score between high (19 or greater) and low CAG (<19) patients within each treatment group. Number of CAG repeats alone did not significantly influence LF, DM, PSS, and OS. However, when the CAG repeat outcome was studied in conjunction with androgen deprivation therapy, patients with CAG <19 who received H + RT had improved local control as compared with patients who received RT alone (P = 0.026, 5-year rates 4.6% versus 36.4%) and improved local control over patients with CAG > or =19 that received H + RT (P = 0.028). CONCLUSIONS: Patients with short CAG repeats show a local control benefit with short-term androgen deprivation therapy, but no improvement in survival. PMID: 16462497 [PubMed - in process]

Posted by blogposter at 05:26 PM | Permalink

Integral radiation dose to normal structures with conformal external beam radiation.

Integral radiation dose to normal structures with conformal external beam radiation.
Related Articles Integral radiation dose to normal structures with conformal external beam radiation. Int J Radiat Oncol Biol Phys. 2006 Mar 1;64(3):962-7 Authors: Aoyama H, Westerly DC, Mackie TR, Olivera GH, Bentzen SM, Patel RR, Jaradat H, Tome WA, Ritter MA, Mehta MP Background: This study was designed to evaluate the integral dose (ID) received by normal tissue from intensity-modulated radiotherapy (IMRT) for prostate cancer. Methods and Materials: Twenty-five radiation treatment plans including IMRT using a conventional linac with both 6 MV (6MV-IMRT) and 20 MV (20MV-IMRT), as well as three-dimensional conformal radiotherapy (3DCRT) using 6 MV (6MV-3DCRT) and 20 MV (20MV-3DCRT) and IMRT using tomotherapy (6MV) (Tomo-IMRT), were created for 5 patients with localized prostate cancer. The ID (mean dose x tissue volume) received by normal tissue (NTID) was calculated from dose-volume histograms. Results: The 6MV-IMRT resulted in 5.0% lower NTID than 6MV-3DCRT; 20 MV beam plans resulted in 7.7%-11.2% lower NTID than 6MV-3DCRT. Tomo-IMRT NTID was comparable to 6MV-IMRT. Compared with 6MV-3DCRT, 6MV-IMRT reduced IDs to the rectal wall and penile bulb by 6.1% and 2.7%, respectively. Tomo-IMRT further reduced these IDs by 11.9% and 16.5%, respectively. The 20 MV did not reduce IDs to those structures. Conclusions: The difference in NTID between 3DCRT and IMRT is small. The 20 MV plans somewhat reduced NTID compared with 6 MV plans. The advantage of tomotherapy over conventional IMRT and 3DCRT for localized prostate cancer was demonstrated in regard to dose sparing of rectal wall and penile bulb while slightly decreasing NTID as compared with 6MV-3DCRT. PMID: 16458781 [PubMed - in process]

Posted by blogposter at 05:12 PM | Permalink

[Evaluation of Setup Error and Adequate Setup Margins in Patients with Prostate Cancer Treated by IMRT and Fixed in the Prone Position Using a Set of Immobilization Devices.]

[Evaluation of Setup Error and Adequate Setup Margins in Patients with Prostate Cancer Treated by IMRT and Fixed in the Prone Position Using a Set of Immobilization Devices.]
Related Articles [Evaluation of Setup Error and Adequate Setup Margins in Patients with Prostate Cancer Treated by IMRT and Fixed in the Prone Position Using a Set of Immobilization Devices.] Nippon Hoshasen Gijutsu Gakkai Zasshi. 2006 Jan 20;62(1):130-5 Authors: Takakura T, Nakata M, Yano S, Okada T, Fujimoto T, Matsubara K, Mizowaki T, Takayama K, Norihisa Y Purpose: Positional reproducibility in patients with prostate cancer fixed in the prone position with a set of immobilization devices for external-beam intensity-modulated radiation therapy (IMRT) was evaluated. In addition, the adequacy of our positional error reduction strategy and current planning target volume (PTV) margins was also evaluated. Results: Systematic error was corrected by the positional correction that we executed at the first stage of irradiation. The setup margin that we had calculated was 1.1 mm in the L-R direction, 1.3 mm in the A-P direction, and 2.7 mm in the C-C direction. Conclusion: We determined that the effectiveness of the method of correcting the error margin and the setup accuracy of the fixed method were well maintained. PMID: 16456514 [PubMed - in process]

Posted by blogposter at 11:41 AM | Permalink

Oblique needle segmentation and tracking for 3D TRUS guided prostate brachytherapy.

Oblique needle segmentation and tracking for 3D TRUS guided prostate brachytherapy.
Related Articles Oblique needle segmentation and tracking for 3D TRUS guided prostate brachytherapy. Med Phys. 2005 Sep;32(9):2928-41 Authors: Wei Z, Gardi L, Downey DB, Fenster A An algorithm was developed in order to segment and track brachytherapy needles inserted along oblique trajectories. Three-dimensional (3D) transrectal ultrasound (TRUS) images of the rigid rod simulating the needle inserted into the tissue-mimicking agar and chicken breast phantoms were obtained to test the accuracy of the algorithm under ideal conditions. Because the robot possesses high positioning and angulation accuracies, we used the robot as a "gold standard," and compared the results of algorithm segmentation to the values measured by the robot. Our testing results showed that the accuracy of the needle segmentation algorithm depends on the needle insertion distance into the 3D TRUS image and the angulations with respect to the TRUS transducer, e.g., at a 10 degrees insertion anglulation in agar phantoms, the error of the algorithm in determining the needle tip position was less than 1 mm when the insertion distance was greater than 15 mm. Near real-time needle tracking was achieved by scanning a small volume containing the needle. Our tests also showed that, the segmentation time was less than 60 ms, and the scanning time was less than 1.2 s, when the insertion distance into the 3D TRUS image was less than 55 mm. In our needle tracking tests in chicken breast phantoms, the errors in determining the needle orientation were less than 2 degrees in robot yaw and 0.7 degrees in robot pitch orientations, for up to 20 degrees needle insertion angles with the TRUS transducer in the horizontal plane when the needle insertion distance was greater than 15 mm. PMID: 16266107 [PubMed - indexed for MEDLINE]

Posted by blogposter at 12:24 PM | Permalink

Optimization of intensity-modulated radiation therapy with biological objectives.

Optimization of intensity-modulated radiation therapy with biological objectives.
Related Articles Optimization of intensity-modulated radiation therapy with biological objectives. Phys Med Biol. 2005 Nov 21;50(22):5357-79 Authors: Olafsson A, Jeraj R, Wright SJ IMRT treatment planning via biological objectives gives rise to constrained nonlinear optimization problems. We consider formulations with nonlinear objectives based on the equivalent uniform dose (EUD), with bound constraints on the beamlet weights, and describe fast, flexible variants of the two-metric gradient-projection approach for solving them efficiently and in a mathematically sound manner. We conclude that an approach that calculates the Newton component of the step iteratively, by means of the conjugate-gradient algorithm and an implicit representation of the Hessian matrix, is most effective. We also present an efficient heuristic for obtaining an approximate solution with a smoother distribution of beamlet weights. The effectiveness of the methods is verified by testing on a medium-scale clinical case. PMID: 16264258 [PubMed - indexed for MEDLINE]

Posted by blogposter at 05:29 PM | Permalink

Thermotherapy using magnetic nanoparticles combined with external radiation in an orthotopic rat model of prostate cancer.

Thermotherapy using magnetic nanoparticles combined with external radiation in an orthotopic rat model of prostate cancer.
Related Articles Thermotherapy using magnetic nanoparticles combined with external radiation in an orthotopic rat model of prostate cancer. Prostate. 2006 Jan 1;66(1):97-104 Authors: Johannsen M, Thiesen B, Gneveckow U, Taymoorian K, Waldöfner N, Scholz R, Deger S, Jung K, Loening SA, Jordan A BACKGROUND: We evaluated the effects of thermotherapy using magnetic nanoparticles, also referred to as magnetic fluid hyperthermia (MFH), combined with external radiation, in the Dunning model of prostate cancer. METHODS: Orthotopic tumors were induced in 96 male Copenhagen rats. Animals were randomly allocated to eight groups, including controls and groups for dose-finding studies of external radiation. Treatment groups received two serial thermotherapy treatments following a single intratumoral injection of magnetic fluid or thermotherapy followed by external radiation (10 Gy). On day 20, after tumor induction, tumor weights in the treatment and control groups were compared and iron measurements in selected organs were carried out. RESULTS: Mean maximal and minimal intratumoral temperatures obtained were 58.7 degrees C (centrally) and 42.7 degrees C (peripherally) during the first thermotherapy and 55.4 degrees C and 42.3 degrees C, respectively, during the second of two treatment sessions. Combined thermotherapy and radiation with 20 Gy was significantly more effective than radiation with 20 Gy alone and reduced tumor growth by 87.5-89.2% versus controls. Mean iron content in the prostates on day 20 was 87.5% of the injected dose of ferrites, whereas only 2.5% was found in the liver. CONCLUSIONS: An additive effect was demonstrated for the combined treatment at a radiation dose of 20 Gy, which was equally effective in inhibiting tumor growth as radiation alone with 60 Gy. Serial heat treatments were possible without repeated injection of magnetic fluid. The optimal treatment schedules of this combination regarding temperatures, radiation dose, and fractionation need to be defined in further experimental studies. PMID: 16114060 [PubMed - indexed for MEDLINE]

Posted by blogposter at 11:32 AM | Permalink

Severity categories of the International Prostate Symptom Score before, and urinary morbidity after, permanent prostate brachytherapy.

Severity categories of the International Prostate Symptom Score before, and urinary morbidity after, permanent prostate brachytherapy.
Related Articles Severity categories of the International Prostate Symptom Score before, and urinary morbidity after, permanent prostate brachytherapy. BJU Int. 2006 Jan;97(1):62-8 Authors: Gutman S, Merrick GS, Butler WM, Wallner KE, Allen Z, Galbreath RW, Adamovich E OBJECTIVE: To determine if the International Prostate Symptom Score (IPSS) before seed implantation, stratified into mild (0-7), moderate (8-19) and severe (>20) categories, predicts brachytherapy-related morbidity in terms of IPSS resolution, catheter dependency and the need for surgical intervention after brachytherapy. PATIENTS AND METHODS: From January 1998 to September 2003, 1034 consecutive patients had permanent interstitial brachytherapy for clinical stage T1b-T3a NXM0 (2002 system) prostate cancer. Of the 1034 patients, 739 (71.5%) presented with an IPSS of 0-7, 287 (27.7%) of 8-19, and eight (0.8%) of > or = 20. The IPSS 8-19 cohort was further stratified into 8-14 (237 men) and 15-19 (50 men) subgroups. The median follow-up was 38.2 months. In all patients, an alpha-blocker was initiated before brachytherapy and continued at least until the IPSS normalized, the latter defined as a return to within 1 point of that before implantation. A median of 21 IPSS questionnaires were obtained per patient. Several clinical, treatment and dosimetric variables were evaluated as predictors of urinary morbidity. RESULTS: For the entire cohort, the IPSS peaked at a mean of 0.5 months after implantation and resolved at a mean of 1.7 months. At 5 years after brachytherapy, 90.1% of patients at risk (88.8%, 95.5%, and four of eight patients with a pre-implant IPSS of 0-7, 8-19 and > or = 20, respectively) were within the IPSS 0-7 category. Compared to the pre-implant IPSS, 13 patients (8%) were assigned to a higher IPSS severity category. Neither prolonged urinary catheter dependency (>5 days; 16 patients, 1.5%) or transurethral resection of the prostate (TURP, 17 patients, 1.6%) depended on the pre-implant IPSS subgroup. In Cox regression analysis, IPSS resolution was best predicted by pre-implant IPSS, prolonged catheter dependency by patient age, and TURP by any catheter dependency, the maximum IPSS increase and the maximum urethral dose. CONCLUSIONS: The IPSS before implantation predicted the resolution of IPSS after brachytherapy, but did not correlate with substantial urinary morbidity, including catheter dependency or the need for TURP. At 5 years after brachytherapy, 90.1% of patients at risk were assigned to the IPSS 0-7 category. PMID: 16336330 [PubMed - indexed for MEDLINE]

Posted by blogposter at 09:08 PM | Permalink

L14: erectile dysfunction after radiotherapy for prostate cancer.

L14: erectile dysfunction after radiotherapy for prostate cancer.
Related Articles L14: erectile dysfunction after radiotherapy for prostate cancer. J Sex Med. 2004 Nov;1 Suppl 1:16-7 Authors: Incrocci L PMID: 16422934 [PubMed - in process]

Posted by blogposter at 07:53 PM | Permalink

Expanding the therapeutic index of radiation therapy by combining in situ gene therapy in the treatment of prostate cancer.

Expanding the therapeutic index of radiation therapy by combining in situ gene therapy in the treatment of prostate cancer.
Related Articles Expanding the therapeutic index of radiation therapy by combining in situ gene therapy in the treatment of prostate cancer. Technol Cancer Res Treat. 2006 Feb;5(1):23-36 Authors: Tetzlaff MT, Teh BS, Timme TL, Fujita T, Satoh T, Tabata KI, Mai WY, Vlachaki MT, Amato RJ, Kadmon D, Miles BJ, Ayala G, Wheeler TM, Aguilar-Cordova E, Thompson TC, Butler EB The advances in radiotherapy (3D-CRT, IMRT) have enabled high doses of radiation to be delivered with the least possible associated toxicity. However, the persistence of cancer (local recurrence after radiotherapy) despite these increased doses as well as distant failure suggesting the existence of micro-metastases, especially in the case of higher risk disease, have underscored the need for continued improvement in treatment strategies to manage local and micro-metastatic disease as definitively as possible. This has prompted the idea that an increase in the therapeutic index of radiotherapy might be achieved by combining it with in situ gene therapy. The goal of these combinatorial therapies is to maximize the selective pressure against cancer cell growth while minimizing treatment-associated toxicity. Major efforts utilizing different gene therapy strategies have been employed in conjunction with radiotherapy. We reviewed our and other published clinical trials utilizing this combined radio-genetherapy approach including their associated pre-clinical in vitro and in vivo models. The use of in situ gene therapy as an adjuvant to radiation therapy dramatically reduced cell viability in vitro and tumor growth in vivo. No significant worsening of the toxicities normally observed in single-modality approaches were identified in Phase I/II clinical studies. Enhancement of both local and systemic T-cell activation was noted with this combined approach suggesting anti-tumor immunity. Early clinical outcome including biochemical and biopsy data was very promising. These results demonstrate the increased therapeutic efficacy achieved by combining in situ gene therapy with radiotherapy in the management of local prostate cancer. The combined approach maximizes tumor control, both local-regional and systemic through radio-genetherapy induced cytotoxicity and anti-tumor immunity. PMID: 16417399 [PubMed - in process]

Posted by blogposter at 07:43 PM | Permalink

The Actual Value of the Surgical Margin Status as a Predictor of Disease Progression in Men with Early Prostate Cancer.

The Actual Value of the Surgical Margin Status as a Predictor of Disease Progression in Men with Early Prostate Cancer.
The Actual Value of the Surgical Margin Status as a Predictor of Disease Progression in Men with Early Prostate Cancer. Eur Urol. 2006 Jan 6; Authors: Vis AN, Schröder FH, van der Kwast TH OBJECTIVES: The surgical margin status after radical prostatectomy for prostate cancer has long been considered a powerful prognostic factor, as well as an important risk factor for local recurrent disease after radical prostatectomy. In this study, a critical analysis of the predictive value of the surgical margin status was performed. METHODS: A well-described cohort of 281 participants of a population-based randomized screening trial who underwent radical prostatectomy between 1994 and 2000 was analyzed. Besides pathologic tumor stage, Gleason score, percentage of high-grade cancer, and tumor volume, the prognostic value of the surgical margin status for disease outcome (prostate-specific antigen [PSA] relapse, local recurrence) was statistically evaluated. Specifically, site ('apical' or 'circumferential') and extent of surgical margin negativity ('negative', or 'close') or positivity ('focal' or 'extensive') was assessed. RESULTS: At a median follow-up of 7 yr (range, 5-120 mo), 39 (13.9%) and 7 (2.5%) men had biochemical failure (PSA >/=0.1ng/ml), and local relapse, respectively. The surgical margin status was positive in 66 (23.5%), with 26 (9.3%) at the prostatic apex. The margin status was an independent statistically significant risk factor for biochemical relapse, though not for local relapse. Of those with positive margins, 22 (33.3%) had PSA relapse and 4 (6.1%) had local recurrence, whereas these figures were 17 (7.9%) and 3 (1.4%) for those with a negative surgical margin, respectively. The extent of margin positivity was not predictive of PSA relapse nor was the site of the surgical margin. CONCLUSIONS: In surgically treated prostate cancer, the surgical margin status has, although being a statistically significant prognostic factor, only limited predictive value for PSA relapse and local recurrent disease. The majority of men with (extensive) positive surgical margins will not experience PSA relapse nor local disease progression, even in absence of adjuvant radiotherapy. So, cases with a positive margin of resection may still be cured, although the procedure in itself was not 'radical'. PMID: 16413660 [PubMed - as supplied by publisher]

Posted by blogposter at 11:35 AM | Permalink

[Delay to radiotherapy: a study of three tumour sites]

[Delay to radiotherapy: a study of three tumour sites]
Related Articles [Delay to radiotherapy: a study of three tumour sites] Cancer Radiother. 2005 Dec;9(8):590-601 Authors: Schlienger M In the following review of the literature, the reasons and consequences of a tendency to the increase of the delay between the diagnosis and the first irradiation session will be studied. The duration of the delay varies according to the protocol of treatment, which itself depends on the tumour. Moreover, all types of radiotherapy are concerned by the increase in delay. A retrospective study enables to determine for a given series of similar tumours and treatments the mean duration of delay and find the excessive duration. The increase of delay phenomenon exists in different countries. We know that before irradiation the tumour grows according to its biological characteristics and the TNM initial determination will no longer be true. On the other hand, effective treatments such as chemotherapy and hormone therapy are increasingly used alone, before or in combination with radiotherapy. Consequently, the classical timing of radiation therapy could be modified often delayed. It is difficult to consider that successive treatments are a real increase of delay and compare its results with previous data from radiotherapy alone. We will study its impact in three types of tumours, including tumours of head and neck, of the breast and prostate, which are the most widely reported. The consequences of prolonged delay are not easily evaluated: one of the more important parameters is the possible modification of the stage of tumour. This phenomenon is not restricted to the studied types of tumours. We will try to find possible ways of reducing abnormal delays before irradiation. PMID: 16168693 [PubMed - indexed for MEDLINE]

Posted by blogposter at 07:22 PM | Permalink

Defining biochemical failure after radiotherapy with and without androgen deprivation for prostate cancer.

Defining biochemical failure after radiotherapy with and without androgen deprivation for prostate cancer.
Related Articles Defining biochemical failure after radiotherapy with and without androgen deprivation for prostate cancer. Int J Radiat Oncol Biol Phys. 2005 Dec 1;63(5):1455-62 Authors: Buyyounouski MK, Hanlon AL, Eisenberg DF, Horwitz EM, Feigenberg SJ, Uzzo RG, Pollack A PURPOSE: To compare several characteristics of alternative definitions of biochemical failure (BF) in men with extended follow-up after radiotherapy (RT) with or with androgen deprivation therapy (ADT) for prostate cancer. METHODS AND MATERIALS: From December 1, 1991, to April 30, 1998, 688 men with Stage T1c-T3NX-N0M0 prostate cancer received RT alone (n = 586) or RT plus ADT (n = 102) with a minimal follow-up of 4 years and five or more "ADT-free" posttreatment prostate-specific antigen levels. BF was defined by three methods: (1) the ASTRO definition (three consecutive rises in prostate-specific antigen level); (2) a modified American Society for Therapeutic Radiology Oncology (ASTRO) definition requiring two additional consecutive rises when a decline immediately subsequent to three consecutive rises occurred; and (3) the "Houston" or nadir plus 2-ng/mL definition (a rise of at least 2 ng/mL greater than the nadir). The sensitivity, specificity, positive predictive value, negative predictive value, and overall accuracy were determined for each using clinical progression as the endpoint. Furthermore, the misclassification rates for a steadily rising prostate-specific antigen level, ability to satisfy the proportional hazards (RT with or without ADT), effects of short follow-up, and intervals to the diagnosis of BF were compared. RESULTS: The misclassification rate for BF using the nadir plus 2-ng/mL definition was 2% for RT alone and 0% for RT plus ADT compared with 0% and 0% for the modified ASTRO definition, and 5% and 23% for the ASTRO definition, respectively. The hazard rates for RT alone and RT plus ADT were proportional only for the nadir plus 2 ng/mL definition and seemingly unaffected by the length of follow-up. For RT with or without ADT, the nadir plus 2 ng/mL definition was the most specific (RT, 80% vs. RT plus ADT, 75%) with the greatest positive predictive value (RT, 36% vs. RT plus ADT, 25%) and overall accuracy (RT, 81% vs. RT plus ADT, 77%). A greater proportion of BF was diagnosed in the first 2 years of follow-up with the nadir plus 2 ng/mL definition compared with the ASTRO definition (13% vs. 5%, p = 0.0138, chi-square test). CONCLUSION: The nadir plus 2 ng/mL definition was the best predictor of sustained, true, biochemical, and clinical failure, and was not affected by the use of ADT or follow-up length. PMID: 16169682 [PubMed - indexed for MEDLINE]

Posted by blogposter at 09:55 PM | Permalink

A phase III randomized, placebo-controlled, double-blind study of misoprostol rectal suppositories to prevent acute radiation proctitis in patients with prostate cancer.

A phase III randomized, placebo-controlled, double-blind study of misoprostol rectal suppositories to prevent acute radiation proctitis in patients with prostate cancer.
Related Articles A phase III randomized, placebo-controlled, double-blind study of misoprostol rectal suppositories to prevent acute radiation proctitis in patients with prostate cancer. Int J Radiat Oncol Biol Phys. 2005 Dec 1;63(5):1488-93 Authors: Hille A, Schmidberger H, Hermann RM, Christiansen H, Saile B, Pradier O, Hess CF PURPOSE: Acute radiation proctitis is the most relevant complication of pelvic radiation and is still mainly treated supportively. Considering the negative impact of acute proctitis symptoms on patients' daily activities and the potential relationship between the severity of acute radiation injury and late damage, misoprostol was tested in the prevention of acute radiation-induced proctitis. METHODS AND MATERIALS: A total of 100 patients who underwent radiotherapy for prostate cancer were entered into this phase III randomized, placebo-controlled, double-blind study with misoprostol or placebo suppositories. Radiation-induced toxicity was evaluated weekly during radiotherapy using the Common Toxicity Criteria. RESULTS: Between the placebo and the misoprostol groups, no significant differences in proctitis symptoms occurred: 76% of patients in each group had Grade 1 toxicity, and 26% in the placebo group and 36% in the misoprostol group had Grade 2 toxicity. No differences were found in onset or symptom duration. Comparing the peak incidence of patients' toxicity symptoms, significantly more patients experienced rectal bleeding in the misoprostol group (p = 0.03). CONCLUSION: Misoprostol given as a once-daily suppository did not decrease the incidence and severity of radiation-induced acute proctitis and may increase the incidence of acute bleeding. PMID: 16137837 [PubMed - indexed for MEDLINE]

Posted by blogposter at 01:10 PM | Permalink

[Advances in brachytherapy]

[Advances in brachytherapy]
Related Articles [Advances in brachytherapy] Arch Esp Urol. 2005 May;58(4):279-84 Authors: Green TC PMID: 15989090 [PubMed - indexed for MEDLINE]

Posted by blogposter at 09:06 PM | Permalink

[Advances in brachytherapy]

[Advances in brachytherapy]
Related Articles [Advances in brachytherapy] Arch Esp Urol. 2005 May;58(4):279-84 Authors: Green TC PMID: 15989090 [PubMed - indexed for MEDLINE]

Posted by blogposter at 09:00 PM | Permalink

prostate cancer Radiation therapy; +24 new citations

prostate cancer Radiation therapy; +24 new citations
24 new PubMed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results: prostate cancer Radiation therapy These PubMed results were generated on 2005/12/29PubMed, a service of the National Library of Medicine, includes over 15 million citations for biomedical articles back to the 1950's. These citations are from MEDLINE and additional life science journals. PubMed includes links to many sites providing full text articles and other related resources.

Posted by blogposter at 01:58 PM | Permalink

Statins, especially atorvastatin, may favorably influence clinical presentation and biochemical

Statins, especially atorvastatin, may favorably influence clinical presentation and biochemical progression-free survival after brachytherapy for clinically localized prostate cancer.

Related Articles

Statins, especially atorvastatin, may favorably influence clinical presentation and biochemical progression-free survival after brachytherapy for clinically localized prostate cancer.

Urology. 2005 Dec;66(6):1150-4

Authors: Moyad MA, Merrick GS, Butler WM, Wallner KE, Galbreath RW, Kurko B, Adamovich E

OBJECTIVES: To conduct a preliminary investigation on statin use and its impact on clinical presentation and biochemical progression-free survival after brachytherapy. METHODS: A total of 512 consecutive patients were treated with permanent brachytherapy for clinical Stage T1c-T3aNxM0 prostate cancer at least 3 years before analysis. Biochemical progression-free survival was defined by a prostate-specific antigen (PSA) level of 0.4 ng/mL or less after nadir. The median follow-up was 5.3 years. The clinical, treatment, and dosimetric parameters evaluated included use of any and specific statins, age, body mass index, PSA level, Gleason score, percentage of positive biopsies, perineural invasion, prostate volume, planning volume, dosimetric quality, supplemental external beam radiotherapy, tobacco use, hypertension, and diabetes. RESULTS: The actuarial 8-year biochemical progression-free survival rate for the entire group was 94.6%. On forward conditional Cox regression analysis, the pretreatment PSA level and percentage of positive biopsies were statistically significant predictors of biochemical outcome. However, a significantly lower pretreatment PSA level, percentage of positive biopsy cores, and PSA density and earlier clinical stage were found in the statin group. Almost every clinical presentation parameter comparison at least favored statin users. When stratified by any or specific statin use, 97.0% of patients taking statins compared with 94.3% not taking statins and 97.8% of patients taking atorvastatin compared with 94.7% taking other statins were free of biochemical progression. CONCLUSIONS: The results of this brachytherapy investigation with the longest reported follow-up period to date suggest that statins, especially atorvastatin, may improve most clinical presentations with a nonsignificant improvement in 8-year biochemical progression-free survival.

PMID: 16360430 [PubMed - in process]

Moyad MA, Merrick GS, Butler WM, Wallner KE, Galbreath RW, Kurko B, Adamovich E

Posted by blogposter at 09:31 PM | Permalink

Gene therapy for prostate cancer: Current strategies and new cell-based

Gene therapy for prostate cancer: Current strategies and new cell-based approaches.

Related Articles

Gene therapy for prostate cancer: Current strategies and new cell-based approaches.

Prostate. 2005 Dec 13;

Authors: Macrae EJ, Giannoudis A, Ryan R, Brown NJ, Hamdy FC, Maitland N, Lewis CE

Prostate cancer is the most commonly diagnosed cancer in adult males in the Western world. It accounts for one in ten cancer cases and is the second leading cause of cancer death in men, after lung cancer. A number of curative treatments are available for patients with localized prostate cancer such as radical prostatectomy, radiotherapy, or brachytherapy. However, a proportion of these men will develop progressive disease, and some will present de novo with advanced and metastatic prostate cancer, which is amenable to palliation only with androgen-withdrawal therapy. Most of these patients will eventually develop hormone refractory disease which is incurable, and for whom gene therapy, if feasible may develop as an alternative treatment option. In this review we discuss the gene therapy vectors and strategies that are currently in use, new cell-based approaches, discuss their advantages and disadvantages, and review the potential or proven pre-clinical and clinical efficacy in prostate cancer models/patients. (c) 2005 Wiley-Liss, Inc.

PMID: 16353250 [PubMed - as supplied by publisher]

Macrae EJ, Giannoudis A, Ryan R, Brown NJ, Hamdy FC, Maitland N, Lewis CE

Posted by blogposter at 07:53 PM | Permalink

Retrospective evaluation of bone pain palliation after samarium-153-EDTMP therapy. Related

Retrospective evaluation of bone pain palliation after samarium-153-EDTMP therapy.

Related Articles

Retrospective evaluation of bone pain palliation after samarium-153-EDTMP therapy.

Rev Hosp Clin Fac Med Sao Paulo. 2004 Dec;59(6):321-8

Authors: Sapienza MT, Ono CR, Guimar es MI, Watanabe T, Costa PA, Buchpiguel CA

PURPOSE: The aim of this study was to evaluate the degree of metastatic bone pain palliation and medullar toxicity associated with samarium-153-EDTMP treatment. METHODS: Seventy-three patients with metastatic bone pain having previously undergone therapy with samarium-153-EDTMP (1 mCi/kg) were retrospectively evaluated. Routine follow-up included pain evaluation and blood counts for 2 months after treatment. Pain was evaluated using a subjective scale (from 0 to 10) before and for 8 weeks after the treatment. Blood counts were obtained before treatment and once a week for 2 months during follow-up. Dosimetry, based upon the urinary excretion of the isotope, was estimated in 41 individuals, and the resulting radiation absorbed doses were correlated with hematological data. RESULTS: Reduction in pain scores of 75% to 100% was obtained in 36 patients (49%), with a decrease of 50% to 75%, 25% to 50%, and 0% to 25% in, respectively, 20 (27%), 10 (14%), and 7 (10%) patients. There was no significant relationship between the pain response and location of the primary tumor (breast or prostate cancer). Mild to moderate myelosuppression was noted in 75.3% of patients, usually with hematological recovery at 8 weeks. The mean bone marrow dose was 347 +/- 65 cGy, and only a weak correlation was found between absorbed dose and myelosuppression (Pearson coefficient = .4). CONCLUSIONS: Samarium-153-EDTMP is a valuable method for metastatic bone pain palliation. A mild to moderate and transitory myelosuppression is the main toxicity observed after samarium therapy, showing a weak correlation with dosimetric measures.

PMID: 15654484 [PubMed - indexed for MEDLINE]

Sapienza MT, Ono CR, Guimar es MI, Watanabe T, Costa PA, Buchpiguel CA

Posted by blogposter at 05:28 PM | Permalink

prostate cancer Radiation therapy; +48 new citations 48 new PubMed

prostate cancer Radiation therapy; +48 new citations

48 new PubMed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:

prostate cancer Radiation therapy

These PubMed results were generated on 2005/12/14

PubMed, a service of the National Library of Medicine, includes over 15 million citations for biomedical articles back to the 1950's. These citations are from MEDLINE and additional life science journals. PubMed includes links to many sites providing full text articles and other related resources.

PubMed

Posted by blogposter at 04:15 PM | Permalink

Antiandrogenic therapy can cause coronary arterial disease. Related Articles Antiandrogenic

Antiandrogenic therapy can cause coronary arterial disease.

Related Articles

Antiandrogenic therapy can cause coronary arterial disease.

Int J Urol. 2005 Oct;12(10):886-91

Authors: Chen KC, Peng CC, Hsieh HM, Peng CH, Hsieh CL, Huang CN, Chyau CC, Wang HE, Peng RY

Aim: To study the change of lipid metabolism by antiandrogen therapy in patients with prostate cancer. Materials and methods: We studied with a 2.5 years follow-up the changes in plasma cholesterols (C), triglycerides (TG), lipoproteins (LP), and apolipoproteins (Apo) B-100, A-I, and A-II pro fi les in 24 patients of mean age 60 years with low risk prostate cancer (stage: T1cN(0)M(0), Gleason score: 2-5) during treatment with cyproterone acetate (CPA) without surgical management or radiation therapy. Results: Signi fi cant decreases of HDL-C, Apo A-I and Apo A-II and an increase of triglyceride levels in VLDL were induced by CPA. After a period of 2.5 years on CPA treatment, four patients out of twenty-four were found to be affected by coronary heart disease. Conclusions: Ischaemic coronary arteriosclerosis with an incidence rate of 16.6% as caused by prolonged CPA therapy is mediated through changes in HDL cholesterol, Apo A-I and Apo A-II pro fi les, other than the well-known hyperglyceridemic effect caused by estrogen.

PMID: 16323982 [PubMed - in process]

Chen KC, Peng CC, Hsieh HM, Peng CH, Hsieh CL, Huang CN, Chyau CC, Wang HE, Peng RY

Posted by blogposter at 09:16 PM | Permalink

The potential of proton beam radiation therapy in prostate cancer,

The potential of proton beam radiation therapy in prostate cancer, other urological cancers and gynaecological cancers.

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The potential of proton beam radiation therapy in prostate cancer, other urological cancers and gynaecological cancers.

Acta Oncol. 2005 Dec;44(8):890-895

Authors: Johansson B, Ridderheim M, Glimelius B

A group of Swedish oncologists and hospital physicists have estimated the number of patients in Sweden suitable for proton beam therapy. The estimations have been based on current statistics of tumour incidence, number of patients potentially eligible for radiation treatment, scientific support from clinical trials and model dose planning studies and knowledge of the dose-response relations of different tumours and normal tissues. In prostate cancer it is estimated that annually about 300 patients and in gynaecological cancer about 50 patients, are candidates for proton beam therapy. Owing to major uncertainties, it has not been possible to give an estimate of the number of potential patients with urinary bladder cancer.

PMID: 16332598 [PubMed - as supplied by publisher]

Johansson B, Ridderheim M, Glimelius B

Posted by blogposter at 12:15 PM | Permalink

Sexual function after external-beam radiotherapy for prostate cancer: What do

Sexual function after external-beam radiotherapy for prostate cancer: What do we know?

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Sexual function after external-beam radiotherapy for prostate cancer: What do we know?

Crit Rev Oncol Hematol. 2005 Nov 30;

Authors: Incrocci L

Quality of life in general and sexual functioning in particular have become very important in cancer patients. Due to modern surgical techniques, improved quality of drugs for chemotherapy and very modern radiation techniques, more patients can be successfully treated without largely compromising sexual functioning. One can assume that because of the life-threatening nature of cancer, sexual activity is not important to patients and their partners, but this is not true. Prostate cancer has become the most common non-skin malignant neoplasm in older men in Western countries. In this paper, we discuss the various methods used to evaluate erectile and sexual dysfunction and the definition of potency. Data on the etiology of erectile dysfunction after external-beam radiotherapy for prostate cancer is reviewed, and the literature is been summarized. Patients should be offered sexual counseling and informed about the availability of effective treatments for erectile dysfunction, such as sildenafil, intracavernosal injection, and vacuum devices. Cancer affects quality of life and sexual function. The challenge for oncologists is to address this with compassion.

PMID: 16325413 [PubMed - as supplied by publisher]

Incrocci L

Posted by blogposter at 08:25 PM | Permalink

Spinal leptomeningeal metastases from prostate cancer. Spinal leptomeningeal metastases from

Spinal leptomeningeal metastases from prostate cancer.

Spinal leptomeningeal metastases from prostate cancer.

Acta Neurochir (Wien). 2005 Nov 30;

Authors: Deinsberger R, Regatschnig R, Kaiser B, Bankl HC

Objective. Prostate cancer is a well known cause of spinal column metastases; however, an intradural location is extremely rare. It is considered to be a type of leptomeningeal spread. Cerebral seeding has usually occurred by the time of presentation. Due to a poor prognosis, surgery is rarely indicated, and controversially discussed.Patient and results. We review the known cases of spinal leptomeningeal prostate cancer spread, including our patient, who developed paraparesis over 6 weeks, 3 years after prostate cancer was diagnosed. Following surgical decompression and resection, the patient additionally received radiation therapy of the spinal meninges and antihormonal treatment. 6 months after surgery, the patient is still ambulatory with a good quality of life.Conclusion. Spinal leptomeningeal metastases occur at a late stage of systemic disease, and the prognosis is generally poor. In the literature, outcomes after surgery are reported as devastating, with mortality and morbidity rates of up to 20% and 60%. The aim of surgery is to relieve pain, preserve or even restore neurological function, and reveal histology if uncertain. This may be achieved by debulking the tumor without placing the patient at an unacceptably high risk. Surgery should be performed in selected cases of spinal leptomeningeal metastases, in patients who are still ambulatory with controlled systemic disease, and should be followed by adjuvant therapy.

PMID: 16322903 [PubMed - as supplied by publisher]

Deinsberger R, Regatschnig R, Kaiser B, Bankl HC

Posted by blogposter at 10:24 PM | Permalink

Phase II Feasibility Study of High-Dose Radiotherapy for Prostate Cancer

Phase II Feasibility Study of High-Dose Radiotherapy for Prostate Cancer Using Proton Boost Therapy: First Clinical Trial of Proton Beam Therapy for Prostate Cancer in Japan.

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Phase II Feasibility Study of High-Dose Radiotherapy for Prostate Cancer Using Proton Boost Therapy: First Clinical Trial of Proton Beam Therapy for Prostate Cancer in Japan.

Jpn J Clin Oncol. 2005 Nov 28;

Authors: Nihei K, Ogino T, Ishikura S, Kawashima M, Nishimura H, Arahira S, Onozawa M

OBJECTIVE: To assess the feasibility of high-dose radiotherapy for prostate cancer using proton boost therapy following photon radiotherapy. METHODS: The primary endpoint was acute grade 3 or greater genitourinary (GU) and gastrointestinal (GI) toxicities. The study included patients with clinical stage T1-3N0M0 prostate cancer. Radiotherapy consisted of 50 Gy/25 fx photon irradiation to the prostate and the bilateral seminal vesicles followed by proton boost of 26 GyE/13 fx to the prostate alone. Hormonal therapy was allowed before and during the radiation therapy. RESULTS: Between January 2001 and January 2003, 30 patients were enrolled in this study. Acute grade 1/2 GU and GI toxicities were observed in 20/4 and 17/0 patients, respectively. With the median follow-up period of 30 months (range 20-45), late grade 1/2 GU and GI toxicities occurred in 2/3 and 8/3 patients, respectively. No grade 3 or greater acute or late toxicities were observed. All patients were alive, but six patients relapsed biochemically after 7-24 months. CONCLUSIONS: Proton boost therapy following photon radiotherapy for prostate cancer is feasible. To evaluate the efficacy and safety of proton beam therapy, a multi-institutional phase II trial is in progress in Japan.

PMID: 16314345 [PubMed - as supplied by publisher]

Nihei K, Ogino T, Ishikura S, Kawashima M, Nishimura H, Arahira S, Onozawa M

Posted by blogposter at 08:23 PM | Permalink

Cancer of the prostate. Related Articles Cancer of the prostate.

Cancer of the prostate.

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Cancer of the prostate.

Crit Rev Oncol Hematol. 2005 Nov 22;56(3):379-396

Authors: Bracarda S, de Cobelli O, Greco C, Prayer-Galetti T, Valdagni R, Gatta G, de Braud F, Bartsch G

Prostate carcinoma, with about 190,000 new cases occurring each year (15% of all cancers in men), is the most frequent cancer among men in northern and western Europe. Causes of the disease are essentially unknown, although hormonal factors are involved, and diet may exert an indirect influence; some genes, potentially involved in hereditary prostate cancer (HPC) have been identified. A suspect of prostate cancer may derive from elevated serum prostate-specific antigen (PSA) values and/or a suspicious digital rectal examination (DRE) finding. For a definitive diagnosis, however, a positive prostate biopsy is requested. Treatment strategy is defined according to initial PSA stage, and grade of the disease and age and general conditions of the patient. In localized disease, watchful waiting is indicated as primary option in patients with well or moderately differentiated tumours and a life expectancy <10 years, while radical prostatectomy and radiotherapy (with or without hormone-therapy) could be appropriate choices in the remaining cases. Hormone-therapy is the treatment of choice, combined with radiotherapy, for locally advanced or bulky disease and is effective, but not curative, in 80-85% of the cases of advanced disease. Patients who develop a hormone-refractory prostate cancer disease (HRPC) have to be evaluated for chemotherapy because of the recent demonstration of improved overall survival (2-2.5 months) and quality of life with docetaxel in more than 1600 cases.

PMID: 16310371 [PubMed - as supplied by publisher]

Bracarda S, de Cobelli O, Greco C, Prayer-Galetti T, Valdagni R, Gatta G, de Braud F, Bartsch G

Posted by blogposter at 10:32 PM | Permalink

Epidural spinal cord compression. Related Articles Epidural spinal cord compression.

Epidural spinal cord compression.

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Epidural spinal cord compression.

Crit Rev Oncol Hematol. 2005 Nov 22;56(3):397-406

Authors: Spinazzé S, Caraceni A, Schrijvers D

Spinal cord compression from epidural metastases (epidural spinal cord compression, ESCC) is the most common neurological complication of cancer after brain metastases. Extradural compression represents 97% of spinal cord metastatic lesions. ESCC usually occurs in patients with disseminated disease. The most common tumours associated with ESCC are lung and breast cancers, followed by lymphoma, myeloma, prostate cancer and sarcoma. ESCC represents a medical emergency because delayed treatment can be responsible for irreversible deficits, such as paralysis and loss of sphincter control. Patients with ESCC require a multidisciplinary diagnostic and therapeutic approach. Clinical suspect is radiologically detected for confirmation. The median expected survival time from diagnosis usually ranges from 3 to 6 months. The nature of the primary tumour and the degree of the neurological deficit are the most important factors affecting survival. The lack of prospective randomized trials makes the optimal treatment of ESCC controversial and the decision is to be tailored to the individual. Treatment options include: bed rest, administration of corticosteroids, surgery followed by radiation therapy, radiotherapy alone and, to a limited extent, chemotherapy and hormonal therapy.

PMID: 16310372 [PubMed - as supplied by publisher]

Spinazz S, Caraceni A, Schrijvers D

Posted by blogposter at 10:10 PM | Permalink

Cancer of the prostate. Related Articles Cancer of the prostate.

Cancer of the prostate.

Related Articles

Cancer of the prostate.

Crit Rev Oncol Hematol. 2005 Nov 22;56(3):379-396

Authors: Bracarda S, de Cobelli O, Greco C, Prayer-Galetti T, Valdagni R, Gatta G, de Braud F, Bartsch G

Prostate carcinoma, with about 190,000 new cases occurring each year (15% of all cancers in men), is the most frequent cancer among men in northern and western Europe. Causes of the disease are essentially unknown, although hormonal factors are involved, and diet may exert an indirect influence; some genes, potentially involved in hereditary prostate cancer (HPC) have been identified. A suspect of prostate cancer may derive from elevated serum prostate-specific antigen (PSA) values and/or a suspicious digital rectal examination (DRE) finding. For a definitive diagnosis, however, a positive prostate biopsy is requested. Treatment strategy is defined according to initial PSA stage, and grade of the disease and age and general conditions of the patient. In localized disease, watchful waiting is indicated as primary option in patients with well or moderately differentiated tumours and a life expectancy <10 years, while radical prostatectomy and radiotherapy (with or without hormone-therapy) could be appropriate choices in the remaining cases. Hormone-therapy is the treatment of choice, combined with radiotherapy, for locally advanced or bulky disease and is effective, but not curative, in 80-85% of the cases of advanced disease. Patients who develop a hormone-refractory prostate cancer disease (HRPC) have to be evaluated for chemotherapy because of the recent demonstration of improved overall survival (2-2.5 months) and quality of life with docetaxel in more than 1600 cases.

PMID: 16310371 [PubMed - as supplied by publisher]

Bracarda S, de Cobelli O, Greco C, Prayer-Galetti T, Valdagni R, Gatta G, de Braud F, Bartsch G

Posted by blogposter at 03:16 PM | Permalink

Monotherapeutic brachytherapy for clinically organ-confined prostate cancer. Related Articles Monotherapeutic

Monotherapeutic brachytherapy for clinically organ-confined prostate cancer.

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Monotherapeutic brachytherapy for clinically organ-confined prostate cancer.

W V Med J. 2005 Jul-Aug;101(4):168-71

Authors: Merrick GS, Butler WM, Wallner KE, Galbreath RW, Adamovich E

Since the mid-1980s, permanent prostate brachytherapy has been utilized increasingly as a potentially curative treatment for patients of all ages with clinically localized prostate cancer To determine the 8-year biochemical progression-free survival rate for patients who had undergone monotherapeutic brachytherapy for clinically organ-confined prostate cancer, we conducted a study of 202 patients at Schiffler Cancer Center at Wheeling Hospital in Wheeling, W.Va. These patients had undergone brachytherapy without supplemental external beam radiation therapy or androgen deprivation therapy for clinical T1b-T2c NxM0 (2002 AJCC) prostate cancer from April 1995 through May 2001. No patient underwent seminal vesicle biopsy or pathologic lymph node staging. The median follow-up was 5.2 years. All patients underwent brachytherapy more than 3 years prior to analysis. Biochemical success was defined as a PSA < 0.4 ng/mL after a nadir. Clinical, treatment and dosimetric parameters evaluated for biochemical progression-free survival included patient age, clinical T-stage, Gleason score, pretreatment PSA, risk group, percent positive biopsies, isotope, prostate volume, brachytherapy planning volume, V100/150/200, D90, tobacco status, hypertension and diabetes. For the entire group, 8-year biochemical progression-free survival was 97.4% for Pd-103 and 93.3% for I-125. The median post-treatment PSA for the entire group was < 0.1 ng/mL. In multivariate analysis, only pretreatment PSA predicted biochemical outcome with a trend for better outcome with younger patient age and lesser percent positive biopsies. The results of our study indicate that permanent interstitial brachytherapy as a monotherapeutic approach for patients with clinically organ-confined disease results in a high probability of 8-year biochemical progression-free survival with a median PSA < 0.1 ng/mL. Generous periprostatic treatment margins with documented high quality day 0 postoperative dosimetry are mandatory for such outcomes.

PMID: 16296198 [PubMed - in process]

Merrick GS, Butler WM, Wallner KE, Galbreath RW, Adamovich E

Posted by blogposter at 01:10 PM | Permalink

Low-grade toxicity after conformal radiation therapy for prostate cancer-impact of

Low-grade toxicity after conformal radiation therapy for prostate cancer-impact of bladder volume.

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Low-grade toxicity after conformal radiation therapy for prostate cancer-impact of bladder volume.

Int J Radiat Oncol Biol Phys. 2005 Nov 10;

Authors: Pinkawa M, Fischedick K, Asadpour B, Gagel B, Piroth MD, Eble MJ

PURPOSE: To assess the impact of dose-volume histogram parameters on low-grade toxicity after radiotherapy for prostate cancer. METHODS AND MATERIALS: Eighty patients have been surveyed prospectively before (time A), at the last day (B), 2 months after (C), and 16 months (median) after (D) radiotherapy (70.2 Gy) using a validated questionnaire (Expanded Prostate Cancer Index Composite). Dose-volume histograms were correlated with urinary and bowel function/bother scores. RESULTS: The initial bladder volume and the percentage of the bladder volume receiving 10%-90% of the prescription dose significantly correlated with urinary function/bother scores (significant cutoff levels found for all dose levels). Pain with urination proved to be mainly an acute problem, subsiding faster for patients with larger bladder volumes and smaller volumes inside particular isodose lines. At time D, persisting problems with smaller initial bladder volumes were a weak stream and an increased frequency of urination. Though bladder volume and planning target volume both independently have an influence on dose-volume histogram parameters for the bladder, bladder volume plays the decisive role for urinary toxicity. CONCLUSIONS: The patient's ability to fill the bladder has a major impact on the dose-volume histogram and both acute and late urinary toxicity.

PMID: 16289911 [PubMed - as supplied by publisher]

Pinkawa M, Fischedick K, Asadpour B, Gagel B, Piroth MD, Eble MJ

Posted by blogposter at 06:40 PM | Permalink

Corticosteroid-Induced Chemotherapy Resistance in Urological Cancers. Related Articles Corticosteroid-Induced Chemotherapy

Corticosteroid-Induced Chemotherapy Resistance in Urological Cancers.

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Corticosteroid-Induced Chemotherapy Resistance in Urological Cancers.

Cancer Biol Ther. 2006 Jan 25;5(1)

Authors: Zhang C, Mattern J, Haferkamp A, Pfitzenmaier J, Hohenfellner M, Rittgen W, Edler L, Debatin KM, Groene E, Herr I

Purpose: Glucocorticoids such as dexamethasone are widely used for medication of urological diseases, e.g., as cotreatment of advanced prostate cancer, to improve appetite, weight loss, fatigue, relieve bone pain, diminish ureteric obstruction, to reduce the production of adrenal androgens, as an antiemetic in patients undergoing chemo- and/or radiotherapy together with serving as "standard" therapy arm in randomized studies. While the potent pro-apoptotic properties and the supportive effects of glucocorticoids to tumor therapy in lymphoid cells are well studied, the impact to growth of prostate and other urological carcinomas is unknown. Methods: We isolated cells from surgical resections of 21 prostate tumors and measured apoptosis and viability in these primary cells and 17 established cell lines from human prostate, bladder, renal cell and testicular carcinomas. Results: We found that dexamethasone induces resistance regarding exposure to several cytotoxic agents such as taxol, gemcitabine, cisplatin, 5-FU and gamma-irradiation in 86% of the freshly isolated prostate tumors and in 100% of the established urological cell lines. No difference in dexamethasone-mediated protection was found in normal, benign and malignant prostate tumors. Conclusions: These data show for the first time that dexamethasone induced therapy resistance in urological carcinomas is not the exception but a more common phenomenon and implicate that glucocorticoids may have two faces in cancer therapy, a beneficial and a dangerous one.

PMID: 16294015 [PubMed - as supplied by publisher]

Zhang C, Mattern J, Haferkamp A, Pfitzenmaier J, Hohenfellner M, Rittgen W, Edler L, Debatin KM, Groene E, Herr I

Posted by blogposter at 08:49 PM | Permalink

Differential expression of steroid receptors in prostate tissues before and

Differential expression of steroid receptors in prostate tissues before and after radiation therapy for prostatic adenocarcinoma.

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Differential expression of steroid receptors in prostate tissues before and after radiation therapy for prostatic adenocarcinoma.

Int J Cancer. 2005 Nov 10;117(3):381-6

Authors: Torlakovic E, Lilleby W, Berner A, Torlakovic G, Chibbar R, Furre T, Fosså SD

The expression, distribution and the role of steroid receptors in benign and malignant untreated prostate tissues is well recognized, however, the status of steroid receptors in prostate after radiotherapy (RT) for adenocarcinoma has not yet been studied fully. Immunohistochemical evaluation of androgen receptor (AR), estrogen receptor-alpha (ER-alpha), estrogen receptor-beta (ER-beta), and progesterone receptor (PR) was carried out in prostate needle biopsies obtained before and after radiotherapy from 60 patients with adenocarcinoma. The ER-beta transcripts were also studied by RT-PCR in LNCaP prostate carcinoma cell line before and 24 hr after gamma-irradiation at 0.5 Gy and 8.0 Gy. Significantly higher level of ER-beta expression was found in post-radiation samples of prostate adenocarcinoma and benign epithelium. After RT, all steroid receptors were upregulated in prostatic stroma. Tumor AR expression did not change significantly. Although a positive association between AR and ER-beta expression was observed in pre-treatment prostate adenocarcinoma, it was lost after RT suggesting that these 2 steroid receptors respond differently to RT. High levels of pretreatment tumor ER-beta were associated with local recurrence after RT and decreased biochemical recurrence-free survival (p = 0.028). LNCaP cell line that expressed no ER-beta mRNA before gamma-irradiation, clearly expressed ER-beta mRNA 24 hr after 0.5 Gy and 8.0 Gy. Upregulation of all steroid receptors in the prostate stroma and upregulation of ER-beta in the tumor epithelium after RT, may represent a protective tissue response to radiation-induced tissue injury. Although stromal AR was doubled after RT, the tumor and benign epithelium expression of AR seemed resistant to change by RT.

PMID: 15900599 [PubMed - indexed for MEDLINE]

Torlakovic E, Lilleby W, Berner A, Torlakovic G, Chibbar R, Furre T, Foss SD

Posted by blogposter at 09:06 PM | Permalink

Dose-volume impact in high-dose-rate Iridium-192 brachytherapy as a boost to

Dose-volume impact in high-dose-rate Iridium-192 brachytherapy as a boost to external beam radiotherapy for localized prostate cancer- a phase II study.

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Dose-volume impact in high-dose-rate Iridium-192 brachytherapy as a boost to external beam radiotherapy for localized prostate cancer- a phase II study.

Radiother Oncol. 2005 Nov 3;

Authors: Pinkawa M, Fischedick K, Treusacher P, Asadpour B, Gagel B, Piroth MD, Borchers H, Jakse G, Eble MJ

BACKGROUND AND PURPOSE: Evaluation of dose-volume-time-related factors in 64 patients treated with high-dose-rate brachytherapy (HDR-BT) as a boost to external beam radiotherapy (EBRT) for localized prostate cancer. PATIENTS AND METHODS: Clinical parameters were correlated with morbidity scores of the EPIC (Expanded Prostate Cancer Index) questionnaire. Median time after radiotherapy (HDR-BT up to 18Gy in two fractions and EBRT up to a median dose of 50.4Gy) was 1.5 and 3 years (first and second questionnaire). RESULTS: A significant impact of a urethra D1 exceeding 15Gy in at least one HDR fraction concerning urinary morbidity and a rectum D1 exceeding 6Gy to the rectal mucosa in the first and second HDR fraction concerning the rectal bleeding rate was found. A higher number of needles was associated with lower urinary and bowel scores after 1.5 years. A prostate length >4.8cm and a longer duration of EBRT (independently of the dose) predisposed for lower urinary and bowel scores. In contrast to a urethra D1>15Gy as an independent factor, a rectum D1>6Gy per HDR fraction correlated with a higher number of needles and an increased prostate length. CONCLUSIONS: To minimize morbidity in HDR-BT for prostate cancer, a maximum dose to the urethra of 15Gy and a maximum dose to the rectal mucosa of 6Gy is advisable. Treatment- and patient-related factors have a major impact on toxicity.

PMID: 16271785 [PubMed - as supplied by publisher]

Pinkawa M, Fischedick K, Treusacher P, Asadpour B, Gagel B, Piroth MD, Borchers H, Jakse G, Eble MJ

Posted by blogposter at 04:16 PM | Permalink

Prostate Cancer Research

A blog devoted to surviving prostate cancer, finding treatment options, new drug therapies and new clinical trials. We cover the very latest research.

September 27, 2006

prostate cancer Radiation therapy; +137 new citations

August 21, 2006

prostate cancer Radiation therapy; +40 new citations

August 09, 2006

prostate cancer Radiation therapy; +178 new citations

June 13, 2006

prostate cancer Radiation therapy; +28 new citations

June 05, 2006

prostate cancer Radiation therapy; +31 new citations

May 24, 2006

Prognostic value of PSA nadir < or =4 ng/mL within 4 months of high-dose radiotherapy for locally advanced prostate cancer.

May 21, 2006

Positron emission tomography with C11-acetate for tumor detection and localization in patients with prostate-specific antigen relapse after radical prostatectomy.

May 15, 2006

prostate cancer Radiation therapy; +40 new citations

May 04, 2006

Health outcomes in older men with localized prostate cancer: results from the Prostate Cancer Outcomes Study.

May 02, 2006

prostate cancer Radiation therapy; +49 new citations

April 18, 2006

Integral radiation dose to normal structures with conformal external beam radiation.

April 12, 2006

prostate cancer Radiation therapy; +50 new citations

March 21, 2006

Patterns of practice in the management of prostate cancer: results from multidisciplinary surveys of clinicians in Australia and New Zealand in 1995 and 2000.

March 16, 2006

Genitourinary small cell carcinoma: a retrospective review of treatment and survival patterns at The Ottawa Hospital Regional Cancer Center.

March 15, 2006

Hyperglycemia and insulin resistance in men with prostate carcinoma who receive androgen-deprivation therapy.

March 12, 2006

prostate cancer Radiation therapy; +44 new citations

February 27, 2006

A comparison of three-field and four-field techniques in different clinical target volumes in prostate cancer irradiation using dose volume histograms: a prospective three-dimensional analysis.

February 20, 2006

[Advancement of treatment for prostate cancer.]

February 15, 2006

Rising prostate-specific antigen after primary prostate cancer therapy.

February 14, 2006

Is pretreatment PSA velocity associated with prostate-cancer-specific mortality rate after radiotherapy?

Locally advanced prostate cancer treated with radiotherapy and androgen deprivation.

February 13, 2006

Advances in radiotherapy for prostate cancer.

Advances in radiotherapy for prostate cancer.

February 12, 2006

Large deformation three-dimensional image registration in image-guided radiation therapy.

February 09, 2006

Radiation sensitivity of human carcinoma cells transfected with small interfering RNA targeted against cyclooxygenase-2.

February 08, 2006

Influence of number of CAG repeats on local control in the RTOG 86-10 protocol.

February 07, 2006

Integral radiation dose to normal structures with conformal external beam radiation.

February 05, 2006

[Evaluation of Setup Error and Adequate Setup Margins in Patients with Prostate Cancer Treated by IMRT and Fixed in the Prone Position Using a Set of Immobilization Devices.]

January 30, 2006

Oblique needle segmentation and tracking for 3D TRUS guided prostate brachytherapy.

January 29, 2006

Optimization of intensity-modulated radiation therapy with biological objectives.

January 28, 2006

Thermotherapy using magnetic nanoparticles combined with external radiation in an orthotopic rat model of prostate cancer.

January 24, 2006

Severity categories of the International Prostate Symptom Score before, and urinary morbidity after, permanent prostate brachytherapy.

January 23, 2006

L14: erectile dysfunction after radiotherapy for prostate cancer.

January 21, 2006

Expanding the therapeutic index of radiation therapy by combining in situ gene therapy in the treatment of prostate cancer.

January 18, 2006

The Actual Value of the Surgical Margin Status as a Predictor of Disease Progression in Men with Early Prostate Cancer.

January 13, 2006

[Delay to radiotherapy: a study of three tumour sites]

January 12, 2006

Defining biochemical failure after radiotherapy with and without androgen deprivation for prostate cancer.

January 11, 2006

A phase III randomized, placebo-controlled, double-blind study of misoprostol rectal suppositories to prevent acute radiation proctitis in patients with prostate cancer.

January 07, 2006

[Advances in brachytherapy]

[Advances in brachytherapy]

December 29, 2005