scholarly journals Does the Presence of a Major Psychiatric Disorder Affect Tolerance and Outcomes in Men With Prostate Cancer Receiving Radiation Therapy?

2016 ◽  
Vol 11 (1) ◽  
pp. 5-12 ◽  
Author(s):  
Joseph J. Safdieh ◽  
David Schwartz ◽  
Justin Rineer ◽  
Joseph P. Weiner ◽  
Andrew Wong ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Specific Antigen ◽  
Delayed Diagnosis ◽  
External Beam Radiation ◽  
Definitive Treatment ◽  
Biochemical Control ◽  
Cancer Specific Survival ◽  
Beam Radiation ◽  
Propensity Score Adjustment

Prior studies have suggested that men with prostate cancer and psychiatric disorders (+Psy) have worse outcomes compared with those without (−Psy), particularly due to delayed diagnosis or reduced access to definitive treatment. In the current study, the toxicity and outcomes of men who were primarily diagnosed through prostate-specific antigen screening and who underwent definitive treatment with external beam radiation was investigated. The charts of 469 men diagnosed with prostate cancer from 2003 to 2010 were reviewed. The presence of +Psy was based on a Diagnostic and Statistical Manual of Mental Disorders–Fourth edition diagnosis of posttraumatic stress disorder, depression, schizophrenia, bipolar disorder, and/or generalized anxiety disorder. Kaplan–Meier analysis was used to analyze biochemical control, distant control, prostate cancer–specific survival, and overall survival. One hundred patients (21.3%) were identified as +Psy. At a median follow-up of 73 months, there were no differences regarding 6-year biochemical control (79.8% −Psy vs. 80.4% +Psy, p = .50) or 6-year distant metastatic-free survival (96.4% −Psy vs. 98.0% +Psy, p = .36). There were also no differences regarding the 6-year prostate cancer–specific survival (98.4% −Psy vs. 99.0% +Psy, p = .45) or 6-year overall survival (80.2% −Psy vs. 82.2% +Psy, p = .35). Short- and long-term genitourinary and gastrointestinal toxicities were similar between the groups. On multivariate analyses with propensity score adjustment, +Psy was not a significant predictor for toxicity, biochemical recurrence, or survival. The presence of +Psy was not associated with higher toxicity or worse clinical outcomes, suggesting that effective removal of screening and treatment barriers may reduce the survival disparities of these patients.

External beam radiation therapy or high intensity-focused ultrasound for localized prostate cancer: A matched pair analysis in the prostate-specific antigen era.

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 109-109
Author(s):  
Gilles Pasticier ◽  
Sebastien Crouzet ◽  
Pascal Pommier ◽  
Christian Carrie ◽  
Olivier Rouviere ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Survival Rate ◽  
Specific Antigen ◽  
Progression Free Survival ◽  
Androgen Deprivation ◽  
High Intensity Focused Ultrasound ◽  
External Beam Radiation ◽  
Matched Pair ◽  
Beam Radiation ◽  
Free Survival

109 Background: In the absence of randomised study data institutional series have shown High Intensity Focused Ultrasound (HIFU) to produce excellent overall and cancer specific survival rates in patients with localized prostate cancer (LPCa) compared with alternative curative treatments. The aim of this study was to evaluate the oncologic outcome of patients treated with HIFU versus conformal external beam radiation therapy (C-EBRT) without previous or associated androgen deprivation(AD).This study was designed to overcome limitations of case series studies by using a matched pair design in patients treated contemporaneously with HIFU and C- EBRT in two institutions in the same town. Methods: 256 eligible patients with intermediate risk prostate cancer (d’Amico classification) treated between 2000 and 2005 were prospectively followed and matched to a 1:1 basis following know prognostic variables: prostate-specific antigen (PSA) level and Gleason score.190 perfect matches of patients (95 in each group) were further analysed. Progression free survival rate were the primary endpoint. Other endpoints were secondary used of salvage therapy, and survival rate without salvage palliative androgen deprivation therapy (S-ADT).The progression free survival rates were calculated with Kaplan-Meier estimate. For progression free calculation, failure was defined using the Phoenix definition (nadir + 2ng/ml) or at the time of a salvage treatment for local relapse evidenced by control biopsy. Results: The seven years progression free survival rate was not significantly different after HIFU than after C-EBRT (47% versus 52%, p: 0.311) . The palliative androgen deprivation free rate at seven years was significantly different after HIFU than after C-EBRT (85% versus 58%, p: 0.002). Conclusions: The progression free survival rate was not significantly different after HIFU use than after C-EBRT but the rate of patients who need palliative S-ADT was significantly different after HIFU or C-EBRT: Higher rate of S-ADT was associated with C-EBRT use than with HIFU use.

Impact of dose-escalated radiation on overall survival in men with nonmetastatic prostate cancer.

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 28-28
Author(s):  
Anusha Kalbasi ◽  
Jiaqi Li ◽  
Abigail T. Berman ◽  
Samuel Swisher-McClure ◽  
Marc C. Smaldone ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
High Risk ◽  
Standard Dose ◽  
Low Risk ◽  
External Beam Radiation ◽  
Risk Category ◽  
Beam Radiation ◽  
Treatment Groups

28 Background: Infive publishedRCTs, dose-escalated external beam radiation therapy (EBRT) for prostate cancer resulted in improved biochemical and local control. However, the question of whether dose escalation improves overall survival (OS) remains unanswered. We examined OS among men with non-metastatic prostate cancer undergoing EBRT in the modern era. Methods: Using the National Cancer Database (NCDB), we conducted non-randomized comparative effectiveness studies of dose-escalated versus standard-dose EBRT in men diagnosed from 2004-2006 in three analytic cohorts defined by NCCN risk category: low- (N=12,848), intermediate- (N=14,966) or high-risk (N=14,587) prostate cancer. We categorized patients in each risk cohort into 2 treatment groups: standard-dose (68.4 Gy to <75.6 Gy) or dose-escalated (≥75.6 Gy to 90 Gy) EBRT. The primary outcome was time to death from any cause, measured from diagnosis to NCDB date of death or end of follow-up (December 31, 2011). We compared OS between treatment groups in the three analytic cohorts using Cox proportional hazard models. Inverse probability weighted propensity score methods were used to balance differences between treatment groups in age, race, year of diagnosis, AJCC T- and N-stage, PSA, Gleason score, androgen deprivation therapy, IMRT use, comorbid disease, income, insurance, urban/rural location, facility type and facility volume. In secondary analyses, we evaluated dose response for survival by categorizing dose in approximately 2 Gy increments. Results: Median follow up for survivors was between 73 and 74 months in all three risk cohorts. Dose-escalated EBRT was associated with improved survival in the intermediate-risk (adjusted HR 0.81, 95% CI 0.77 and 0.85, p<0.0001) and high-risk groups (aHR 0.85, 95% CI 0.81 and 0.89, p<0.0001), but not the low-risk group (aHR 0.99, 95% CI 0.92-1.06, p=0.803). For every incremental ~2Gy increase in dose, there was a 9% (95% CI 6% – 11%, p<0.0001) and 7% (95% CI 3% - 10%, p=0.004) reduction in the hazard of death for intermediate- and high-risk patients, respectively. Conclusions: Dose-escalated EBRT is associated with improved survival in men with intermediate- and high-risk, but not low-risk, prostate cancer.

PROSTATE SPECIFIC ANTIGEN BOUNCE AFTER RADIOACTIVE SEED IMPLANTATION FOLLOWED BY EXTERNAL BEAM RADIATION FOR PROSTATE CANCER

2000 ◽  
pp. 1085-1089 ◽  
Author(s):  
FRANK A. CRITZ ◽  
W. HAMILTON WILLIAMS ◽  
JAMES B. BENTON ◽  
A. KEITH LEVINSON ◽  
CLINTON T. HOLLADAY ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
External Beam Radiation ◽  
External Beam ◽  
Beam Radiation ◽  
Seed Implantation ◽  
Radioactive Seed

PROSTATE SPECIFIC ANTIGEN BOUNCE AFTER RADIOACTIVE SEED IMPLANTATION FOLLOWED BY EXTERNAL BEAM RADIATION FOR PROSTATE CANCER

2000 ◽  
Vol 163 (4) ◽  
pp. 1085-1089 ◽  
Author(s):  
FRANK A. CRITZ ◽  
W. HAMILTON WILLIAMS ◽  
JAMES B. BENTON ◽  
A. KEITH LEVINSON ◽  
CLINTON T. HOLLADAY ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
External Beam Radiation ◽  
External Beam ◽  
Beam Radiation ◽  
Seed Implantation ◽  
Radioactive Seed

scholarly journals Vaccines for prostate cancer : a new era?

2016 ◽  
Vol 28 (3) ◽  
pp. i-iii
Author(s):  
Julius I Mulia
Keyword(s):  
Prostate Cancer ◽  
Clinical Symptoms ◽  
Specific Antigen ◽  
Local Therapy ◽  
The United States ◽  
External Beam Radiation ◽  
Western World ◽  
Beam Radiation ◽  
Hormone Refractory ◽  
Androgen Independent

Prostate adenocarcinoma is the most prevalent type of noncutaneous cancer in the Western world, with an estimated 218,890 new cases and 27,050 deaths in the United States in 2007. Currently prostate cancer is detected by measurement of prostate-specific antigen (PSA), a serine protease synthesized by the prostatic epithelium. PSA is an organ-specific and tumor-associated antigen (TAA) but it is not tumor-specific.(1) Partly because of increased cancer screening with PSA, prostatic cancer may now be diagnosed when it is still localized. Localized tumors of the prostate are generally treated with radical prostatectomy, external-beam radiation therapy (EBRT), brachytherapy, or watchful waiting. Unfortunately, up to 30%-40% of patients fail local therapy. The standard treatment of recurrent or metastatic disease is androgen-deprivation therapy (ADT), but this is only a temporary measure as in the majority of cases the cancer ultimately becomes hormone refractory, the condition being termed androgen-independent prostate cancer (AIPC) or hormone refractory prostate cancer (HRPC), which then progresses rapidly. The only available nonpalliative therapy for androgen-independent prostate cancer is docetaxel in combination with prednisone. However, ADT given prior to the onset of clinical symptoms results in rising PSA levels with castrate levels of testosterone, often with a relatively low tumor burden. This systemic treatment earlier in the disease course combined with effective palliative chemotherapy is implicated in the improvement in median survival time of patients with AIPC from an average of about 12 months to about 17-18 months.

scholarly journals Active surveillance for prostate cancer: to whom, when and how

2019 ◽  
Vol 10 (3) ◽  
pp. 37-44
Author(s):  
M. S. Taratkin ◽  
E. A. Laukhtina ◽  
K. I. Adelman ◽  
Y. G. Alyaev ◽  
L. M. Rapoport ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Active Surveillance ◽  
Standard Treatment ◽  
Treatment Options ◽  
Low Risk ◽  
External Beam Radiation ◽  
Treatment Modalities ◽  
Malignant Neoplasms ◽  
Cancer Specific Survival ◽  
Beam Radiation

Prostate cancer (PCa) is the most common oncological disease among men. It is important to note that over 50% of the first identified primary malignant neoplasms of prostate are low - risk PCa. Recently, radical prostatectomy and external beam radiation therapy have been the standard treatment options for PCa. According to recent data, patients with low - risk PCa have a favourable prognosis because of the slow progression of the disease. Some studies show no links between 10-year cancer - specific survival and treatment modalities and no progression even in the absence of therapy. Active surveillance (AS) allows avoiding unnecessary treatment in men who do not require immediate intervention but achieves the correct timing for curative treatment in those who eventually need it. According to the guidelines of the European Association of Urology, AS is one of the standard treatment options for low - risk PCa and should be consideredfor all patients in this category. The advantage of AS is to improve the quality of life in men with low - risk PCa and to delay surgical interventions as much as possible. However, despite widespread AS worldwide, there are only a few centres, which use it routinely in Russia. In this review, we would like to shed some light on the most important questions of AS strategy: what criteria should we use for selection of patients for AS strategy? How often should patient visit the urologist, control PSA level, and undergo prostate biopsy? When should a doctor change strategy and turn to active treatment? In this article, we considered indications for AS in men with PCa and showed the most recent data on the efficacy and relevance of this modality.

Prostate Specific Antigen Bounce Phenomenon After External Beam Radiation for Clinically Localized Prostate Cancer.

2002 ◽  
pp. 2001-2005 ◽  
Author(s):  
CHARLES J. ROSSER ◽  
DEBORAH A. KUBAN ◽  
LAWRENCE B. LEVY ◽  
RAMSEY CHICHAKLI ◽  
ALAN POLLACK ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Localized Prostate Cancer ◽  
External Beam Radiation ◽  
External Beam ◽  
Beam Radiation

Prostate-specific antigen as a predictor of radiotherapy response and patterns of failure in localized prostate cancer.

1992 ◽  
Vol 10 (8) ◽  
pp. 1208-1217 ◽  
Author(s):  
M A Ritter ◽  
E M Messing ◽  
T G Shanahan ◽  
S Potts ◽  
R J Chappell ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
Prostatic Acid Phosphatase ◽  
Prognostic Indicator ◽  
Localized Prostate Cancer ◽  
External Beam Radiation ◽  
Beam Radiation ◽  
Metastatic Recurrence

PURPOSE A study of preradiation and postradiation, serial serum prostate-specific antigen (PSA) levels was performed in patients who had clinically localized prostate cancer. The prognostic value of the PSA in pretreatment evaluation and posttreatment follow-up was assessed. PATIENTS AND METHODS Sixty-three patients who presented with clinically localized prostate cancer and who were treated with external-beam radiation therapy were followed-up for a median of 25 months. A serum PSA and physical examination were performed at 3-month intervals, and a bone scan was done yearly. An increase in PSA triggered an additional metastatic workup. Prostate rebiopsy was performed for new, palpable nodules or for a serial increase in PSA in the context of a negative metastatic workup. RESULTS Forty-one patients remained recurrence-free and 22 recurred clinically, 15 distantly and seven locally. The PSA was the strongest, independent, pretreatment prognostic indicator (P = .019) among pretreatment PSA, stage, and grade, but lost significance when the serum prostatic acid phosphatase (PAP) status was included. The initial rate of the PSA decrease after radiation (median half-life, 2.6 months) failed to predict outcome. Recurrence-free patients reached postradiation PSA levels that were equivalent to those reported in disease-free male populations; failure of the PSA to reach such normal levels was a multivariate predictor of subsequent failure (P less than .037). All clinicopathologic documentations of failure were preceded by an increase in PSA levels during follow-up. Delayed versus early PSA increase was associated with clinically localized versus metastatic first recurrence. CONCLUSIONS The serum PSA is an independent pretreatment and posttreatment predictor of outcome. Additionally, for a median follow-up of 25 months, delayed PSA failure is associated with clinically localized rather than metastatic recurrence, a relationship that may help in selection for local salvage therapy.

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