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Abramson Cancer CenterNCI CANCERLIT® Search: Therapy of Prostate Cancer - May 2002
National Cancer Institute®
Last Modified: May 1, 2002
Table of Contents
1
UI - 10737471
AU - Critz FA; Williams WH; Benton JB; Levinson AK; Holladay CT; Holladay DA
TI -
Prostate specific antigen bounce after radioactive seed implantation
followed by external beam radiation for prostate cancer.
SO - J Urol 2000 Apr;163(4):1085-9
AD - Radiotherapy Clinics of Georgia and Georgia Urology, Decatar, USA.
PURPOSE: Prostate specific antigen (PSA) may temporarily increase
following radiotherapy for prostate cancer without signaling cancer
recurrence. We describe this phenomenon which is called PSA bounce.
MATERIALS AND METHODS: From 1984 to 1995, 779 stage T1T2N0 cancer cases
were treated with simultaneous radiotherapy with a 125iodine prostate
implant followed by external beam radiation. Median pretreatment PSA was
7.7 ng./ml. (range 0.3 to 188). PSA bounce was defined as an increase of
0.1 ng./ml. or greater above the preceding PSA level after simultaneous
radiation followed by a subsequent decrease below that level.
Disease-free status was defined as the ability to achieve and maintain
posttreatment PSA 0.2 ng./ml. or less. RESULTS: PSA bounce was observed
in 35% of men (273 of 779). Median time to PSA bounce was 18 months from
the time of implant and 92% of bounces were observed within 36 months.
Median pre-bounce PSA was 0.7 ng/ml. (range 0.1 to 8.9) and median
bounce height (increase above the pre-bounce level) was 0.4 ng./ml.
(range 0.1 to 15.8). No distinguishing characteristics were observed
between men with PSA bounce and those with cancer recurrence, and bounce
had no prognostic significance relative to recurrence. CONCLUSIONS: PSA
bounce is common following seed implantation for prostate cancer. It
produces anxiety in men previously treated for prostate cancer and
confounds the diagnosis of recurrence.
2
UI - 11061918
AU - Frankel G
TI -
Re: Radical prostatectomy for localized prostate cancer provides durable
cancer control with excellent quality of life: a structured debate.
SO - J Urol 2000 Dec;164(6):2030-1
3
UI - 11061919
AU - Pruthi RS
TI -
Re: Prostate specific antigen bounce after radioactive seed implantation
followed by external beam radiation for prostate cancer.
SO - J Urol 2000 Dec;164(6):2031
4
UI - 11764662
AU - von Knobloch R; Wille S; Hofmann R
TI -
Clinical side effects after radical prostatectomy.
SO - Front Radiat Ther Oncol 2002;37():191-5
AD - Department of Urology, Philipps University Medical School, Marburg,
Germany. r.von-knobloch@mailer.uni-marburg.de
5
UI - 11764663
AU - Nutting CM; Dearnaley DP
TI -
Prostate cancer--the Royal Marsden conformal experience.
SO - Front Radiat Ther Oncol 2002;37():196-9
AD - Academic Unit of Radiotherapy and Oncology, Institute of Cancer
Research, Royal Marsden NHS Trust, Sutton, UK. chrisnutting@cs.com
6
UI - 11173142
AU - Teh BS; Mai WY; Augspurger ME; Uhl BM; McGary J; Dong L; Grant WH 3rd;
TI -
Lu HH; Woo SY; Carpenter LS; Chiu JK; Butler EB
Intensity modulated radiation therapy (IMRT) following prostatectomy:
more favorable acute genitourinary toxicity profile compared to primary
IMRT for prostate cancer.
SO - Int J Radiat Oncol Biol Phys 2001 Feb 1;49(2):465-72
AD - Department of Radiology/Radiation Oncology, Baylor College of Medicine
and The Methodist Hospital, Houston, Texas, USA. bteh@bcm.tmc.edu
PURPOSE: To report our initial experience on postprostatectomy IMRT
(PPI), addressing acute genitourinary (GU) toxicity in comparison to
primary IMRT (PI) for prostate cancer. METHODS AND MATERIALS: From April
intensity modulated radiation therapy (IMRT) to a median prescribed dose
of 64 Gy (mean dose of 69 Gy). The Radiation Therapy Oncology Group
(RTOG) scoring system was used to assess acute GU toxicity. Target
volume and maximum and mean doses were evaluated. The mean doses to the
bladder and irradiated bladder volume receiving >65 Gy were assessed.
These were compared to those of 125 patients treated with PI to a
prescribed dose of 70 Gy (mean dose of 76 Gy). RESULTS: The acute GU
toxicity profile is more favorable in the PPI group with 82.5% of Grade
0-1 and 17.5% of Grade 2 toxicity compared to 59.2% and 40.8%,
respectively, in the PI group (p < 0.001). There was no Grade 3 or
higher toxicity in either group. The target volume was larger in the PPI
group, while the maximum and mean doses to the target were higher in the
PI group. The mean dose delivered to the bladder was higher in the PPI
group. The irradiated bladder volume receiving >65 Gy was significantly
larger in the PI group (p < 0.001). CONCLUSIONS: PPI can be delivered
with acceptable ute GU toxicity. The larger PPI target volume may be
related to the difficulty in delineating prostatic fossa. Despite a
larger target volume and a higher mean dose to the bladder, PPI produced
a more favorable acute GU toxicity profile. This may be related to a
combination of lower mean and maximum doses and smaller bladder volumes
receiving >65 Gy in the PPI group, as well as urethral rather than
bladder irradiation. The findings have implications in the evaluation of
IMRT treatment plan for prostate cancer, whereby the irradiated bladder
volumes above 65 Gy may be more meaningful than the mean dose to the
bladder. Longer term toxicity results are awaited.
7
UI - 11867200
AU - Jackson KM; DeLeon M; Verret CR; Harris WB
TI -
Dibenzoylmethane induces cell cycle deregulation in human prostate
cancer cells.
SO - Cancer Lett 2002 Apr 25;178(2):161-5
AD - Winship Cancer Institute, Emory University School of Medicine, 1365-B
Clifton Road, NE Rm. # 5204, Atlanta, GA 30322, USA.
Dibenzoylmethane (DBM), a minor beta-diketone constituent of licorice
and sunscreens, has been shown to exhibit anti-neoplastic effects in
chemically induced skin and mammary cancers in several animal models. To
date, no mechanism for the growth inhibitory effects of DBM on prostate
cancer cells has been proposed. In this study, we examined the effects
of DBM on the growth and cell cycle kinetics of several human prostate
carcinoma cell lines. Using an MTT cytotoxicity assay, IC50 values of
25-100 microM were observed following 72 h exposure to DBM. LNCaP,
DU145, and PC-3 prostate carcinoma cell lines were particularly
sensitive in comparison to the cells with the vehicle alone. Flow
cytometric analyses showed deregulation of the cell cycle, which
correlated with the observed cytostatic effects of DBM in prostate
carcinoma cells. These data suggest a potential role for DBM in the
prevention and treatment of prostate cancer.
8
UI - 11588893
AU - Neuhouser ML; Kristal AR; Patterson RE; Goodman PJ; Thompson IM
TI -
Dietary supplement use in the Prostate Cancer Prevention Trial:
implications for prevention trials.
SO - Nutr Cancer 2001;39(1):12-8
AD - Cancer Prevention Research Program, Fred Hutchinson Cancer Research
Center, Seattle, WA 98109, USA. mneuhous@fhcrc.org
Nutrients included in commonly used dietary supplements, such as
vitamins C and E, may affect cancer risk. To better understand how
supplement use may affect the interpretation of cancer prevention
trials, we examined dietary supplement use among participants in the
Prostate Cancer Prevention Trial, a double-blind, placebo-controlled
trial of the drug finasteride (Proscar) for the primary prevention of
prostate cancer. Of 15,387 men who completed food frequency
questionnaires and dietary supplement questionnaires, 44.3% used a
multivitamin, 35% used single supplements of vitamin C or E, and 10-15%
used antioxidant mixtures or single supplements of vitamins A and D,
zinc, or beta-carotene at least three times per week. The strongest
correlates of supplement use were higher education and lower body mass
index (p < 0.001), and whites and Asians were more likely to use
multivitamins and single supplements of vitamins C and E than were
blacks and Hispanics. Supplement users obtained 87% of their total daily
vitamin E intake, 61-64% of vitamins A, C, and D, and about half of
beta-carotene, folate, and zinc from supplements. Because supplements,
especially antioxidants, may confer independent cancer-preventive
effects, analytic models of study findings should include exposure
measurement of dietary supplements with appropriate tests for
interaction. Our results can be generalized to similar chemoprevention
trials.
9
UI - 11880864
AU - Lissoni P; Malugani F; Casu M; Bukovec R; Egardi R; Bordin V; Fumagalli
TI -
E; Mengo S; Gardani G
Effect of bicalutamide therapy on prolactin response to L-dopa in
metastatic prostate cancer patients.
SO - Neuroendocrinol Lett 2002 Feb;23(1):61-3
AD - U.O. di Oncologia Medica e Radioterapia, Ospedale San Gerardo dei
Tintori, 20052 Monza (MI), Italy.
OBJECTIVES: The secretion of prolactin (PRL), which is a growth factor
for prostate cancer cell proliferation, has been proven to present
profound alterations in advanced prostate cancer patients, consisting of
abnormally elevated baseline levels and paradoxical response to L-dopa.
Moreover, the efficacy of standard therapies for prostate cancer may be
mediated at least in part by changes in PRL secretion. The present study
was carried out to analyze the effects of the new antiandrogen agent
bicalutamide on basal levels of PRL and on its response to L-dopa in
metastatic prostate cancer patients. MATERIAL & METHODS: The study
included 10 metastatic prostate cancer patients. They were treated with
bicalutamide at a dose of 50 mg/day orally. They were investigated with
L-dopa test before therapy and after one month of treatment. L-dopa was
given orally at 500 mg, by collecting blood samples before and at 60,
120 and 180 minutes after L-dopa administration. Serum levels of PRL
were measured by the RIA method. RESULTS: Abnormally basal levels of PRL
were seen in 4/10 (40%) patients. Mean PRL basal levels decreased after
bicalutamide therapy, without, however, significant differences. Before
therapy, a paradoxical increase in PRL levels after L-dopa occurred in 4
patients, 3 of them showed basal concentrations of PRL within the normal
range. Moreover, bicalutamide therapy significantly reduced PRL increase
in response to L-dopa. CONCLUSIONS: This study would suggest that the
measurement of the only basal levels is not sufficient to define as
normal the secretion of PRL in advanced prostate cancer, because of the
possible existence of altered response to the dynamic tests for PRL
secretion. Moreover, the study shows that the antitumor therapy with the
new anti-androgen bicalutamide may reduce PRL secretion and improve its
paradoxical secretion in response to L.-Dopa. Further studies will be
required to better define the possible prognostic impact of changes in
PRL secretion on the efficacy of treatments for metastatic prostate
cancer.
10
UI - 11956172
AU - Krishnan AV; Zhao XY; Swami S; Brive L; Peehl DM; Ely KR; Feldman D
TI -
A glucocorticoid-responsive mutant androgen receptor exhibits unique
ligand specificity: therapeutic implications for androgen-independent
prostate cancer.
SO - Endocrinology 2002 May;143(5):1889-900
AD - Department of Medicine, Stanford University School of Medicine,
Stanford, CA 94305, USA.
The cortisol/cortisone-responsive AR (AR(ccr)) has two mutations (L701H
and T877A) that were found in the MDA PCa human prostate cancer cell
lines established from a castrated patient whose metastatic tumor
exhibited androgen-independent growth. Cortisol and cortisone bind to
the AR(ccr) with high affinity. In the present study, we characterized
the structural determinants for ligand binding to the AR(ccr). Our data
revealed that many of the C17, C19, and C21 circulating steroids, at
concentrations that are found in vivo, functioned as effective
activators of the AR(ccr) but had little or no activity via the
wild-type AR or GRalpha. Among the synthetic glucocorticoids tested,
dexamethasone activated both GRalpha and AR(ccr), whereas triamcinolone
was selective for GRalpha. In MDA PCa 2b cells, growth and
prostate-specific antigen production were stimulated by potent AR(ccr)
agonists such as cortisol or 9alpha-fluorocortisol but not by
triamcinolone (which did not bind to or activate the AR(ccr)). Of the
potential antagonists tested, bicalutamide (casodex) and GR antagonist
RU38486 showed inhibitory activity. We postulate that corticosteroids
provide a growth advantage to prostate cancer cells harboring the
promiscuous AR(ccr) in androgen-ablated patients and contribute to their
transition to androgen-independence. We predict that triamcinolone, a
commonly prescribed glucocorticoid, would be a successful therapeutic
agent for men with this form of cancer, perhaps in conjunction with the
antagonist casodex. We hypothesize that triamcinolone administration
would inhibit the hypothalamic-pituitary-adrenal axis, thus suppressing
endogenous corticosteroids, which stimulate tumor growth. Triamcinolone,
by itself, would not activate the AR(ccr) or promote tumor growth but
would provide glucocorticoid activity essential for survival.
11
UI - 11993206
AU - Habuchi T; Iinuma M; Sato K; Sato S; Matsuura S; Shimoda N; Tsuchiya N;
TI -
Mitsumori K; Kato T
[Early results in the initial 15 cases of laparoscopic radical
prostatectomy in Akita University Medical Center]
SO - Hinyokika Kiyo 2002 Mar;48(3):139-44
AD - Department of Urology, Akita University School of Medicine.
We herein report our experience and early results of laparoscopic
radical prostatectomy in 15 cases of localized prostate cancer (11 T1c
operative procedure was almost identical to the Montsouris technique.
Conversion to the open procedure was required only in the first case
because of a widely opened bladder neck that involved the ureteral
orifice. No severe intraoperative or postoperative complications were
observed. The mean operating time and blood loss was 383 minutes and 640
ml including intraoperative urine, respectively. Only one patient
required blood transfusion. All 14 patients with a successful procedure
could take fluid and walk freely on postoperative day 1. Twelve (86%) of
the 14 patients could take food on postoperative day 1 and a Foley
catheter was successfully removed on day 6 to 8 in 12 (86%) cases.
Histologically, positive surgical margin was observed in 5 (33%) cases
and all of them were considered non-organ confined (pT3 or more).
Without adjuvant hormonal therapy, biochemical (PSA) failure was
observed in 5 (36%) cases (median follow-up period: 11 months).
Continence has been well maintained in 12 patients with no need for a
pad by 3 months postoperatively and 2 patients are using only 1 pad/day
for caution's sake. In terms of early postoperative recovery,
intraoperative blood loss and maintenance of continence, laparoscopic
radical prostatectomy may give a satisfactory result. Although long-term
follow-up is required to assess disease control and maintenance of
sexual function, laparoscopic radical prostatectomy may become an
alternative for the treatment of organ-confined prostate cancer.
12
UI - 11942169
AU - Mansueto G; Longo F
TI -
[Adjuvant treatment of prostatic carcinoma after primary therapy. The
"Early Prostate Cancer" Program]
SO - Recenti Prog Med 2002 Mar;93(3):175-8
AD - U.B. Oncologia Medica, Ospedale Regionale Valle D'Aosta.
13
UI - 11942170
AU - Martorana G
TI -
[Adjuvant hormone therapy in prostatic cancer: after treatment with
curative intent. The viewpoint of the urologist]
SO - Recenti Prog Med 2002 Mar;93(3):179-82
AD - Cattedra e Scuola di Specializzazione in Urologia, Dipartimento di
Scienze Chirurgiche e Anestesiologiche, Alma Mater Studiorum, Universita
di Bologna.
14
UI - 11942171
AU - Rigatti P; Scattoni V
TI -
[Efficacy of bicalutamide in adjuvant treatment of prostatic carcinoma
after primary therapy with curative aim. The viewpoint of the surgeon]
SO - Recenti Prog Med 2002 Mar;93(3):183-5
AD - Istituto Scientifico Ospedale San Raffaele, Universita Vita e Salute,
Milano.
15
UI - 11955744
AU - Magrini SM; Bertoni F; Vavassori V; Villa S; Cagna E; Maranzano E;
TI -
Pertici M; Pradella R; Spediacci MA; Chiavacci A; Ambrosi E; Livi L;
Magli A; Bellavita R; Bossi A; Biti G
Practice patterns for prostate cancer in nine central and northern Italy
radiation oncology centers: a survey including 1759 patients treated
during two decades (1980-1998).
SO - Int J Radiat Oncol Biol Phys 2002 Apr 1;52(5):1310-9
AD - Department of Radiation Oncology, Istituto del Radio, O. Alberti Brescia
University, Brescia, Italy. magrini@master.cci.unibs.it
PURPOSE: Prostate cancer patients in Italy are offered the choice of the
full spectrum of possible treatment options for their disease, but the
diffusion of the more recent technological refinements among the
Radiation Oncology centers is not homogeneous and there is a need to
establish a reference "historical" data source. This retrospective study
describes the changing patterns in prostate cancer patient practice and
the therapeutic results obtained in nine Radiation Oncology centers of
Northern and Central Italy (five in Northern Italy and four in Central
Italy). METHODS AND MATERIALS: A total of 1759 prostate cancer patients,
radically treated in the nine radiotherapy (RT) centers between 1980 and
1998, made up the study population. Data collected for each patient
included clinical, pathologic, therapeutic features, and toxicity. The
overall survival, disease-specific survival (DSS), and clinical
relapse-free survival (RFS) were calculated for the whole series and for
the subsets of patients defined by different clinical, pathologic, and
therapeutic features, according to three accrual periods (A, 1980-1990;
B, 1991-1994; and C, 1995-1998). Univariate and multivariate analyses
were performed to identify prognostic factors related to survival and
late adverse effects (cystitis and proctitis) probability. RESULTS:
Patient accrual increased markedly during the 2 decades considered, and
the percentage of cases with Stage C or D disease dropped from 49%
(period A) to 43% (period B) to 37% (period C) (p < 0.0001, chi-square).
The baseline prostate-specific antigen value was available for 10%, 76%,
and 95% of the cases treated in the three different periods. The major
changes in the therapeutic options were an increase in dose to the
prostate (>66 Gy in 44%, 84%, and 93% of the patients treated in period
A, B, and C, respectively); a reduction in treated volumes, including
pelvic lymphatic drainage (56-39% before 1995, 22% thereafter); and an
increase in cases treated in association with hormonal therapy (50%
before 1991, 80% thereafter). Lower energy (<10 MV) photon beams were
progressively abandoned (12% before 1990 vs. 6-7% thereafter), along
with an increase in the use of blocks (60% in the last 4 years of the
study vs. about 30-40% before 1995) and "conformal" RT (applied in 41%
of cases treated after 1994). The actuarial RFS, DSS, and overall
survival rate at 5 years was, respectively, 60% +/- 2%, 75% +/- 2%, 66%
+/- 2% for period A; 74% +/- 2%, 90% +/- 1%, 83% +/- 2%, for period B;
and 67% +/- 5%, 90% +/- 2%, 79% +/- 5% for period C. The actuarial
overall survival, DSS, and RFS rate for the whole series of 1759
patients was 77% +/- 1%, 86% +/- 1%, and 68% +/- 1% at 5 years,
respectively. Multivariate analysis showed that only American Urologic
Association stage, grade, dose to the prostate, accrual period,
association with hormonal treatment after (or both after and before) RT
(only in terms of DSS and RFS), and baseline prostate-specific antigen
value (only for RFS) retained prognostic significance in the final Cox
model. CONCLUSION: The increase in the accrual of prostate cancer
patients radically treated with RT has been accompanied by considerable
changes in the clinical features at presentation, as well as in the
staging and treatment procedures. Patients treated more recently had
better survival results. An earlier stage and more favorable grade were
linked with better overall, DSS, and RFS at multivariate analysis. Lower
prostate-specific antigen baseline values were also related to better
RFS. Better results were obtained with higher radiation doses, and the
dose to tumor seemed the most important treatment-related prognostic
factor. The toxicity (cystitis and proctitis, every Radiation Therapy
Oncology Group grade) was substantially the same in the different
accrual periods, but larger treated volumes and higher doses appeared to
increase the incidence of late effects.
16
UI - 11955763
AU - Dale RG; Jones B
TI -
Is the alpha/beta for prostate tumors really low? In regard to Fowler et
al., IJROBP 2001;50:1021-1031.
SO - Int J Radiat Oncol Biol Phys 2002 Apr 1;52(5):1427-8; discussion 1428
17
UI - 11977390
AU - Gershkevitsh E; Hildebrandt G; Wolf U; Kamprad F; Realo E; Trott KR
TI -
Chromosomal aberration in peripheral lymphocytes and doses to the active
bone marrow in radiotherapy of prostate cancer.
SO - Strahlenther Onkol 2002 Jan;178(1):36-42
AD - Department of Radiotherapy, Hematology-Oncology Clinic, Clinicum of the
University of Tartu, Estonia.
BACKGROUND AND PURPOSE: Radiotherapy plays an important role in the
management of prostate cancer. Epidemiological data indicate a small but
significant risk of radiation-induced leukemia after radiotherapy which
might be related to the high mean bone marrow dose associated with
radiotherapy of prostate cancer. The purpose of the study was to
investigate the relation between the mean bone marrow dose and unstable
chromosome aberrations in peripheral blood lymphocytes in patients
undergoing conformal radiotherapy for prostate cancer as a possible
indicator of risk. Endometrial cancer patients were also included for
comparison. PATIENTS AND METHODS: Nine patients, six with prostate
cancer (60-73 years old) and three with endometrial cancer (61-81 years
old) treated with radiotherapy were included in the study. The non-bony
spaces inside the pelvic bones were outlined on every CT slice using the
treatment planning system and mean doses to the bone marrow calculated.
Blood samples of the patients were obtained at different times before,
during and at the end of treatment. Lymphocytes were cultured in the
usual way and metaphases scored for dicentric aberrations. RESULTS: 46
samples from nine patients were obtained. The mean number of metaphases
analyzed per sample was 180 with a range from 52 to 435. The mean bone
marrow doses for prostate cancer patients ranged from 2.8 to 4.2 Gy and
for endometrial cancer patients from 12.8 to 14.8 Gy. The aberration
yield increased with the planning target volume and the mean bone marrow
dose. CONCLUSION: The yield of dicentric aberrations for prostate cancer
patients correlated closely with the mean bone marrow dose albeit the
induction of dicentrics occurred in mature T lymphocytes most of which
were probably in transit through the irradiated volumes. Therefore, the
observed relationship between dicentrics and mean bone marrow doses are
indirect.
18
UI - 11872025
AU - Walsh IK; Williams SG; Mahendra V; Nambirajan T; Stone AR
TI -
Artificial urinary sphincter implantation in the irradiated patient:
safety, efficacy and satisfaction.
SO - BJU Int 2002 Mar;89(4):364-8
AD - Department of Urology, University of California, Davis, California, USA.
OBJECTIVE: To compare the long-term outcome of artificial urinary
sphincter (AUS) implantation in patients after prostatectomy, with and
with no history of previous irradiation. PATIENTS AND METHODS: The study
included 98 men (mean age 68 years) with urinary incontinence after
prostatectomy for prostate cancer (85 radical, 13 transurethral
resection) who had an AUS implanted. Twenty-two of the patients had
received adjuvant external beam irradiation before AUS implantation.
Over a mean (range) follow-up of 46 (5-118) months, the complication and
surgical revision rates were recorded and compared between irradiated
and unirradiated patients. The two groups were also compared for the
resolution of incontinence and satisfaction, assessed using a
questionnaire. RESULTS: Overall, surgical revision was equally common in
irradiated (36%) and unirradiated (24%) patients. After activating the
AUS, urethral atrophy, infection and erosion requiring surgical revision
were more common in irradiated patients (41% vs. 11%; P < 0.05); 70% of
patients reported a significant improvement in continence, regardless of
previous irradiation. Patient satisfaction remained high, with > 80% of
patients stating that they would undergo surgery again and/or recommend
it to others, despite previous irradiation and/or the need for surgical
revision. CONCLUSIONS: Despite higher complication and surgical revision
rates in patients who have an AUS implanted and have a history of
previous irradiation, the long-term continence and patient satisfaction
appear not to be adversely affected.
19
UI - 11889593
AU - Helpap B; Kloppel G
TI -
Neuroendocrine carcinomas of the prostate and urinary bladder: a
diagnostic and therapeutic challenge.
SO - Virchows Arch 2002 Mar;440(3):241-8
AD - Department of Pathology, Academic Hospital of the University of
Freiburg, Postfach 720, 78207 Singen, Germany.
pathologie@hegau-klinikum.de
This review addresses the various morphological, immunohistochemical and
cell kinetic aspects of pure and mixed neuroendocrine carcinomas of the
prostate and urinary bladder and of carcinomas with focal neuroendocrine
differentiation. It is important that neuroendocrine tumours of the
prostate and urinary bladder be clearly distinguished from their
nonneuroendocrine counterparts because of differences in treatment and
prognosis. In the case of high-grade neuroendocrine carcinomas, early
diagnosis and initiation of appropriate chemotherapy may increase
survival and potentially induce complete remission in individual cases.
20
UI - 11989904
AU - Lorusso V
TI -
Prostate carcinoma.
SO - Tumori 2002 Jan-Feb;88(1 Suppl 1):S125-7
AD - Medical Oncology Department, Oncology Institute, Bari.
21
UI - 11989940
AU - Olmi P
TI -
Limits to the radiation therapy due to age.
SO - Tumori 2002 Jan-Feb;88(1 Suppl 1):S95-7
AD - Divisione di Radioterapia, Istituto Nazionale Tumori, Milano.
22
UI - 11995697
AU - Bracarda S
TI -
[Chemotherapy of prostate cancer: potential role of docetaxel]
SO - Tumori 2001 Nov-Dec;87(6):A12-4
23
UI - 11072184
AU - Wilkinson DA; Lee EJ; Ciezki JP; Mohan DS; Zippe C; Angermeier K;
TI -
Ulchaker J; Klein EA; Mohan D
Dosimetric comparison of pre-planned and or-planned prostate seed
brachytherapy.
SO - Int J Radiat Oncol Biol Phys 2000 Nov 1;48(4):1241-4
AD - Department of Radiation Oncology, The Cleveland Clinic Foundation,
Cleveland, OH 44195, USA. wilkinson@radonc.ccf.org
PURPOSE: To compare the dosimetry of the traditional two step procedure
(volume study + treatment planning several weeks later) with that of an
OR-based single procedure in which these two steps follow one another
immediately. Computer generated treatment plans were used in both
procedures. METHODS AND MATERIALS: Several dosimetric parameters
relating to target coverage were obtained from dose volume histograms of
CT-based evaluation plans developed either 1 or 3 days following seed
implantation. A total of 113 patients with early stage (T1C, T2A)
prostate cancer were used for this retrospective study. RESULTS: The
fraction of target (prostate) covered by the prescription dose (144 Gy),
90% of the prescription dose (115 Gy), and the dose encompassing 90% of
the target in the evaluation plan were all statistically significantly
improved for OR-based plans compared to pre-planned cases. CONCLUSION:
In our hands, there is a small but significant improvement in dose
coverage of the prostate when the ultrasound volume study and treatment
planning are combined into a single procedure.
24
UI - 11181666
AU - Leventis AK; Shariat SF; Kattan MW; Butler EB; Wheeler TM; Slawin KM
TI -
Prediction of response to salvage radiation therapy in patients with
prostate cancer recurrence after radical prostatectomy.
SO - J Clin Oncol 2001 Feb 15;19(4):1030-9
AD - Matsunaga-Conte Prostate Cancer Research Center, Baylor College of
Medicine and Methodist Hospital, Houston, TX 77030, USA.
PURPOSE: To identify factors predictive of local recurrence as defined
by a complete response to salvage radiation therapy in patients whose
disease recurs after radical prostatectomy. PATIENTS AND METHODS:
Ninety-five patients with recurrence after radical prostatectomy who
were evaluated by prostatic fossa biopsies, and a subset of 49 of these
patients treated with radiation for control of presumed or biopsy-proven
local recurrence, were studied. RESULTS: Biopsies were positive in 40
(42%) of the 95 biopsied patients. Multivariate analysis revealed that
prebiopsy prostate-specific antigen (PSA) level, postrecurrence PSA
doubling time, and positive digital rectal examination (DRE) of the
prostatic fossa were all statistically significant predictors of a
positive biopsy. For the 49 patients subsequently treated with salvage
radiation therapy, the overall actuarial 3- and 5-year PSA relapse-free
probabilities were 43% and 24%, respectively. Univariate analysis showed
no differences in the PSA relapse-free probabilities associated with any
pathologic features of the radical prostatectomy specimen, biopsy
confirmation of local recurrence, or DRE of the prostatic fossa. In
multivariate analysis, controlling for all other variables, preradiation
PSA and postrecurrence PSA doubling time measured before radiation were
the only statistically significant predictors of outcome. CONCLUSION:
DRE of the prostatic fossa, prebiopsy PSA, and postrecurrence PSA
doubling time predict which patients will have biopsy-proven local
recurrence. However, response to salvage radiation therapy is associated
with postrecurrence PSA doubling time and with preradiation PSA level
only. DRE of the prostatic fossa and biopsy confirmation of local
recurrence are not associated with salvage radiation outcome.
25
UI - 11966834
AU - Salmenpera L
TI -
The use of complementary therapies among breast and prostate cancer
patients in Finland.
SO - Eur J Cancer Care (Engl) 2002 Mar;11(1):44-50
AD - Department of Nursing, 20014 University of Turku, Finland.
liisa.salmenpera@pp.inet.fl
This study describes the use of complementary therapies (CTs) among
breast (women) and prostate cancer patients (men) in Finland. The data
were collected using a self-administered postal questionnaire. Responses
were received from 216 women (response rate 54.9%) and 190 men (response
rate 55.4%). Data analysis was based on descriptive statistics, the
chi-square test and Fisher and Wilcoxon tests. Interpretation of the
responses to the open-ended questions used the method of content
analysis. Half the respondents (women 53%, men 50%) were interested in
CTs. Women (59%) had seriously considered using CTs significantly (P =
0.006) more often than men (44%). Among the women and men who had
considered the option, CT use was not started because there was not
enough scientific evidence (women 56%, men 77%) or because conventional
treatments had worked well enough (women 45%, men 70%). Almost one-third
of all women (30%) and men (28%) either continued to use or started
using CTs after they had fallen ill with cancer. They resorted to CTs in
order to restore their hope in the future (women 36%, men 36%) and to do
as much as they could for themselves (women 46%, men 29%). The results
indicate that cancer patients are interested in CTs and use them quite
frequently. This presents a major challenge to official health care: how
should cancer patients be supported in the care relationship to make an
informed decision about using CTs; what kind of advice should they be
given; and how can patients' individual requirements be adequately met
in nursing care?
26
UI - 11980024
AU - Oudard S
TI -
[Chemotherapy: principles and practice]
SO - Prog Urol 2002 Feb;12(1 Suppl 2):19-30
AD - Hopital Europeen Georges Pompidou, Departement de Cancerologie Medicale,
20 rue Leblanc Paris 75015, France.
stephane.oudard@hop.egp.ap-hop-paris.fr
27
UI - 11980025
AU - Culine S
TI -
[Role of mitoxantrone in the treatment of hormone-independent metastatic
cancer of the prostate]
SO - Prog Urol 2002 Feb;12(1 Suppl 2):31-5
28
UI - 11684247
AU - Inoue K; Takano H; Yoshikawa T
TI -
Fatty fish supplementation and risk of prostate cancer.
SO - Lancet 2001 Oct 20;358(9290):1367
29
UI - 11978206
AU - Fisher M; Beck E
TI -
Is prostate-specific antigen (PSA) screening indicated for any subgroup
of men?
SO - J Fam Pract 2002 Feb;51(2):113
AD - Department of Family Medicine, University of North Carolina, Chapel
Hill, NC, USA.
30
UI - 11958585
AU - Feleppa E J; Ennis R D; Schiff P B; Wuu C S; Kalisz A; Ketterling J;
TI -
Urban S; Liu T; Fair W R; Porter C R; Gillespie J R
Spectrum-analysis and neural networks for imaging to detect and treat
prostate cancer.
SO - Ultrason Imaging 2001 Jul;23(3):135-46
AD - Biomedical Engineering Laboratories, Riverside Research Institute, New
York, NY 10038, USA. feleppa@rrinyc.org
Conventional B-mode ultrasound currently is the standard means of
imaging the prostate for guiding prostate biopsies and planning
brachytherapy to treat prostate cancer. Yet B-mode images do not
adequately display cancerous lesions of the prostate. Ultrasonic
tissue-type imaging based on spectrum analysis of radiofrequency (rf)
echo signals has shown promise for overcoming the limitations of B-mode
imaging for visualizing prostate tumors. This method of tissue-type
imaging utilizes nonlinear classifiers, such as neural networks, to
classify tissue based on values of spectral parameter and clinical
variables. Two- and three-dimensional images based on these methods
demonstrate potential for guiding prostate biopsies and targeting
radiotherapy of prostate cancer. Two-dimensional images are being
generated in real time in ultrasound scanners used for real-time biopsy
guidance and have been incorporated into commercial dosimetry software
used for brachytherapy planning. Three-dimensional renderings show
promise for depicting locations and volumes of cancer foci for disease
evaluation to assist staging and treatment planning, and potentially for
registration or fusion with CT images for targeting external-beam
radiotherapy.
31
UI - 11977805
AU - Erlichman M; Handelsman H; Hotta SS
TI -
Cryosurgery for recurrent prostate cancer following radiation therapy.
SO - Health Technol Assess (Rockv) 1999;(13):i-v, 1-9
Patients with prostate cancer are commonly treated medically or undergo
radical prostatectomy and/or radiation therapy. Radiation therapy is
usually selected for patients with local or regional disease and
patients for whom traditional surgery has failed. The local recurrence
of cancer in patients treated with radiation therapy presents a
difficult challenge regarding the selection of further treatment
options. A commonly applied treatment is salvage prostatectomy, but it
can be difficult and complicated, with positive surgical margins
occurring in as many as 50 percent of patients and with significant
postoperative morbidity. Hormonal therapy, which is not curative, has
served as an alternative to surgery in patients who have failed to
respond to radiation therapy. Cryosurgery, the destruction of diseased
tissue by freezing, is increasingly used both as a first-line therapy
and as a second-line therapy (salvage therapy) in patients for whom
radiation therapy has failed. Recent reports suggest that cryosurgery
may be a useful alternative procedure for treating some of these
patients with recurrent cancers. Outcomes of cryosurgery are improving
through better instrumentation, surgical technique, and experience. The
available data suggest that some patients with radioresistant cancer
appear to benefit from the use of cryosurgery as a salvage therapy. Use
of this technique has resulted in biochemical disease-free survival for
varying periods of some patients who had recurrent prostate carcinoma
following radiation therapy; however, morbidity remains high and
relatively few patients have had adequate followup. Salvage cryosurgery
prospective clinical trials are warranted and would help determine
long-term survival benefits and make possible the comparison of
cryotherapy patient survival rates with those of untreated
biopsy-positive patients.
32
UI - 11992848
AU - Chawla AK; Thakral HK; Zietman AL; Shipley WU
TI -
Salvage radiotherapy after radical prostatectomy for prostate
adenocarcinoma: analysis of efficacy and prognostic factors.
SO - Urology 2002 May;59(5):726-31
AD - Department of Radiation Oncology, Massachusetts General Hospital,
Harvard Medical School, Boston, Massachusetts 02114, USA.
OBJECTIVES: To determine the probability of biochemical control for
patients treated with salvage irradiation and identify prognostic
factors associated with successful salvage. The optimal management of
prostate cancer in patients with an elevated prostate-specific antigen
(PSA) level after radical prostatectomy remains unclear. METHODS: We
reviewed the records of 54 patients with node-negative prostate cancer
treated with radiotherapy alone between 1991 and 1998 for isolated
biochemical relapse after prostatectomy. The median preoperative PSA
level was 15 ng/mL, and the median salvage PSA level was 1.3 ng/mL.
Complete pathologic information was recorded, as was the interval to
postoperative PSA failure. Radiotherapy was delivered to the prostatic
fossa using appropriate techniques. The primary endpoint was biochemical
failure, measured from radiotherapy initiation to the first detectable
PSA level. Biochemical control rates were determined using Kaplan-Meier
methods. The median follow-up was 45 months. RESULTS: The initial
complete response rate was 76%. Only seminal vesicle status demonstrated
borderline significance for the rate of the initial complete response.
The 5-year actuarial biochemical control rate was 35%. The presence of
seminal vesicle invasion, Gleason score greater than 6, and an
immediately detectable postoperative PSA level all predicted for
decreased 5-year biochemical control. Gleason score and detectable
postoperative PSA retained significance on multivariate analysis. Those
with a salvage PSA level of 1.2 ng/mL or less had a trend toward a
decreased 5-year biochemical control rate (P = 0.07). CONCLUSIONS:
Salvage radiotherapy yields a 76% complete response rate, with 35% of
treated patients free of a detectable PSA at 5 years. Those with
favorable biochemical and pathologic tumor features are most likely to
remain disease free.
33
UI - 11992849
AU - Mayer R; Pummer K; Quehenberger F; Mayer E; Fink L; Hackl A
TI -
Postprostatectomy radiotherapy for high-risk prostate cancer.
SO - Urology 2002 May;59(5):732-9
AD - Department of Radiotherapy, University Medical School, Graz, Austria.
OBJECTIVES: To assess the biochemical and clinical results of
postprostatectomy radiotherapy (RT) for high-risk, mostly
non-rgan-confined prostate cancer. METHODS: After radical prostatectomy,
66 consecutive patients received either adjuvant (n = 29) or therapeutic
(n = 37) postoperative RT. Therapeutic RT was given for persistently
elevated postoperative prostate-specific antigen (PSA) levels (n = 14),
gradually rising PSA levels (n = 6), or clinical local recurrence (n =
17). The selection of time and referral for RT was at the discretion of
the treating urologists. RESULTS: The mean and median follow-up after
surgery was 56.8 and 54.2 months, and after radiotherapy, it was 43.2
and 35.0 months, respectively. At 5 years, the actuarial biochemical
control for the whole collective was 59.7% (95% confidence interval [CI]
43.3% to 72.8%). Patients treated with adjuvant RT had statistically
improved biochemical control (85.2% versus 34.0%, P = 0.001), but not
disease-free survival (91% versus 73%, P = 0.09). Advanced tumor stage
(pT3b-4) (relative risk 16.6; 95% CI 0.9 to 313.3; P = 0.01), poorly
differentiated histologic features (relative risk 4.63; 95% CI 1.8 to
12.2; P = 0.001), and pre-RT PSA (relative risk 1.15, 95% CI 1.06 to
1.25; P = 0.003) were associated with a statistically significant
increased risk of biochemical failure. CONCLUSIONS: Although adjuvant
postoperative RT resulted in improved biochemical control, no
significant difference in disease-free survival has been obtained to
date. It therefore remains to be determined whether the better
biochemical control observed will ultimately translate into a survival
benefit after longer follow-up and prospective trials.
34
UI - 11992920
AU - Amano H; Goya N; Ryoji O; Yagisawa T; Nakazawa H; Toma H
TI -
Ethanol injection therapy for locally invasive prostatic adenocarcinoma.
SO - Urology 2002 May;59(5):771-2
AD - Department of Urology, Sanyudo Hospital, Yamagata, Japan.
35
UI - 12011281
AU - Zaidat OO; Ruff RL
TI -
Treatment of spinal epidural metastasis improves patient survival and
functional state.
SO - Neurology 2002 May 14;58(9):1360-6
AD - Neurology Service and Rehabilitation and Spinal Cord Injury and
Dysfunction Care Line, Louis Stokes Cleveland Department of Veterans
Affairs Medical Center, Case Western Reserve University, Cleveland, OH
44106, USA.
OBJECTIVES: To determine factors affecting the success of radiation
therapy (RT) of spinal epidural metastases and patient survival after
RT. DESIGN/METHODS: One hundred thirty-nine male veterans with an
initial spinal epidural metastases treated with dexamethasone and RT
were evaluated prospectively. Patients were followed until death.
RESULTS: At presentation, 84 patients could walk. After RT, 119 patients
walked. The likelihood of regaining ambulation increased if treatment
began <12 hours after loss of ambulation and if patients had bladder and
bowel function and sacral sensory sparing. Treatment reduced pain
levels, and ambulatory patients had less pain compared with
nonambulatory patients. Median length of sur
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