X-Ray induced radiation damage in taurine: a combined X-ray diffraction and Raman study

The impact of X-radiation on crystalline taurine has been investigated by time resolved synchrotron X-ray powder and single crystal diffraction and Raman spectroscopy. Multiple data sets have been collected at 120 and 296 K. All the observed effects of radiation, i.e. broadening and shifts of Raman and diffraction lines, a dose dependent irreversible increase in the atomic displacement parameters (ADPs) as well as in one of the unit-cell axes, and an apparent enhancement of electron density in the SO(3) group can be tentatively attributed to primary radical formation predominantly involving the SO(3) group. In secondary reactions molecular species that are distinct from taurine are created in minute quantities, thereby introducing local departure from crystalline order, i.e. enhanced static disorder and a build-up of local strain. Our study provides evidence for ascribing the linear increase in ADPs as well as the expansion of the c axis to the accumulation of foreign species in the crystal, and not to a thermal effect. Once initiated, this process appears to continue also without radiation, however, then at a much reduced rate.

A phase I study of intra-arterial (IA) cisplatin (C) and accelerated fractionation (AF) radiotherapy (RT) for locally advanced head and neck squamous cell carcinoma (HNSCC)

16512

Background: Concurrent IAC and conventional fractionation (CF) RT is an effective treatment for locally advanced HNSCC. AF RT with 2 late concurrent IAC doses may be equally effective since AF RT produces better local tumor control compared with CF RT and late chemotherapy boost may counteract accelerated repopulation of tumor cells. The maximum-tolerated dose (MTD) of IAC given concurrently with AF RT is not known. Methods: A phase I study was conducted in patients with locally advanced stage III/IV HNSCC to determine the MTD of C that was given as 2 selective IA infusions 1 week apart during the last 2 weeks of AF RT (70 Gy/35 fractions/6 weeks) using 6 fractions/week. IV sodium thiosulfate was used to neutralize the systemic toxicity of C. Starting at 100 mg/m2, cohorts of 3 to 6 patients were treated with escalating doses of IAC, in 25 mg/m2 increments, up to the highest level of 200 mg/m2 per infusion. Dose-limiting toxicity (DLT) was defined as the occurrence in 2 patients at a dose level of grade 3 acute mucositis or skin reactions lasting more than 8 weeks after completion of treatment; grade 4 hematologic, infective, metabolic or hearing toxicity; or grade 3 renal, hepatic or neurological toxicity. The MTD was defined as the dose level immediately lower than that resulting in DLT. Results: Ten patients were recruited with a mean age of 56 years. Two patients had stage III; 1, stage IVa; and 7, stage IVb disease. The T-stages were T1 (n = 2), T2 (n = 1), T3 (n = 2), and T4 (n = 5). The N-stages were N0 (n = 2), N1 (n = 1), N2 (n = 4), and N3 (n = 3). Three patients received IAC at a dose level of 100 mg/m2, 3 at 125 mg/m2, and 4 at 150 mg/m2. All patients had the 2 planned doses except one in the lowest dose level who developed grade 3 hyponatremia after the first dose. There was no treatment-related mortality. DLT occurred in 2 patients at the 150 mg/m2 dose level. One of them had grade 4 leukopenia, and the other had grade 3 acute skin reactions lasting 9 weeks after RT. Thus, MTD was 125 mg/m2. At a median follow-up of 24 months, 6 patients remained alive and disease-free. Conclusions: In patients with locally advanced HNSCC, AF RT with 2 doses of late IAC boost was feasible. The MTD of IAC was 125 mg/m2.

No significant financial relationships to disclose.

High incidence of symptomatic methemoglobinemia (metHb) in Asian patients (pts) treated with 3-Aminopyridine-2-carboxaldehyde thiosemicarbazone (3-AP, triapine) and gemcitabine (GEM) in a second-line phase II trial of metastatic non-small cell lung cancer

18207

Background: Triapine (Vion Pharmaceuticals) is an inhibitor of ribonucleotide reductase that can enhance GEM uptake in GEM- resistant cell lines. Clinically significant metHb has been rarely reported with triapine & G6PD-deficient pts maybe more susceptible. This multicenter study evaluated the activity & safety of combined triapine-GEM in pts with metastatic NSCLC who had progressed despite prior response or disease stabilization to 1st line platinum-GEM regimen. Methods: Eligible pts were treated with triapine (105mg/m2) as 4-hr IV infusion, followed by GEM (1g/m2) over 30-min on days 1, 8 & 15, repeating every 28 days for 6 cycles. G6PD-deficient pts were excluded. Results: 6 males & 6 female Asian pts (median age: 65 yrs) received a median no. of 2 cycles (range 1–6 cycles). At a median follow-up of 4.6 mos, no response was seen. 4 pts had stable disease. Median time to progression was 3 mos (95% CI: 1.7–9.1 mos). Gr 3–4 toxicities included neutropenia (gr 3, 2 pts), hypoxia (gr 3, 3 pts) & dyspnea (gr 3, 1 pt). There were no treatment-related deaths & all pts remained alive at analysis. 4 pts developed symptomatic metHb during, or ≤ 4 hrs of stopping triapine. This was manifested as dyspnea &/or hypoxia, associated with an oxygen saturation of ≤90% at room air. Arterial metHb assay performed during the hypoxic episode showed a metHb level of up to 15% of total concentration of hemoglobin ([Hb]), which fell to < 5% of [Hb] within 4–6 hrs of stopping triapine. All pts recovered with conservative treatment & none required reversal with methylene blue. 3 out of the 4 pts were able to continue treatment after dose-reduction of triapine. Conclusions: The cause of the relatively high incidence of triapine-related symptomatic metHb was unclear in this Asian cohort. This study was terminated prematurely due to lack of response.

No significant financial relationships to disclose.

Efficacy of neoadjuvant docetaxel and cisplatin followed by concurrent cisplatin-radiotherapy in locally advanced nasopharyngeal carcinoma (NPC): A randomized phase II study

6037

Background: The current standard treatment for locally advanced NPC is chemoradiation (CRT) ± adjuvant chemotherapy. However, adjuvant chemotherapy is often poorly tolerated after intensive CRT. Our previous study of neoadjuvant chemotherapy followed by CRT showed encouraging toxicity profile and disease control in advanced NPC (JCO 2004: 22: 3053–60). The current study compared the safety and efficacy of neoadjuvant chemotherapy (neoadj) followed by CRT. Methods: Newly diagnosed patients (pts) with stage III to IVB NPC were randomized (stratified by stage III vs IV) to: (1) Neoadj-CRT: docetaxel 75 mg/m2 D1, cisplatin 75 mg/m2 D1, q3w × 2 cycles, followed by cisplatin 40 mg/m2 weekly × 6–8 cycles concurrent with RT (= 66 Gy in 2-Gy fractions), or (2) CRT: cisplatin-RT (same as arm 1) without neoadj. The primary endpoint was toxicity. Secondary endpoints included survival and quality of life. Planned accrual was 30 pts per arm to detect a 20% difference in toxicity on one side of a 95% confidence interval (CI). Results: From 11/2002 to 11/2004, 65 pts were recruited. Five pts were excluded after randomization but before treatment started (three pts were subsequently found ineligible, and two pts withdrew consent). There was a higher rate of G3–4 neutropenia (100% vs 16%, p<0.001), but not neutropenic fever (3% vs 4%) or other non-hematologic toxicity in the neoadj-CRT vs CRT arm. The proportion of pts progressing at 2-yrs by group was compared by Fisher’s Exact Test (p=0.158). At median follow-up of 2.74 yrs, there were 10 deaths and 13 progressions. The 2-yr progression free survival for neoadj-CRT vs CRT was 80% vs 71% (hazard ratio 0.42; CI 0.14− 1.27; p=0.11). The 2-yr overall survival was 93% vs 76% (hazard ratio 0.17; CI 0.037–0.82; p=0.013). Conclusions: Neoadjuvant docetaxel and cisplatin followed by CRT was well tolerated with a manageable toxicity profile and allowed subsequent delivery of full dose CRT. Preliminary result suggested improved survival. A phase 3 study to definitively test this strategy is warranted. Acknowledgement: Sanofi-Aventis Hong Kong Ltd supported this study in part.

No significant financial relationships to disclose.

A double-blind placebo-controlled randomized study of Chinese herbal medicine as complementary therapy for reduction of chemotherapy-induced toxicity

BACKGROUND

Chinese herbal medicine (CHM) is a common complementary therapy used by patients with cancer for reduction of chemotherapy-induced toxic effects. This study applied the highest standard of clinical trial methodology to examine the role of CHM in reducing chemotherapy-induced toxicity, while maintaining a tailored approach to therapy.

PATIENTS AND METHODS

Patients with early-stage breast or colon cancer who required postoperative adjuvant chemotherapy were eligible for the study. Enrolled patients were randomly assigned to one of three Chinese herbalists who evaluated and prescribed a combination of single-item packaged herbal extract granules. Patients received either CHM or placebo packages with a corresponding serial number. The placebo package contained nontherapeutic herbs with an artificial smell and taste similar to a typical herbal tea. The primary end points were hematologic and non-hematologic toxicity according to the National Cancer Institute Common Toxicity Criteria Version 2.

RESULTS

One hundred and twenty patients were accrued at the time of premature study termination. Patient characteristics of the two groups were similar. The incidence of grade 3/4 anemia, leukopenia, neutropenia, and thrombocytopenia for the CHM and placebo groups were 5.4%, 47.3%, 52.7%, and 1.8% and 1.8%, 32.2%, 44.7%, and 3.6%, respectively (P = 0.27, 0.37, 0.63, and 0.13, respectively). Incidence of grade 2 nausea was the only non-hematologic toxicity that was significantly reduced in the CHM group (14.6% versus 35.7%, P = 0.04).

CONCLUSIONS

Traditional CHM does not reduce the hematologic toxicity associated with chemotherapy. CHM, however, does have a significant impact on control of nausea.

Transarterial ethanol ablation of unresectable hepatocellular carcinoma with lipiodol-ethanol mixture (LEM): A phase II study

14054

Background: Transarterial ablation with lipiodol-ethanol mixture (LEM) induced potent dual embolization of arterioles and portal venules in preclinical studies, and extensive tumor necrosis in clinical studies. It is potentially an effective treatment and a better alternative to chemoembolization for unresectable hepatocellular carcinoma (HCC). The authors aim to study the safety and efficacy of this treatment. Methods: Unresectable HCC diagnosed by histology or viral serology + AFP > 500 ug/l + typical imaging; bilirubin ≤ 30 umol/l; hypervascular tumor on CT / angiogram, no vascular invasion or extrahepatic spread. LEM with Lipiodol and ethanol mixed in ratio of 2:1 by volume was infused transarterially into tumor vasculature by superselective catheterization of tumor feeders at a subsegmental level under fluoroscopy until flow stagnation. Adverse events (AE) graded by NCI-CTC V2.0. Tumor response monitored by CT scan q3m. LEM repeated for residual enhancing lesion or intrahepatic progression on CT scan. Primary endpoint was response rate. Secondary endpoints: toxicity and survival. Results: From 7/2001 to 4/2005, 77 pts enrolled. Age 28–85 (median 64). M:F=60:17. ECOG 0=68; 1=9. Cirrhosis 92%. HBV 77%, HCV 14%, alcohol 4%. Child A 88%, B 12%. Okuda A 73%, B 27%. Histology confirmed in 78%. 39% had previous treatment. Median tumor size 4.5cm (range 1.5–15cm); Number of lesions: One (58), Two (14), Three (5). Best tumor response (WHO criteria): CR 0%, PR 43%, MR 36%, SD 17%, PD 4%. Patients received 1 to 8 LEM treatments (mean 2.2). Mean hospital stay 2.7 days (range 2 -15). Significant AEs are shown in the table. Fever in 15% for mean duration of 3.1 days. After a median follow-up of 1.65 yr, 23 pts died. One year survival 77%. 3 pts had tumor resection after downstage by LEM. Conclusions: Transarterial ablation with LEM is a well tolerated and effective local regional treatment of unresectable HCC. The high tumor response and 1-year survival rate warrants further investigation in comparative study. [Table: see text]

No significant financial relationships to disclose.

High hepatitis B virus (HBV) DNA viral load is an important risk factor for HBV reactivation in breast cancer patients undergoing cytotoxic chemotherapy

Hepatitis B virus (HBV) reactivation during cytotoxic chemotherapy for cancer may complicate treatment and cause liver damage. The complication has been reported to occur in 10% to over 50% of HBV carriers, but the factors that determine which patients will develop reactivation remain unclear. The objective of the study is to test the hypothesis that the prechemotherapy HBV DNA level is a risk factor for the development of HBV reactivation. We studied 41 women undergoing cytotoxic chemotherapy for breast cancer, 17 of whom developed reactivation and 24 who did not. We developed a novel, ultra-sensitive, real-time polymerase chain reaction assay for the measurement of HBV DNA. The sera of 37 patients (16 who developed reactivation and 21 who did not) were available for measurement of HBV DNA using this technique. The results showed that patients in the reactivation group had a significantly higher median HBV DNA load (1.03 x 10(6) copies/mL; range <2.9 x 10(3) to 8.723 x 10(7)) than did the nonreactivation group (<2.9 x 10(3) copies/ml; range <2.9 x 10(3) to 6.331 x 10(7)) (P < 0.001). The optimal cut-off between the two groups was found to be at serum HBV DNA level of 3 x 10(5), which gave a sensitivity of 81.0% and a specificity of 85.0%. In conclusion, for breast cancer patients receiving standard cytotoxic chemotherapy, a high HBV viral load prior to the administration of cytotoxic chemotherapy is a significant predictive factor for the development of HBV reactivation. Such information may be useful in determining which patients would benefit most from prophylactic antiviral therapy during cytotoxic chemotherapy.

[Observation on hemocytes of Culex pipiens quinquefasciatus larvae infected by Lagenidium giganteum]

OBJECTIVE

To explore the possible defensive immunity of Culex pipiens quinquefasciatus larvae after being infected by Lagenidium giganteum.

METHODS

To count and analyze morphologically hemocytes of the mosquito larvae with Giemsa's stain and by both phase contrast microscope and ordinary microscope.

RESULTS

1. Following the prolonged duration of infection, the number of hemocytes featured as increase, intense increase and gradual decrease. 2. 48 and 72 h after infection the proportion of plasmatocytes and granulocytes increased significantly, but that of prohemocytes showed a relatively slow increase, while 96 and 120 h after infection the proportion of spherulocytes and oenocytoids increased gradually and that of plasmatocyte and granulocytes showed a slow decrease. 3. After L. giganteum infection, vacuolation and morpholysis were found in plasmatocytes.

CONCLUSION

The changes of hemocytes in amount, classification and morphology after infection revealed that Lagenidium giganteum can induce some defensive immune reactions in the larvae of Culex pipiens quinquefasciatus possibly due to a release of antigens or toxic substances by the fungus.

Physical estimation of triplet phases from two new proteins

Three-beam interference experiments have been performed with crystals of two glycosidases: guinea-fowl hexagonal lysozyme, MW 14.3 kDa, and C. thermocellum endoglucanase CelA, MW 40 kDa. In both cases triplet phases could be estimated. Experimental parameters and details of the procedure are presented along with some examples of the results. The average differences between the estimated phases and those calculated from the crystallographic refinements were 17.9 and 15.9 degrees, respectively. A brief discussion of alternative methods for physical phase acquisition is given, including possible strategies for the measurement and application of experimental phases in macromolecular crystallography.

Concurrent chemotherapy-radiotherapy compared with radiotherapy alone in locoregionally advanced nasopharyngeal carcinoma: progression-free survival analysis of a phase III randomized trial

PURPOSE

Nasopharyngeal carcinoma (NPC) is highly sensitive to both radiotherapy (RT) and chemotherapy. This randomized phase III trial compared concurrent cisplatin-RT (CRT) with RT alone in patients with locoregionally advanced NPC.

PATIENTS AND METHODS

Patients with Ho's N2 or N3 stage or N1 stage with nodal size > or = 4 cm were randomized to receive cisplatin 40 mg/m(2) weekly up to 8 weeks concurrently with radical RT (CRT) or RT alone. The primary end point was progression-free survival (PFS).

RESULTS

Three hundred fifty eligible patients were randomized. Baseline patient characteristics were comparable in both arms. There were significantly more toxicities, including mucositis, myelosuppression, and weight loss in the CRT arm. There were no treatment-related deaths in the CRT arm, and one patient died during treatment in the RT-alone arm. At a median follow-up of 2.71 years, the 2-year PFS was 76% in the CRT arm and 69% in the RT-alone arm (P =.10) with a hazards ratio of 1.367 (95% confidence interval [CI], 0.93 to 2.00). The treatment effect had a significant covariate interaction with tumor stage, and a subgroup analysis demonstrated a highly significant difference in favor of the CRT arm in Ho's stage T3 (P =.0075) with a hazards ratio of 2.328 (95% CI, 1.26 to 4.28). For T3 stage, the time to first distant failure was statistically significantly different in favor of the CRT arm (P =.016).

CONCLUSION

Concurrent CRT is well tolerated in patients with advanced NPC in endemic areas. Although PFS was not significantly different between the concurrent CRT arm and the RT-alone arm in the overall comparison, PFS was significantly prolonged in patients with advanced tumor and node stages.

Gross elevation of TT virus genome load in the peripheral blood mononuclear cells of cancer patients

TT virus (TTV) is a recently described circular DNA virus of about 3.8 kb, which is related to the circoviridae viruses. It is commonly detected in healthy subjects and no association with any specific disease has been established. TTV was initially thought to be hepatotropic, but subsequent reports have shown that it is detectable in other tissues, including kidney, prostate, mammary gland, brain, bone marrow, and peripheral blood mononuclear cells. Plasma samples from cancer patients and healthy subjects were tested for the presence or absence of TTV by heminested polymerase chain reaction (PCR). We also developed a quantitative competitive PCR (QC-PCR) assay for TTV that permits accurate measurement of TTV DNA load. Using this assay, the TTV genome load in peripheral blood mononuclear cells (PBMCs) of healthy control subjects (n = 50) and patients with various types of cancer (n = 148), including breast cancer, non-Hodgkin's lymphoma, colon cancer, hepatocellular carcinoma, nasopharyngeal carcinoma, and other cancers, was measured. TTV DNA was detected in 69 of 100 plasma samples (69%) of cancer patients tested and in 39 of 100 plasma samples (39%) randomly selected from 1000 plasma samples of blood donors (p < 0.05). TTV DNA was detectable in the PBMCs of 99% of the cancer patients and 86% of the controls. However, the median virus load was more than 100-fold higher in the cancer patients (3599 copies/100,000 cells) than among the controls (30 copies/100,000 cells; p < 0.0001). There was no significant difference in TTV load among the different cancer types. Using a cutoff value of >250 copies per 100,000 PBMCs, 93.2% of cancer patients were "positive" compared to only 4% of healthy control subjects. Almost all the cancer patients have TTV infection and their TTV genome load in PBMCs is significantly higher than that in control subjects. It remains to be elucidated whether such findings are specific to cancer patients or occur in all seriously ill subjects.

Three-beam interference measurements with a six-circle κ diffractometer

A procedure for calculating the correct angle setting for a specific three-beam situation on a six-circle κ diffractometer is outlined. It is experimentally shown that interference profiles can be recorded using this approach. Limitations owing to mechanical constraints, with particular emphasis on the ability to measure Friedel-related triplets, are discussed.

Reliability and validity of the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) quality of life instrument

BACKGROUND

This paper describes the development of the Functional Assessment of Cancer Therapy-Colorectal (FACT-C)--a questionnaire assessing quality of life concerns pertinent to colorectal cancer patients. This self-report instrument combines specific concerns related to colorectal cancer with concerns that are common to all cancer patients as assessed with the FACT-General (FACT-G).

METHOD

Three separate and distinct validation samples were used with different ethnic and stage of disease compositions.

RESULTS

Results suggest that the FACT-C is a reliable and valid measure in both its English and Spanish language versions. Specifically, the FACT-C evidenced good internal consistency reliability and concurrent validity, as well as an ability to distinguish between groups based on functional status and extent of disease. The FACT-C was also found to be sensitive to changes in functional status. Colorectal cancer-specific items form the Colorectal Cancer Subscale (CCS) which was found to have adequate convergent and divergent validity. Internal consistency was adequate in most samples. In addition, the CCS was able to distinguish among groups that differed in functional status and was sensitive to change in functional status.

CONCLUSION

It is recommended that the entire FACT-C (rather than simply the CCS) be used when studying patients with colorectal cancer in order to provide a comprehensive assessment of quality of life. Recommendations are offered concerning the appropriate use of these measures in clinical research and directions for future research with colorectal cancer patients.

[Observation of clinical effect of acupuncture on vascular dementia and its influence on superoxide dismutase, lipid peroxide and nitric oxide]

OBJECTIVE

To observe the clinical effect of electroacupuncture and acupuncture on vascular dementia (VaD) and the influence on superoxide dismutase (SOD), lipid peroxide (LPO) and nitric oxide (NO) levels.

METHODS

Forty-six cases of VaD were randomly divided into two groups, the electroacupuncture group (EA group) and the acupuncture group (AP group). Assessment of Hasgawa's dementia scale (HDS), functional activities questionnaire (FAQ) and neurologic deficit scoring were done before and after treatment, and the changes on SOD, LPO and NO levels were observed.

RESULTS

After treatment, in the EA group, the HDS elevated, the FAQ lowered, SOD increased and LPO and NO decreased significantly, as compared with before treatment, P < 0.01. But these parameters were not changed significantly in the AP group after treatment. The clinical symptoms were improved in both groups, but the reduction on neurologic deficit score was not significant. The total effective rate of the EA group was higher than that of the AP group.

CONCLUSION

The immediate effect of electroacupuncture was superior to that of acupuncture, suggesting that the electroacupuncture was more effective in promoting the intelligence recovery than acupuncture.

Physical estimation of triplet phases--effects of different radiation sources and modes for profile scans

A comparative study has been made of the intensity profiles from three-beam experiments to estimate triplet phases using radiation from a conventional sealed-tube X-ray source and two different synchrotron sources. Synchrotron radiation, with its much smaller angular divergence, narrower spectral bandwidth and higher flux, distinctly improves the experimental conditions for physical phase estimation. Pure psi scans about the primary diffraction vector, such as can be made with a six-circle diffractometer, further improve the conditions compared with combined omega/psi scans with a four-circle instrument, where the rotation in psi is accomplished by combining rotations about the three axes omega, chi and varphi. Interference profiles collected by pure psi scans and unfocused synchrotron radiation have FWHM values reduced by factors in the range 20-35 relative to those obtained with combined omega-2theta/psi scans and radiation from a conventional source. As a consequence of these changes, which also involve greatly increased peak amplitudes, the 0/pi-type asymmetry of the profiles is exposed much more pronounced closer to the three-beam point, enabling unambiguous phase assignment for all triplets that were studied. The superiority of the pure psi scan will be even more important in studies of general phases for which the phase information lies also in the relative heights of the (sharp) interference maxima for a triplet and the Friedel-related triplet.

Application of known triplet phases in the crystallographic study of bovine pancreatic trypsin inhibitor. II: study at 2.0 A resolution

Direct methods strengthened by the application of about 130 triplet phases, assumed known with a mean error of about +/- 20 degrees, were used to re-determine the structure of BPTI with data at 2.0 A resolution. The triplet phases served to shift the mean direction and enhance the concentration parameter in the corresponding Cochran distributions. These phases were used in combination with the partial structure extracted from successive density maps to control the gradual expansion and refinement of Fourier coefficients. Single phases were developed iteratively from tangent-formula estimation following the path of the convergence map. The a priori triplet phase information was sufficient to initiate solution of the structure at 2.0 A.

Measuring quality of life in men with prostate cancer using the functional assessment of cancer therapy-prostate instrument

OBJECTIVES

As the incidence of prostate cancer in the United States exceeds 330,000 in 1997, increasingly more men are faced with treatment choices for which there is no clear approach. At every stage of disease, these treatment choices may involve clinically equivalent modalities that differ in side effects and impact upon quality of life (QOL). Comprehensive, yet efficient, questionnaires are needed to measure QOL in patients with prostate cancer.

METHODS

Developed as a disease-specific adjunct to the Functional Assessment of Cancer Therapy (FACT) measurement system, a 12-item prostate cancer subscale (PCS) was developed and tested in three independent samples: a subscale development sample (n = 43), validity sample 1 (n = 34), and validity sample 2 (n = 96). The 12 items ask about symptoms and problems specific to prostate cancer. These questions are added to the general (FACT-G) instrument, thereby comprising a 47-item questionnaire.

RESULTS

Internal consistency of the PCS ranged from 0.65 to 0.69, with coefficients for FACT-G subscales and aggregated scores ranging from 0.61 to 0.90. Concurrent validity was confirmed by the ability to discriminate patients by disease stage, performance status, and baseline prostate-specific antigen (PSA) level. Sensitivity to change in performance status and PSA score over a 2-month period suggested that some subscales of the FACT-Prostate (P) (including the PCS) are sensitive to meaningful clinical change.

CONCLUSIONS

Our findings support use of the FACT-P as a meaningful component of QOL evaluation in men undergoing therapy for prostate cancer.