The Effect of Prostate Cancer Radiotherapy on Testosterone Level: A Systematic Review and Meta-analysis

Introduction: In the current study, a systematic search and meta-analysis were performed to evaluate the effect of prostate cancer radiotherapy on testosterone levels of patients. Methods: To illuminate the effect of radiotherapy on the testosterone level of prostate cancer patients, a systematic search was conducted in accordance with the PRISMA guideline in electronic databases of Scopus, Embase, PubMed, Web of Science, and clinical trials up to December 2018 using relevant keywords. Based on a certain set of inclusion and exclusion criteria, 12 eligible studies that had data on the testosterone level following prostate cancer radiotherapy were included in the meta-analysis. Results: According to the various techniques of prostate cancer radiotherapy, the dose values scattered to the testicular tissues ranged from 0.31 to 10 Gy. Combining the findings from 12 studies, it was found that prostate cancer radiotherapy leads to a significant reduction in the testosterone level (Weighted Mean Difference [WMD]: -51.38 ng/dL, 95% CI: -75.86, -26.90, I2=0.0%, P<0.05). Furthermore, subgroup analysis by the patient number showed a significant reduction in the testosterone level at patient number < 50 (WMD: -80.32 ng/dL, 95% CI: -125.10, -35.55, I2= 0.0%) and 50 < patient number < 100 (WMD: -46.99 ng/dL, 95% CI: - 87.15, -6.82, I2= 0.0%). Subgroup analysis based on treatment technique type revealed a significant reduction in testosterone level after conventional radiotherapy (WMD: -56.67, 95% CI: -100.45,-12.88, I2= 34.3%) and IMRT/SBRT technique (WMD: -57.42, 95% CI: -99.39, -15.46, I2= 0.0%) in comparison with the proton therapy (WMD: 0.00, 95% CI: -80.24, 80.24). Conclusion: The findings showed a significant decrease in the testosterone level of prostate cancer patients after radiotherapy compared with pre-treatment levels.

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The Impact of Metformin Use with Survival Outcomes in Urologic Cancers: A Systematic Review and Meta-Analysis

BioMed Research International ◽

10.1155/2021/5311828 ◽

2021 ◽

Vol 2021 ◽

pp. 1-14

Author(s):

Xiangyang Yao ◽

Haoran Liu ◽

Hua Xu

Keyword(s):

Prostate Cancer ◽

Overall Survival ◽

Bladder Cancer ◽

Cancer Patients ◽

Kidney Cancer ◽

Subgroup Analysis ◽

Meta Analysis ◽

Effect Model ◽

Urologic Cancers ◽

The Impact

Background. Conflicting results exist between the potential protective effects of metformin and the prognosis of urologic cancers. This meta-analysis summarized the effects of metformin exposure on the recurrence, progression, cancer-specific survival (CSS), and overall survival (OS) of the three main urologic cancers (kidney cancer, bladder cancer, and prostate cancer). Methods. We systematically searched PubMed, Embase, Web of Science, Wanfang, and China National Knowledge Infrastructure databases (January 2010 to December 2019), which identified studies regarding metformin users and nonusers with urologic cancers and extracted patient data. A random effect model or fixed effect model was used to analyze hazard ratios (HRs) and 95% confidence intervals (CIs). Results. Among the 1883 confirmed studies, 27 eligible studies were identified, including 123,212 participants. In prostate cancer, patients using metformin have significant benefits for recurrence ( HR = 0.74 ; 95% CI: 0.61-0.90; P = 0.007 ; I 2 = 56 % ), CSS ( HR = 0.74 ; 95% CI: 0.61-0.91; P = 0.002 ; I 2 = 79 % ), and OS ( HR = 0.76 ; 95% CI: 0.65-0.90; P < 0.001 ; I 2 = 86 % ). Moreover, further subgroup analysis showed that the beneficial effects of metformin may be more significant for patients receiving radical radiotherapy. For kidney cancer, metformin was beneficial for progression ( HR = 0.80 ; 95% CI: 0.65-0.98; P = 0.14 ; I 2 = 46 % ). Analysis revealed that the effect of metformin on the overall survival of kidney cancer patients may be related to nationality (American: HR = 0.76 ; 95% CI: 0.59-0.98; P = 0.88 ; I 2 = 0 % ). For bladder cancer, no obvious benefits of metformin use were identified. However, subgroup analysis indicated that metformin may improve the recurrence of bladder cancer, but this improvement was only found in patients with a median follow-up time of more than 4 years ( HR = 0.43 ; 95% CI: 0.28-0.67; P = 0.61 ; I 2 = 0 % ).

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How Has Prostate Cancer Radiotherapy Changed in Italy between 2004 and 2011? An Analysis of the National Patterns-Of-Practice (POP) Database by the Uro-Oncology Study Group of the Italian Society of Radiotherapy and Clinical Oncology (AIRO)

Cancers ◽

10.3390/cancers13112702 ◽

2021 ◽

Vol 13 (11) ◽

pp. 2702

Author(s):

Ercole Mazzeo ◽

Luca Triggiani ◽

Luca Frassinelli ◽

Alessia Guarneri ◽

Sara Bartoncini ◽

...

Keyword(s):

Prostate Cancer ◽

Acute Toxicity ◽

Late Toxicity ◽

Radiotherapy Planning ◽

Treatment Technique ◽

Cancer Radiotherapy ◽

Randomized Controlled Studies ◽

Prostate Cancer Radiotherapy ◽

Patterns Of Practice ◽

Previous Series

Background and purpose: Two previous “Patterns Of Practice” surveys (POP I and POP II), including more than 4000 patients affected by prostate cancer treated with radical external beam radiotherapy (EBRT) between 1980 and 2003, established a “benchmark” Italian data source for prostate cancer radiotherapy. This report (POP III) updates the previous studies. Methods: Data on clinical management and outcome of 2525 prostate cancer patients treated by EBRT from 2004 to 2011 were collected and compared with POP II and, when feasible, also with POP I. This report provides data on clinical presentation, diagnostic workup, radiation therapy management, and toxicity as collected within the framework of POP III. Results: More than 50% of POP III patients were classified as low or intermediate risk using D’Amico risk categories as in POP II; 46% were classified as ISUP grade group 1. CT scan, bone scan, and endorectal ultrasound were less frequently prescribed. Dose-escalated radiotherapy (RT), intensity modulated radiotherapy (IMRT), image guided radiotherapy (IGRT), and hypofractionated RT were more frequently offered during the study period. Treatment was commonly well tolerated. Acute toxicity improved compared to the previous series; late toxicity was influenced by prescribed dose and treatment technique. Five-year overall survival, biochemical relapse free survival (BRFS), and disease specific survival were similar to those of the previous series (POP II). BRFS was better in intermediate- and high-risk patients treated with ≥ 76 Gy. Conclusions: This report highlights the improvements in radiotherapy planning and dose delivery among Italian Centers in the 2004–2011 period. Dose-escalated treatments resulted in better biochemical control with a reduction in acute toxicity and higher but acceptable late toxicity, as not yet comprehensively associated with IMRT/IGRT. CTV-PTV margins >8 mm were associated with increased toxicity, again suggesting that IGRT—allowing for tighter margins—would reduce toxicity for dose escalated RT. These conclusions confirm the data obtained from randomized controlled studies.

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Proximal seminal vesicle displacement and margins for prostate cancer radiotherapy

Journal of Medical Radiation Sciences ◽

10.1002/jmrs.457 ◽

2021 ◽

Author(s):

Daryl Lim Joon ◽

Michael Chao ◽

Angelina Piccolo ◽

Michal Schneider ◽

Nigel Anderson ◽

...

Keyword(s):

Prostate Cancer ◽

Seminal Vesicle ◽

Cancer Radiotherapy ◽

Prostate Cancer Radiotherapy

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Management of prostate cancer radiotherapy during the COVID-19 pandemic: A necessary paradigm change

Cancer Treatment and Research Communications ◽

10.1016/j.ctarc.2021.100331 ◽

2021 ◽

Vol 27 ◽

pp. 100331

Author(s):

Beatrice Detti ◽

Gianluca Ingrosso ◽

Carlotta Becherini ◽

Andrea Lancia ◽

Emanuela Olmetto ◽

...

Keyword(s):

Prostate Cancer ◽

Paradigm Change ◽

Cancer Radiotherapy ◽

Prostate Cancer Radiotherapy

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Evaluation of set-up errors and estimation of set-up margin during external beam radiation therapy of prostate cancer using electronic portal imaging device (EPID)

Journal of Radiotherapy in Practice ◽

10.1017/s1460396921000297 ◽

2021 ◽

pp. 1-8

Author(s):

Daryoush Khoramian ◽

Soroush Sistani ◽

Bagher Farhood

Keyword(s):

Prostate Cancer ◽

Radiation Therapy ◽

Target Volume ◽

External Beam Radiation ◽

Beam Radiation ◽

Cancer Radiotherapy ◽

Imaging Device ◽

Portal Images ◽

Set Up ◽

Prostate Cancer Radiotherapy

Abstract Aim: In radiation therapy, accurate dose distribution in target volume requires accurate treatment setup. The set-up errors are unwanted and inherent in the treatment process. By achieving these errors, a set-up margin (SM) of clinical target volume (CTV) to planning target volume (PTV) can be determined. In the current study, systematic and random set-up errors that occurred during prostate cancer radiotherapy were measured by an electronic portal imaging device (EPID). The obtained values were used to propose the optimum CTV-to-PTV margin in prostate cancer radiotherapy. Materials and methods: A total of 21 patients with prostate cancer treated with external beam radiation therapy (EBRT) participated in this study. A total of 280 portal images were acquired during 12 months. Gross, population systematic (Σ) and random (σ) errors were obtained based on the portal images in Anterior–Posterior (AP), Medio-Lateral (ML) and Superior–Inferior (SI) directions. The SM of CTV to PTV were then calculated and compared by using the formulas presented by the International Commission on Radiation Units and Measurements (ICRU) 62, Stroom and Heijmen and Van Herk et al. Results: The findings showed that the population systematic errors during prostate cancer radiotherapy in AP, ML and SI directions were 1·40, 1·95 and 1·94 mm, respectively. The population random errors in AP, ML and SI directions were 2·09, 1·85 and 2·29 mm, respectively. The SM of CTV to PTV calculated in accordance with the formula of ICRU 62 in AP, ML and SI directions were 2·51, 2·68 and 3·00 mm, respectively. And according to Stroom and Heijmen, formula were 4·23, 5·19 and 5·48 mm, respectively. And Van Herk et al. formula were 4·96, 6·17 and 6·45 mm, respectively. Findings: The SM of CTV to PTV in all directions, based on the formulas of ICRU 62, Stroom and Heijmen and van Herk et al., were equal to 2·73, 4·98 and 5·86 mm, respectively; these values were obtained by averaging the margins in all directions.

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