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Tanabe K, Kobayashi S, Tamiya T, Konishi T, Hinoto R, Tsukamoto N, Kashiyama S, Eriguchi T, Noro A. Risk factors for the long-term persistent genitourinary toxicity after stereotactic body radiation therapy for localized prostate cancer: A single-center, retrospective study of 306 patients. Int J Urol 2024. [PMID: 38822642 DOI: 10.1111/iju.15507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 05/22/2024] [Indexed: 06/03/2024]
Abstract
OBJECTIVES To identify risk factors for the long-term persistent genitourinary toxicity (GUT) after stereotactic body radiation therapy (SBRT) for localized prostate cancer (PCa). METHODS A total of 306 patients who underwent SBRT at our institution between March 2017 and April 2022 were retrospectively evaluated. SBRT was performed at 35 Gy in five fractions over 5 or 10 days. Factors related to the long-term persistence of acute GUT after SBRT were analyzed. RESULTS During the median follow-up period of 39.1 months, 203 (66%) patients experienced any grade of acute GUT, which remained in 78 (26%) patients 6 months after SBRT. Multivariate analysis revealed that age ≥75 years was consistently a significant independent risk factor for any grade of acute GUT 6, 12, and 24 months after SBRT (hazard ratio [HR] 2.31, p = 0.010; HR 2.84, p = 0001; and HR 3.05, p = 0.009, respectively). Older age was not a significant risk factor for the development of grade ≥2 acute GUT. The duration of acute GUT was significantly longer in the older group than in the nonolder group (median duration = 234 vs. 61 days, p < 0.001), and the incidence of persistent GUT was significantly more frequent in the older group beyond 6 months after SBRT. CONCLUSIONS Older age is a significant independent risk factor for the long-term persistent GUT after SBRT for localized PCa.
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Affiliation(s)
- Kenji Tanabe
- Department of Urology, Saitama Red Cross Hospital, Saitama, Japan
| | | | - Takashi Tamiya
- Department of Urology, Saitama Red Cross Hospital, Saitama, Japan
| | - Tsuzumi Konishi
- Department of Urology, Saitama Red Cross Hospital, Saitama, Japan
| | - Ryoichi Hinoto
- Department of Radiation Oncology, Saitama Red Cross Hospital, Saitama, Japan
| | - Nobuhiro Tsukamoto
- Department of Radiation Oncology, Saitama Red Cross Hospital, Saitama, Japan
| | - Shiho Kashiyama
- Department of Radiation Oncology, Saitama Red Cross Hospital, Saitama, Japan
| | - Takahisa Eriguchi
- Department of Radiation Oncology, Saitama Red Cross Hospital, Saitama, Japan
| | - Akira Noro
- Department of Urology, Saitama Red Cross Hospital, Saitama, Japan
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2
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Al-Shehri A, Bakhashab S. Oncogenic Long Noncoding RNAs in Prostate Cancer, Osteosarcoma, and Metastasis. Biomedicines 2023; 11:biomedicines11020633. [PMID: 36831169 PMCID: PMC9953056 DOI: 10.3390/biomedicines11020633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 02/14/2023] [Accepted: 02/16/2023] [Indexed: 02/22/2023] Open
Abstract
Prostate cancer (PC) is a common malignancy and is one of the leading causes of cancer-related death in men worldwide. Osteosarcoma (OS) is the most common bone cancer, representing 20-40% of all bone malignancy cases. Cancer metastasis is a process by which malignant tumor cells detach from the primary tumor site via a cascade of processes and migrate to secondary sites through the blood circulation or lymphatic system to colonize and form secondary tumors. PC has a specific affinity to the bone based on the "seed and soil" theory; once PC reach the bone, it becomes incurable. Several studies have identified long noncoding RNAs (lncRNAs) as potential targets for cancer therapy or as diagnostic and prognostic biomarkers. The dysregulation of various lncRNAs has been found in various cancer types, including PC, OS, and metastasis. However, the mechanisms underlying lncRNA oncogenic activity in tumor progression and metastasis are extremely complex and remain incompletely understood. Therefore, understanding oncogenic lncRNAs and their role in OS, PC, and metastasis and the underlying mechanism may help better manage and treat this malignancy. The aim of this review is to summarize current knowledge of oncogenic lncRNAs and their involvement in PC, OS, and bone metastasis.
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Affiliation(s)
- Aishah Al-Shehri
- Biochemistry Department, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Sherin Bakhashab
- Biochemistry Department, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Correspondence: ; Tel.: +966-12-6400000
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Cheng JJ, Azizoddin AM, Maranzano MJ, Sargsyan N, Shen J. Polypharmacy in Oncology. Clin Geriatr Med 2022; 38:705-714. [DOI: 10.1016/j.cger.2022.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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4
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Wenzel M, Collà Ruvolo C, Würnschimmel C, Nocera L, Tian Z, Saad F, Briganti A, Tilki D, Graefen M, Becker A, Roos F, Mandel P, Chun FKH, Karakiewicz PI. Survival rates with external beam radiation therapy in newly diagnosed elderly metastatic prostate cancer patients. Prostate 2022; 82:78-85. [PMID: 34633102 DOI: 10.1002/pros.24249] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/16/2021] [Accepted: 09/29/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND The survival benefit of primary external beam radiation therapy (EBRT) has never been formally tested in elderly men who were newly diagnosed with metastatic prostate cancer (mPCa). We hypothesized that elderly patients may not benefit of EBRT to the extent as younger newly diagnosed mPCa patients, due to shorter life expectancy. METHODS We relied on Surveillance, Epidemiology and End Results (2004-2016) to identify elderly newly diagnosed mPCa patients, aged >75 years. Kaplan-Meier, univariable and multivariable Cox regression models, as well as Competing Risks Regression models tested the effect of EBRT versus no EBRT on overall mortality (OM) and cancer-specific mortality (CSM). RESULTS Of 6556 patients, 1105 received EBRT (16.9%). M1b stage was predominant in both EBRT (n = 823; 74.5%) and no EBRT (n = 3908; 71.7%, p = 0.06) groups, followed by M1c (n = 211; 19.1% vs. n = 1042; 19.1%, p = 1) and M1a (n = 29; 2.6% vs. n = 268; 4.9%, p < 0.01). Median overall survival (OS) was 23 months for EBRT and 23 months for no EBRT (hazard ratio [HR]: 0.97, p = 0.6). Similarly, median cancer-specific survival (CSS) was 29 months for EBRT versus 30 months for no EBRT (HR: 1.04, p = 0.4). After additional multivariable adjustment, EBRT was not associated with lower OM or lower CSM in the entire cohort, as well as after stratification for M1b and M1c substages. CONCLUSIONS In elderly men who were newly diagnosed with mPCa, EBRT does not affect OS or CSS. In consequence, our findings question the added value of local EBRT in elderly newly diagnosed mPCa patients.
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Affiliation(s)
- Mike Wenzel
- Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt, Germany
- Division of Urology, Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
| | - Claudia Collà Ruvolo
- Division of Urology, Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
- Department of Neurosciences, Reproductive Sciences, and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Christoph Würnschimmel
- Division of Urology, Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Luigi Nocera
- Division of Urology, Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
- Department of Urology and Division of Experimental Oncology, Urological Research Institute (URI), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Zhe Tian
- Division of Urology, Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
| | - Fred Saad
- Division of Urology, Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
| | - Alberto Briganti
- Department of Neurosciences, Reproductive Sciences, and Odontostomatology, University of Naples Federico II, Naples, Italy
| | - Derya Tilki
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
- Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Markus Graefen
- Martini-Klinik Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Andreas Becker
- Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Frederik Roos
- Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Philipp Mandel
- Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Felix K H Chun
- Department of Urology, University Hospital Frankfurt, Goethe University Frankfurt am Main, Frankfurt, Germany
| | - Pierre I Karakiewicz
- Division of Urology, Cancer Prognostics and Health Outcomes Unit, Division of Urology, University of Montréal Health Center, Montréal, Québec, Canada
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Yang B, Diao H, Wang P, Guan F, Liu H. microRNA-877-5p exerts tumor-suppressive functions in prostate cancer through repressing transcription of forkhead box M1. Bioengineered 2021; 12:9094-9102. [PMID: 34654353 PMCID: PMC8806950 DOI: 10.1080/21655979.2021.1989969] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
The study aimed to investigate the significant potential role of miR-877-5p in Prostate cancer. The expression levels of miR-877-5p and forkhead box M1 (FOXM1) mRNA were detected by qRT-PCR. The prognostic significance of miR-877-5p in prostate cancer was investigated using Kaplan Meier analysis. Then, Cell Counting Kit-8 (CCK-8) and transwell assay were used to evaluate the effects of miR-877-5p on cell biological functions. The mechanism of miR-877-5p action on prostate cancer cells was investigated by luciferase activity assay with wide-type or mutation. miR-877-5p was lowly expressed both in prostate cancer tissues and cell lines compared with corresponding normal counterparts. Further, miR-877-5p was significantly correlated with Gleason score and TNM stage. Moreover, miR-877-5p may serve as an independent prognostic predictor. In addition, FOXM1 was checked as a direct target gene of miR-877-5p, and miR-877-5p can inhibit the expression of FOXM1 to restrain the growth, migration, and invasion abilities of prostate cancer cells. Taken together, miR-877-5p may act as a suppressor in prostate cancer and reduces cancer cell proliferation, migration and invasion by targeting FOXM1. miR-877-5p may serve as the effective biomarkers and therapeutic target for treating prostate cancer patients.
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Affiliation(s)
- Bin Yang
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Huifeng Diao
- Department of Urology, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Pu Wang
- Department of Urology, Heze Municipal Hospital, Heze, China
| | - Fengju Guan
- Department of Operating Room, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Hechen Liu
- Department of Urology, Shandong Provincial Third Hospital, Shandong University, Jinan, China
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Frantellizzi V, Monari F, Mascia M, Costa R, Rubini G, Spanu A, Farcomeni A, Lodi Rizzini E, Cindolo L, Murabito A, Lavelli V, Nuvoli S, Cosma L, Dionisi V, Nappi AG, Andreola M, De Vincentis G. A National Multicenter Study on overall survival in elderly metastatic castrate-resistant prostate cancer patients treated with Radium-223. Aging Clin Exp Res 2021; 33:651-658. [PMID: 32358729 DOI: 10.1007/s40520-020-01573-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 04/17/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Radium-223 prolongs overall survival (OS) and delays time to the first symptomatic skeletal events in patients with symptomatic metastatic castration-resistant prostate cancer (mCRPC). There is a lack of evidence on the safety and efficacy of Radium-223 treatment in the very elderly population. AIMS Aim of this multicentre study is to analyze mCRPC patients treated with Radium-223 in terms of OS and to assess whether there are differences between young and elderly, as well as to verify efficacy and safety in patients ≥ 75 years of age. METHODS 430 mCRPC patients of six Italian Centres were analyzed in this multicenter retrospective study. At baseline and after each cycle were collected clinical and diagnostic patients' parameters. The whole cohort was divided into two groups based on the age of the patients (< 75 years old and ≥ 75 years old). RESULTS 47% of the patients were < 75 years old and 53% were ≥ 75 years old. The primary outcome, OS, does not show significant differences between the two subgroups if other basal parameters are considered. Considering clinical covariates in univariate models (p < 0.05) several clinical aspects have an impact on OS, except for age (p = 0.072). Age continues to have no significant impact on the OS (p = 0.274) even in multivariate models in the two groups. The toxic effects are similar in the two groups. CONCLUSIONS Radium-223 prolongs survival in both younger and older patients at the same baseline condition and is a good option in the symptomatic mCRPC setting compared to other agents.
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Furesi G, Rauner M, Hofbauer LC. Emerging Players in Prostate Cancer-Bone Niche Communication. Trends Cancer 2020; 7:112-121. [PMID: 33274720 DOI: 10.1016/j.trecan.2020.09.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/21/2020] [Accepted: 09/28/2020] [Indexed: 12/22/2022]
Abstract
Patients with advanced prostate cancer (PCa) frequently develop skeletal metastases that are associated with fractures, disability, and increased mortality. Within the bone metastatic niche, mutual interactions between tumor cells and osteoblasts have been proposed as major contributors of osteotropism by PCa. Here, we highlight the emerging role of PCa-derived extracellular vesicles (EVs) in reprogramming osteoblasts and support of premetastatic niche formation. We also develop the concept of cancer-associated osteoblasts (CAOs) and outline the potential of PCa cells to acquire an osteoblastic phenotype, termed osteomimicry, as two strategies that PCa utilizes to create a favorable protected niche. Finally, we delineate future research that may help to deconstruct the complexity of PCa osteotropism.
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Affiliation(s)
- Giulia Furesi
- Department of Medicine III and Center for Healthy Aging, Technische Universität Dresden, Dresden, Germany
| | - Martina Rauner
- Department of Medicine III and Center for Healthy Aging, Technische Universität Dresden, Dresden, Germany
| | - Lorenz C Hofbauer
- Department of Medicine III and Center for Healthy Aging, Technische Universität Dresden, Dresden, Germany.
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Shevach JW, Weiner AB, Kasimer RN, Miller CH, Morgans AK. Risk Assessment and Considerations for Proper Management of Elderly Men with Advanced Prostate Cancer: A Systematic Review. Eur Urol Oncol 2020; 3:400-409. [PMID: 32471792 DOI: 10.1016/j.euo.2020.03.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 03/10/2020] [Accepted: 03/31/2020] [Indexed: 02/06/2023]
Abstract
CONTEXT Treatment decisions for elderly men with prostate cancer are complicated by the intersection of competing risks of cancer, potential complications of treatment, and individual patients' comorbidities. OBJECTIVE To perform a systematic review of data guiding the assessment of elderly prostate cancer patients that addresses the risk from cancer and treatment, and to discuss a patient-centered approach to incorporating these factors into decision making. EVIDENCE ACQUISITION Evidence was gathered via a systematic review of the current literature. The search strategy used the terms prostate cancer, elderly, geriatric, >75 yr of age, risk assessment, and treatment in several combinations, and was limited to phase ≥ II clinical trials published between January 2008 and November 2018. Additional supporting literature for the discussion was pulled by hand search. EVIDENCE SYNTHESIS The benefits of treatment identified for systemic therapies commonly used to treat men with prostate in general extend to elderly patients. Evidence supports a multifaceted assessment of the risks of cancer and aging, and an understanding of the side effects of treatment to optimally guide therapeutic decision making for elderly patients. There is little evidence defining a geriatric risk stratification system specific to prostate cancer, and recommendations are predominantly based on adapted geriatric oncology approaches and expert consensus. CONCLUSIONS The care of elderly men with prostate cancer should incorporate a review of cancer risk, an assessment of aging, and an understanding of the effects of treatment to provide the patient with thorough and personalized guidance for treatment decisions. Future studies of elderly men with prostate cancer can define and validate ideal risk stratification methods as well as management approaches that may be distinct from those for younger populations. PATIENT SUMMARY Treatment decisions for elderly men with prostate cancer require consideration of the risk posed by the cancer coupled with an understanding of the patient's general health status.
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9
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Zhai Z, Zheng Y, Li N, Deng Y, Zhou L, Tian T, Yang S, Hao Q, Song D, Wu Y, Zhang D, Wang Z, Dai Z. Incidence and disease burden of prostate cancer from 1990 to 2017: Results from the Global Burden of Disease Study 2017. Cancer 2020; 126:1969-1978. [PMID: 32012233 DOI: 10.1002/cncr.32733] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 12/18/2019] [Accepted: 12/18/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND The patterns of the incidence and mortality of prostate cancer (PC) have been changing over the years. In addition, the unclear etiology of PC necessitates further studies into the geographic distribution and age composition of patients with PC. This study was aimed at examining the patterns of the epidemiology of PC to help policymakers to allocate the limited resources of the health care system accordingly. METHODS Annual case data and age-standardized rates (ASRs) were obtained for the incidence, mortality, and disability-adjusted life-years (DALYs) of PC according to age from 1990 to 2017 and for 21 regions, including 195 countries and territories. The estimated annual percentage changes (EAPCs) of ASRs were calculated to evaluate the incidence and mortality trends of PC. RESULTS Worldwide, the age-standardized incidence rate (ASIR) of PC increased from 30.5 cases per 100,000 population in 1990 to 37.9 cases per 100,000 population in 2017 with an EAPC of 0.59 (95% confidence interval [CI], 0.49-0.7), whereas the mortality decreased with an EAPC of -0.73 (95% CI, -0.80 to -0.67). The ASIR was positively associated with the sociodemographic index (SDI) in most regions, and the increase in the ASIR was steeper with a higher SDI. The proportion of patients younger than 65 years increased from 23.6% in 1990 to 27.3% in 2017. CONCLUSIONS The incidence of PC has been increasing globally, whereas its mortality and DALYs have been decreasing. These trends are particularly significant in developed regions and vary across geographic regions. Adjustments to the medical strategy by governments and medical institutions are required.
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Affiliation(s)
- Zhen Zhai
- Department of Breast Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yi Zheng
- Department of Breast Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Na Li
- Department of Breast Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yujiao Deng
- Department of Breast Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Linghui Zhou
- Department of Breast Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Tian Tian
- Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Si Yang
- Department of Breast Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Qian Hao
- Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Dingli Song
- Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ying Wu
- Department of Breast Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Dai Zhang
- Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ziming Wang
- Department of Urology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Zhijun Dai
- Department of Breast Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.,Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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10
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Padro-Guzman J, Moody JP, Au JL. Rehabilitation Needs of the Elderly Patient with Cancer. Phys Med Rehabil Clin N Am 2017; 28:811-819. [PMID: 29031345 DOI: 10.1016/j.pmr.2017.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Physiatrist taking care of the geriatric patient with cancer should be able to manage an array of conditions that might present from diagnosis throughout completion of treatments and beyond. The elderly cancer population is at greater risk of functional impairments. The physician should anticipate changes in clinical status and must adjust rehabilitation goals accordingly. Treatment options and rehabilitation goals should be tailored to help maximize quality of life in these patients.
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Affiliation(s)
- Jesuel Padro-Guzman
- Department of Neurology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA; Division of Rehabilitation Medicine, Weill Cornell Medicine, 525 East 68th Street, New York, NY 10065, USA.
| | - Jennifer P Moody
- Department of Rehabilitation Medicine, New York Presbyterian Hospital, Harkness Pavilion, 180 Fort Washington Avenue, New York, NY 10032, USA
| | - Jessica L Au
- Department of Rehabilitation Medicine, New York Presbyterian Hospital, Harkness Pavilion, 180 Fort Washington Avenue, New York, NY 10032, USA; Hudson Spine & Pain Medicine, 281 Broadway, New York, NY 10007, USA
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Outcomes of patients older than 75 years with non-metastatic prostate cancer. Asian J Urol 2017; 4:102-106. [PMID: 29264213 PMCID: PMC5717973 DOI: 10.1016/j.ajur.2016.12.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 08/13/2016] [Accepted: 12/02/2016] [Indexed: 11/23/2022] Open
Abstract
Objective Prostate cancer in elderly patients was formerly treated with androgen deprivation therapy. Since the latter of the 1990s new technologies were introduced into treatments, then strategies have varied. We aimed to observe the outcomes of elderly patients treated during transition period and compare each stage with others. Methods During 2008 and 2010, 255 patients with prostate cancer older than 75 years were sequentially treated. With exception of patients with bone and/or visceral metastasis, outcomes of 199 patients with localized and locally advanced stages were examined. Complete records were obtained by the end of 2015. Results In total, 122 (61%), 28 (14%), 37 (19%) and 12 (6%) of patients were in stages T1c-T2a, T2b-c, T3 and T4, respectively. Patients generally presented with abnormal screening or lower urinary tract symptom. Seventy-one percent of patients received androgen deprivation therapy as monotherapy and 22% of the radiation-treated patients added androgen deprivation therapy. Patients in stage T1c-T2a and T2b-c showed a favorable prognosis. Some cancer death appeared in patients with T3 and T4 during observation periods. Twenty-seven percent of patients died from prostate cancer-independent complications: pneumonia, heart disease, and brain vascular disease. Tendency is similar to that of Japanese elderly male population. No remarkable side effects from androgen deprivation therapy were noticed. Conclusion Elderly patients with localized prostate cancer showed favorable prognosis by androgen deprivation therapy with/without radiation, thus efficacy of androgen deprivation therapy is suitable to elderly patients with applicable stages. Prognosis of patients with locally advanced stage is serious and remains to be improved.
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