scholarly journals Dosimetric Analysis of Patients Receiving Radiotherapy with VMAT Technique in Localized Prostate Cancer and Its Correlation with Side Effects

2021 ◽  
Author(s):  
Sıtkı Utku Akay ◽  
İlknur Alsan Çetin ◽  
Gülnaz Nural Bekiroğlu
Keyword(s):  
Prostate Cancer ◽  
Side Effects ◽  
Significant Relationship ◽  
Statistical Significance ◽  
Risk Groups ◽  
Localized Prostate Cancer ◽  
Sexual Side Effects ◽  
Dosimetric Data ◽  
Curative Radiotherapy ◽  
The Mean

Abstract Aim: It is aimed whether there is a relationship between dosimetric data of localized prostate cancer patients who have been treated with curative radiotherapy and gastrointestinal (GIS), genitourinary (GUS), anal and sexual side effects and whether there is a difference between dosimetric data and clinical findings between risk groups. Method : Eighty-seven patients who received curative radiotherapy for localized prostate cancer between 2014 - 2019 were included in the study. Dosimetrically; whether there was a relationship between V30, V40, V50, V60, V65, V70, V75 for rectum and bladder; D90 for the penile bulb, V72, V74, V76 for the bulbomembranous urethra, V30, V45, V53, Dmax for the anus and V45 (cc) for the intestine data and the side effects was analyzed. It was evaluated whether there was a relationship between testosterone values and sexual side effects. The Kolmogorov-Smirnov test, One Way ANOVA (F-test), and paired-sample T-test were used as statistical methods. For statistical significance, p <0.05 was accepted. Results : The mean age of the patients was 69 (50-86), the mean PSA (ng/dl) before RT was 25.1 (0.9-339), the median RT dose was 76 Gy (74-78 Gy), and the mean follow-up period was 38.2 months. PTVmax, PTVmean, PTVmin, bladder V40, bladder V50, rectum V30, rectum V40, rectum V50 and intestinal V45 (cc) were determined as dosimetric data showing differences between risk groups. A statistically significant relationship was found between rectum V30 (p = 0.017), V60 (p = 0.019), V65 (p = 0.008), V70 (p = 0.007) and V75 (p = 0.034) and chronic GIS side effects. G2 GIS side effects were observed in 4 patients (4.6%) in the entire patient group in the acute period. A statistically significant relationship was found between the patients receiving hormonotherapy (p = 0.021) and testosterone values ​​at the last control (p = <0.001) and chronic sexual side effects. Conclusion: Attention should be paid to the rectum V30, V60, V65, V70, and V75 values to minimize the long-term GIS side effects of patients who have undergone RT. Testosterone level and HT status affect chronic sexual toxicity.

scholarly journals Effect of Androgen Deprivation Therapy on Other-Cause of Mortality in Elderly Patients with Clinically Localized Prostate Cancer Treated with Modern Radiotherapy: Is There a Negative Impact?

2019 ◽  
Vol 8 (3) ◽  
pp. 338 ◽  
Author(s):  
Hideya Yamazaki ◽  
Koji Masui ◽  
Gen Suzuki ◽  
Satoaki Nakamura ◽  
Norihiro Aibe ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Survival Rate ◽  
Androgen Deprivation Therapy ◽  
Negative Impact ◽  
Statistical Significance ◽  
Intensity Modulated Radiotherapy ◽  
Risk Groups ◽  
Androgen Deprivation ◽  
Localized Prostate Cancer ◽  
High Dose

The influence of androgen deprivation therapy (ADT) on other-cause of mortality (OCM) was investigated in patients with localized prostate cancer treated with modern high-dose radiotherapy. A retrospective review was conducted on 1125 patients with localized prostate cancer treated with high-dose radiotherapy, including image-guided, intensity-modulated radiotherapy or brachytherapy with a median follow-up of 80.7 months. Overall survival rate was no different between ADT (+) and ADT (−) group in high-, intermediate-, and low-risk groups. OCM was found in 71 patients, consisting of 4% (10/258) in the ADT (−) group and 7% (61/858) in the ADT (+) group (p = 0.0422). The 10-year OCM-free survival rate (OCMFS), if divided by the duration of ADT (ADT naïve (ADT (−)), ADT <2-year, and ADT ≥2-year groups), showed statistical significance, and was 90.7%, 88.2%, and 78.6% (p = 0.0039) for the ADT (−), ADT <2-year, and ADT ≥2-year groups, respectively. In patients aged ≥75 years, 10-year OCMFS for ADT (−), ADT <2-, and ADT ≥2-year groups was 93.5% (at 115.6 months), 85.6%, and 60.7% (p = 0.0189), respectively, whereas it was 90.7%, 89.9%, and 89.0% (p = 0.4716), respectively, in their younger counterparts. In localized prostate cancer patients, treatment with longer ADT for ≥2 years potentially increases the risk of OCM, especially in patients aged ≥75 years.

scholarly journals Men’s experiences of radiotherapy treatment for localized prostate cancer and its long-term treatment side effects: a longitudinal qualitative study

2021 ◽  
Author(s):  
E. Sutton ◽  
◽  
J. A. Lane ◽  
M. Davis ◽  
E. I. Walsh ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Side Effects ◽  
External Beam Radiotherapy ◽  
Qualitative Interviews ◽  
Well Being ◽  
Localized Prostate Cancer ◽  
Short Term ◽  
Age Related ◽  
Qualitative Interview Study ◽  
Long Term Treatment

Abstract Purpose To investigate men’s experiences of receiving external-beam radiotherapy (EBRT) with neoadjuvant Androgen Deprivation Therapy (ADT) for localized prostate cancer (LPCa) in the ProtecT trial. Methods A longitudinal qualitative interview study was embedded in the ProtecT RCT. Sixteen men with clinically LPCa who underwent EBRT in ProtecT were purposively sampled to include a range of socio-demographic and clinical characteristics. They participated in serial in-depth qualitative interviews for up to 8 years post-treatment, exploring experiences of treatment and its side effects over time. Results Men experienced bowel, sexual, and urinary side effects, mostly in the short term but some persisted and were bothersome. Most men downplayed the impacts, voicing expectations of age-related decline, and normalizing these changes. There was some reticence to seek help, with men prioritizing their relationships and overall health and well-being over returning to pretreatment levels of function. Some unmet needs with regard to information about treatment schedules and side effects were reported, particularly among men with continuing functional symptoms. Conclusions These findings reinforce the importance of providing universal clear, concise, and timely information and supportive resources in the short term, and more targeted and detailed information and care in the longer term to maintain and improve treatment experiences for men undergoing EBRT.

scholarly journals Comparative Effectiveness of Conservative Management Compared to Cryotherapy in Localized Prostate Cancer Patients

2018 ◽  
Vol 12 (5) ◽  
pp. 1681-1691 ◽  
Author(s):  
Surbhi Shah ◽  
Henry N. Young ◽  
Ewan K. Cobran
Keyword(s):  
Prostate Cancer ◽  
Side Effects ◽  
Conservative Management ◽  
Comparative Effectiveness ◽  
Urinary Tract Obstruction ◽  
Localized Prostate Cancer ◽  
Long Term Outcomes ◽  
Lower Urinary Tract Obstruction

The high frequency of treatment-related side effects for men with localized prostate cancer creates uncertainty for treatment outcomes. This study assessed the comparative effectiveness of treatment-related side effects associated with conservative management and cryotherapy in patients with localized prostate cancer. A retrospective longitudinal cohort study was conducted, using the linked data of the Surveillance, Epidemiology, and End Results and Medicare, which included patients diagnosed from 2000 through year 2013, and their Medicare claims information from 2000 through 2014. To compare the differences in baseline characteristics and treatment-related side effects between the study cohorts, χ2 tests were conducted. Multivariate logistic regression was used to assess the association between treatment selection and side effects. There were 7,998 and 3,051 patients in the conservative management and cryotherapy cohort, respectively. The likelihood of erectile dysfunction, lower urinary tract obstruction, urinary fistula, urinary incontinence, and hydronephrosis was reported to be significantly lower (53%, 35%, 69%, 65%, and 36%, respectively) in the conservative management cohort. Conservative management had a lower likelihood of treatment-related side effects compared to cryotherapy. However, further research is needed to compare other significant long-term outcomes such as costs associated with these treatment choices and quality of life.

scholarly journals Mapping the prevalence of the neglected sexual side effects after prostate cancer treatment and the questionnaires used in their screening: a scoping review protocol

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Pierre Röscher ◽  
Jacqueline M. van Wyk
Keyword(s):  
Prostate Cancer ◽  
Side Effects ◽  
Scoping Review ◽  
Research Question ◽  
Prostate Cancer Treatment ◽  
Eligibility Criteria ◽  
Sexual Stimulation ◽  
Sexual Side Effects ◽  
Review Team ◽  
Review Protocol

Abstract Background Interventions to treat early prostate cancer (PCa) can leave men with debilitating sexual side effects. The cluster of side effects referred to as the neglected sexual side effects (NSSE) may remain permanent, undiagnosed and untreated because men are hesitant to disclose them. Questionnaires offer a discreet way into the discussion, subsequent diagnosis and possible treatment of the NSSE. This study will be conducted to map the evidence about the prevalence of the neglected sexual side effects (NSSE) after PCa treatment, and use of questionnaires in its diagnosis and screening. Methods This systematic scoping review will involve searching the following electronic databases: PubMed, Science Direct and Google Scholar. Following title searching, two-independent reviewers will conduct screening of abstracts and full articles. Eligibility criteria will guide the screenings. Data will be extracted from the included studies, and the emerging themes will be analysed. The review team will analyse the implications of the findings concerning the research question and aim of the study. The mixed method appraisal tool (MMAT) will be employed for quality appraisal of included studies. Discussion We anticipate finding a number of studies that describe the prevalence of NSSE after early PCa treatment and that report on using questionnaires to screen for the presence of symptoms including orgasm-associated incontinence, urinary incontinence during sexual stimulation, altered perceptions of orgasm, orgasm associated pain, penile shortening and penile deformity. The study findings will be disseminated through publication in a peer-reviewed journal, peer presentations and presentations at relevant conferences.

scholarly journals Development and Validation of a Novel Integrated Clinical-Genomic Risk Group Classification for Localized Prostate Cancer

2018 ◽  
Vol 36 (6) ◽  
pp. 581-590 ◽  
Author(s):  
Daniel E. Spratt ◽  
Jingbin Zhang ◽  
María Santiago-Jiménez ◽  
Robert T. Dess ◽  
John W. Davis ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Distant Metastasis ◽  
Treatment Guidelines ◽  
Risk Groups ◽  
Localized Prostate Cancer ◽  
Tier System ◽  
Genomic Risk ◽  
Clinical Genomic ◽  
Risk Grouping

Purpose It is clinically challenging to integrate genomic-classifier results that report a numeric risk of recurrence into treatment recommendations for localized prostate cancer, which are founded in the framework of risk groups. We aimed to develop a novel clinical-genomic risk grouping system that can readily be incorporated into treatment guidelines for localized prostate cancer. Materials and Methods Two multicenter cohorts (n = 991) were used for training and validation of the clinical-genomic risk groups, and two additional cohorts (n = 5,937) were used for reclassification analyses. Competing risks analysis was used to estimate the risk of distant metastasis. Time-dependent c-indices were constructed to compare clinicopathologic risk models with the clinical-genomic risk groups. Results With a median follow-up of 8 years for patients in the training cohort, 10-year distant metastasis rates for National Comprehensive Cancer Network (NCCN) low, favorable-intermediate, unfavorable-intermediate, and high-risk were 7.3%, 9.2%, 38.0%, and 39.5%, respectively. In contrast, the three-tier clinical-genomic risk groups had 10-year distant metastasis rates of 3.5%, 29.4%, and 54.6%, for low-, intermediate-, and high-risk, respectively, which were consistent in the validation cohort (0%, 25.9%, and 55.2%, respectively). C-indices for the clinical-genomic risk grouping system (0.84; 95% CI, 0.61 to 0.93) were improved over NCCN (0.73; 95% CI, 0.60 to 0.86) and Cancer of the Prostate Risk Assessment (0.74; 95% CI, 0.65 to 0.84), and 30% of patients using NCCN low/intermediate/high would be reclassified by the new three-tier system and 67% of patients would be reclassified from NCCN six-tier (very-low– to very-high–risk) by the new six-tier system. Conclusion A commercially available genomic classifier in combination with standard clinicopathologic variables can generate a simple-to-use clinical-genomic risk grouping that more accurately identifies patients at low, intermediate, and high risk for metastasis and can be easily incorporated into current guidelines to better risk-stratify patients.

scholarly journals Prostate cancer-specific survival differences in patients treated by radical prostatectomy versus curative radiotherapy

2013 ◽  
Vol 7 (5-6) ◽  
pp. 299 ◽  
Author(s):  
Julie M. DeGroot ◽  
Michael D. Brundage ◽  
Miu Lam ◽  
Susan L. Rohland ◽  
Jeremy Heaton ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Proportional Hazards ◽  
Risk Groups ◽  
Cox Proportional Hazards ◽  
Intermediate Risk ◽  
Cancer Specific Survival ◽  
Entire Study ◽  
Curative Radiotherapy ◽  
The Impact ◽  
Cause Specific Survival

Objective: We compared the cause-specific survival of patientswho received radiotherapy to those who received surgery for cureof their prostate cancer using a number of design and analytic stepsto mitigate confounding by indication.Methods: This was a case-cohort study of 2213 patients in theOntario Cancer Registry diagnosed between 1990 and 1998 whowere either treatment candidates or received curative radiotherapyor surgery. Cases included patients who died of prostate cancerwithin 10 years. The study population was restricted to those whowere candidates for either treatment (radiotherapy or surgery)based on disease severity (low and intermediate risk using theGenitourinary Radiation Oncologists of Canada risk groups). Themedian follow-up was 51 months. Cause-specific survival wasanalyzed using Cox-proportional hazards regression with casecohortvariance adjustment.Results from intent-to-treat analyseswere compared to results by treatment received.Results: Adjusted hazard ratios for risk of prostate cancer death forradiotherapy compared to surgery for the entire study populationwere 1.62 (95%CI 1.00-2.61) and 2.02 (1.19-3.43) analyzing byintent-to-treat and treatment received, respectively. Intent-to-treathazard ratios for the low- and intermediate-risk groups were 0.87(0.28-2.76) and 1.57 (0.95-2.61), respectively.Conclusion: Overall results were driven by the finding in the intermediate-risk group, which indicated that radiotherapy was not aseffective as surgery in this group. Confirmation was needed withspecial attention paid to risk stratification and the impact of morecontemporary delivery of these treatment options.

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