scholarly journals Survival in Patients With Metastatic Prostate Cancer Undergoing Radiotherapy: The Importance of Prostate-Specific Antigen-Based Stratification

2021 ◽  
Vol 11 ◽  
Author(s):  
Zijian Tian ◽  
Lingfeng Meng ◽  
Xin Wang ◽  
Xuan Wang ◽  
Tianming Ma ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Prostate Specific Antigen ◽  
Metastatic Prostate Cancer ◽  
Large Population ◽  
Specific Antigen ◽  
Control Group ◽  
Cancer Specific Survival ◽  
Radiotherapy Group ◽  
Cox Analysis

ObjectivesTo explore the effectiveness of radiotherapy in mPCa patients with different PSA stratifications based on the cancer database of a large population.BackgroundScreening criteria for patients with metastatic prostate cancer, who are candidates for radiotherapy, are rarely reported.Patients and MethodsWe identified 22,604 patients with metastatic prostate cancer in the Surveillance, Epidemiology, and End Results database and divided them into a radiotherapy group and a control group. Patients with metastatic prostate cancer were divided into subgroups according to their levels of prostate-specific antigen to evaluate the efficacy of radiotherapy. They were also divided into six subgroups according to their prostate-specific antigen levels. We used multivariate Cox analysis to evaluate overall survival and cancer-specific survival. After 1:1 propensity score matching, Kaplan-Meier analysis was used to explore the difference in overall survival and cancer-specific survival in the radiotherapy and control group.ResultsIn all, 5,505 patients received radiotherapy, compared to 17,099 in the control group. In the multivariate Cox analysis, radiotherapy improved overall survival (hazard ratio [HR]: 0.730, 95% confidence interval [CI]: 0.636–0.838; P<0.001) and cancer-specific survival (HR: 0.764, 95% CI: 0.647–0.903; P=0.002) in patients with a PSA level of 4–10 ng/mL. Similar results were obtained by Kaplan-Meier analysis after 1:1 propensity score matching. In patients with prostate-specific antigen levels between 4–10 ng/mL, the overall survival (P<0.001) and cancer-specific survival (P<0.05) in the radiotherapy group was significantly better than those in the control group.ConclusionThe result of this large population-based study shows that rigorous selection of appropriate metastatic prostate cancer patients for radiotherapy can benefit prognosis significantly. This can be the basis for future prospective trials.

scholarly journals Three-month early change in prostate-specific antigen levels as a predictive marker for overall survival during hormonal therapy for metastatic hormone-sensitive prostate cancer

2021 ◽  
Author(s):  
Shotaro Nakanishi ◽  
Masato Goya ◽  
Mitsuyoshi Tamaki ◽  
Takuma Oshiro ◽  
Seiichi Saito
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Prostate Specific Antigen ◽  
Characteristic Curve ◽  
Specific Antigen ◽  
Predictive Marker ◽  
Castration Resistant Prostate Cancer ◽  
Pretreatment Level ◽  
Castration Resistant ◽  
Hormone Sensitive

Abstract Objective: To date, there are no useful markers for predicting the prognosis of metastatic hormone-sensitive prostate cancer (mHSPC). We evaluated the effect of early changes in prostate-specific antigen (PSA) levels after androgen deprivation therapy (ADT) on castration-resistant prostate cancer (CRPC) progression and overall survival (OS) in mHSPC patients. Results: In 71 primary mHSPC patients treated with ADT, the median times to CRPC and OS were 15 months and 92 months, respectively. In multivariate analysis, a Gleason score of ≥8 (p = 0.004), an extent of disease value (EOD) of ≥2 (p = 0.004), and a 3-month PSA level >1% of the pretreatment level (p = 0.017) were independent predictors of shorter time to CRPC. The area under the receiver operating characteristic curve was feasible at 0.822. For OS, a 3-month PSA level >1% of the pretreatment level was an independent predictor of time to CRPC (p = 0.004).Three factors were independent predictors of shorter time to CRPC. A 3-month PSA level >1% of the pretreatment level correlated with poor a prognosis.

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.

Clinical Protocol: Phase I Study of an Adenovirus/Prostate-Specific Antigen Vaccine in Men with Metastatic Prostate Cancer

2006 ◽  
Vol 0 (0) ◽  
pp. 060123080936010
Author(s):  
David M. Lubaroff ◽  
Badrinath Konety ◽  
Brian K. Link ◽  
Timothy L. Link ◽  
Tammy Madsen ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Phase I ◽  
Prostate Specific Antigen ◽  
Phase I Study ◽  
Metastatic Prostate Cancer ◽  
Specific Antigen ◽  
Clinical Protocol ◽  
Antigen Vaccine
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