1
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Oyortey MA, Adanu KK, Ali MA. The effect of unusual presentation on delayed diagnosis of prostate cancer: a case series. J Med Case Rep 2024; 18:256. [PMID: 38773554 PMCID: PMC11110205 DOI: 10.1186/s13256-024-04543-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 04/03/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND Early diagnosis of prostate cancer is key to achieving a cure and its proper management leads to a good prognosis. In Ghana a large percentage of patients present with advanced disease and unusual presentations in these patients result in greater delay in the diagnosis thus worsening the outcomes. CASE PRESENTATION We present three African males with advanced prostate cancer who had delayed diagnosis. The first patient, a 64 year old male presented with ascites of 2 years duration with weight loss and no lower urinary tract symptoms, the second, a 69 year old man with end stage renal failure of 6 months duration and was receiving dialysis, the third case, an 87 year old man was managed for pulmonary tuberculosis after he presented with chronic cough and lower urinary tract symptoms. All patients eventually had a prostate specific antigen done which were elevated. Further investigations including prostate biopsies, abdominopelvic CT scans for case 1, abdominopelvic ultrasound, prostate biopsies and blood urea and electrolytes for case 2, prostate biopsies, chest and lumbosacral showed a diagnosis of metastatic prostate carcinoma, and all patients were managed with androgen deprivation. The second patient received additional radiotherapy. CONCLUSION A lack of knowledge of prostate cancer symptoms including unusual symptoms, can result in delayed diagnosis especially in regions of the world where a large number of patients present with advanced disease.
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Dhere VR, Schuster DM, Goyal S, Schreibmann E, Hershatter BW, Rossi PJ, Shelton JW, Patel PR, Jani AB. Randomized Trial of Conventional Versus Conventional Plus Fluciclovine ( 18F) Positron Emission Tomography/Computed Tomography-Guided Postprostatectomy Radiation Therapy for Prostate Cancer: Volumetric and Patient-Reported Analyses of Toxic Effects. Int J Radiat Oncol Biol Phys 2022; 113:1003-1014. [PMID: 35417762 DOI: 10.1016/j.ijrobp.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/23/2022] [Accepted: 04/05/2022] [Indexed: 12/25/2022]
Abstract
PURPOSE Postprostatectomy radiation therapy planning with fluciclovine (18F) positron emission tomography (PET)/computed tomography has demonstrated improved disease-free survival over conventional only (computed tomography- or magnetic resonance imaging-based) treatment planning. We hypothesized that incorporating PET would result in larger clinical target volumes (CTVs) without increasing patient-reported toxic effects. METHODS AND MATERIALS From 2012 to 2019, 165 postprostatectomy patients with detectable prostate-specific antigen were randomized (arm 1 [no PET]: 82; arm 2 [PET]: 83). Prostate bed target volumes with (CTV1: 45.0-50.4 Gy/1.8 Gy) or without (CTV2/CTV: 64.8-70.2 Gy/1.8 Gy) pelvic nodes, as well as organ-at-risk doses, were compared pre- versus post-PET (arm 2) using the paired t test and between arms using the t test. Patient-reported outcomes used International Prostate Symptom Score and Expanded Prostate Cancer Index Composite for Clinical Practice (EPIC-CP). Univariate and multivariable analyses were performed and linear mixed models were fitted. RESULTS Median follow-up of the whole cohort was 3.52 years. All patients had baseline patient-reported outcomes, 1 patient in arm 1 and 3 patients in arm 2 withdrew, and 4 arm 2 patients had extrapelvic uptake on PET with radiotherapy aborted, leaving 81 (arm 1) and 76 patients (arm 2) for analysis of toxic effects. Mean CTV1 (427.6 vs 452.2 mL; P = .462, arm 1 vs arm 2) and CTV2/CTV (137.18 vs 134.2 mL; P = .669) were similar before PET incorporation. CTV1 (454.57 vs 461.33 mL; P = .003) and CTV2/CTV (134.14 vs 135.61 mL; P < .001) were modestly larger after PET incorporation. Although V40 Gy (P = .402 and P = .522 for rectum and bladder, respectively) and V65 Gy (P = .157 and P = .182 for rectum and bladder, respectively) were not significantly different pre- versus post-PET, penile bulb dose significantly increased post-PET (P < .001 for both V40 Gy and V65 Gy). On univariate and multivariable analyses, arm was not significant for any EPIC-CP subdomain. International Prostate Symptom Score and EPIC-CP linear mixed models were not significantly different between arms. CONCLUSIONS Despite larger CTVs after incorporation of fluciclovine (18F) PET, we found no significant difference in patient-reported toxic effects with long-term follow-up.
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Affiliation(s)
- Vishal R Dhere
- Departments of Radiation Oncology, Winship Cancer Institute.
| | | | - Subir Goyal
- Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia
| | | | | | - Peter J Rossi
- Departments of Radiation Oncology, Winship Cancer Institute
| | | | | | - Ashesh B Jani
- Departments of Radiation Oncology, Winship Cancer Institute
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Zhen L, Zhien Z, Shengmin Y, Hanzhong L, Xingcheng W, Yi Z, Yi Q, Lin M, Yuliang C, Tianrui F, Weigang Y. Can patients with low-risk prostate cancer really benefit from radical treatment?: A systematic review and network meta-analysis. Andrologia 2021; 53:e14122. [PMID: 34319588 DOI: 10.1111/and.14122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/15/2021] [Accepted: 04/28/2021] [Indexed: 12/13/2022] Open
Abstract
Radical prostatectomy, radiotherapy and active surveillance are three widely used treatment options for patients with low-risk prostate cancer, but the relative effects are controversial. We searched PubMed, Embase and Web of Science until June 2020, focusing on the studies comparing the effect of radical prostatectomy, radiotherapy and active surveillance in patients with low-risk prostate cancer. Through the random-effects model, dichotomous data were extracted and summarised by odds ratio with a 95% confidence interval. Twenty-two studies containing 185,363 participants were pooled for the comprehensive comparison. The Bayesian mixed network estimate demonstrated the cancer-specific mortality of radical prostatectomy was significantly lower than active surveillance (OR, 0.46; 95% CI 0.34-0.64) and external beam radiation therapy (OR, 0.66; 95% CI 0.46-0.96), but not brachytherapy (OR, 0.63; 95% CI 0.41-1.03). The brachytherapy demonstrated the best treatment ranking probability results in terms of all-cause mortality, while no significant difference was observed when compared with other three treatment modalities. Brachytherapy and radical prostatectomy were associated with a similar risk of cancer-specific mortality, and both of them were significantly superior to active surveillance and external beam radiation therapy; nevertheless, there was no significant difference among the aforementioned treatment methods in all-cause mortality.
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Affiliation(s)
- Liang Zhen
- Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Dongcheng District, Beijing, China
| | - Zhou Zhien
- Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Dongcheng District, Beijing, China
| | - Yang Shengmin
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Li Hanzhong
- Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Dongcheng District, Beijing, China
| | - Wu Xingcheng
- Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Dongcheng District, Beijing, China
| | - Zhou Yi
- Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Dongcheng District, Beijing, China
| | - Qiao Yi
- Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Dongcheng District, Beijing, China
| | - Ma Lin
- Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Dongcheng District, Beijing, China
| | - Chen Yuliang
- Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Dongcheng District, Beijing, China
| | - Feng Tianrui
- Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Dongcheng District, Beijing, China
| | - Yan Weigang
- Department of Urology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Dongcheng District, Beijing, China
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4
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Noteboom EA, May AM, van der Wall E, de Wit NJ, Helsper CW. Patients' preferred and perceived level of involvement in decision making for cancer treatment: A systematic review. Psychooncology 2021; 30:1663-1679. [PMID: 34146446 PMCID: PMC8518833 DOI: 10.1002/pon.5750] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 05/28/2021] [Accepted: 06/11/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Patient involvement in decision making is conditional for personalised treatment decisions. We aim to provide an up-to-date overview of patients' preferred and perceived level of involvement in decision making for cancer treatment. METHODS A systematic search was performed in PubMed, EMBASE, PsycINFO and CINAHL for articles published between January 2009 and January 2020. Search terms were 'decision making', 'patient participation', 'oncology', 'perception' and 'treatment'. Inclusion criteria were: written in English, peer-reviewed, reporting patients' preferred and perceived level of involvement, including adult cancer patients and concerning decision making for cancer treatment. The percentages of patients preferring and perceiving an active, shared or passive decision role and the (dis)concordance are presented. Quality assessment was performed with a modified version of the New-Castle Ottawa Scale. RESULTS 31 studies were included. The median percentage of patients preferring an active, shared or passive role in decision making was respectively 25%, 46%, and 27%. The median percentage of patients perceiving an active, shared or passive role was respectively 27%, 39%, and 34%. The median concordance in preferred and perceived role of all studies was 70%. Disconcordance was highest for a shared role; 42%. CONCLUSIONS Patients' preferences for involvement in cancer treatment decision vary widely. A significant number of patients perceived a decisional role other than preferred. Improvements in patient involvement have been observed in the last decade. However, there is still room for improvement and physicians should explore patients' preferences for involvement in decision making in order to truly deliver personalised cancer care.
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Affiliation(s)
- Eveline A. Noteboom
- Department: Julius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Anne M. May
- Department: Julius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Elsken van der Wall
- Department: Medical OncologyUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Niek J. de Wit
- Department: Julius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
| | - Charles W. Helsper
- Department: Julius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrecht UniversityUtrechtThe Netherlands
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5
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Jani AB, Schreibmann E, Goyal S, Halkar R, Hershatter B, Rossi PJ, Shelton JW, Patel PR, Xu KM, Goodman M, Master VA, Joshi SS, Kucuk O, Carthon BC, Bilen MA, Abiodun-Ojo OA, Akintayo AA, Dhere VR, Schuster DM. 18F-fluciclovine-PET/CT imaging versus conventional imaging alone to guide postprostatectomy salvage radiotherapy for prostate cancer (EMPIRE-1): a single centre, open-label, phase 2/3 randomised controlled trial. Lancet 2021; 397:1895-1904. [PMID: 33971152 PMCID: PMC8279109 DOI: 10.1016/s0140-6736(21)00581-x] [Citation(s) in RCA: 101] [Impact Index Per Article: 33.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/04/2021] [Accepted: 03/02/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND Molecular imaging is increasingly used to guide treatment decisions and planning in prostate cancer. We aimed to evaluate the role of 18F-fluciclovine-PET/CT in improving cancer control compared with conventional imaging (bone scan and either CT or MRI) alone for salvage postprostatectomy radiotherapy. METHODS In EMPIRE-1, a single-centre, open-label, phase 2/3 randomised controlled trial, patients with prostate cancer with detectable PSA after prostatectomy and negative conventional imaging (no extrapelvic or bone findings) were randomly assigned in a 1:1 ratio to radiotherapy directed by conventional imaging alone or to conventional imaging plus 18F-fluciclovine-PET/CT. Computer-generated randomisation was stratified by PSA concentration, adverse pathology indicators, and androgen deprivation therapy intent. In the 18F-fluciclovine-PET/CT group, radiotherapy decisions were rigidly determined by PET findings, which were also used for target delineation. The primary endpoint was 3 year event-free survival, with events defined as biochemical or clinical recurrence or progression, or initiation of systemic therapy, using univariate and multivariable analyses in patients who received radiotherapy. This trial is registered with ClinicalTrials.gov, NCT01666808 and is closed to new participants. FINDINGS From Sept 18, 2012, to March 4, 2019, 165 patients were randomly assigned, with median follow-up of 3·52 years (95% CI 2·98-3·95). PET findings resulted in four patients in the 18F-fluciclovine-PET/CT group having radiotherapy aborted; these patients were excluded from survival analyses. Median survival was not reached (95% CI 35·2-not reached; 33% of 81 patients had events) in the conventional imaging group compared with not reached (95% CI not reached-not reached; 20% of 76 patients) in the 18F-fluciclovine-PET/CT group, and 3 year event-free survival was 63·0% (95% CI 49·2-74·0) in the conventional imaging group versus 75·5% (95% CI 62·5-84·6) for 18F-fluciclovine-PET/CT (difference 12·5; 95% CI 4·3-20·8; p=0·0028). In adjusted analyses, study group (hazard ratio 2·04 [95% CI 1·06-3·93], p=0·0327) was significantly associated with event-free survival. Toxicity was similar in both study groups, with the most common adverse events being late urinary frequency or urgency (37 [46%] of 81 patients in the conventional imaging group and 31 [41%] of 76 in the PET group), and acute diarrhoea (11 [14%] in the conventional imaging group and 16 [21%] in the PET group). INTERPRETATION Inclusion of 18F-fluciclovine-PET into postprostatectomy radiotherapy decision making and planning significantly improved survival free from biochemical recurrence or persistence. Integration of novel PET radiotracers into radiotherapy decisions and planning for prostate cancer patients warrants further study. FUNDING National Institutes of Health/National Cancer Institute, Blue Earth Diagnostics, and Winship Cancer Institute of Emory University.
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Affiliation(s)
- Ashesh B Jani
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA.
| | - Eduard Schreibmann
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Subir Goyal
- Biostatistics Shared Resource, Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Raghuveer Halkar
- Department of Radiology and Imaging Sciences, Emory University, Atlanta GA, USA
| | - Bruce Hershatter
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Peter J Rossi
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Joseph W Shelton
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Pretesh R Patel
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Karen M Xu
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Mark Goodman
- Department of Radiology and Imaging Sciences, Emory University, Atlanta GA, USA
| | - Viraj A Master
- Department of Urology, Emory University, Atlanta GA, USA
| | | | - Omer Kucuk
- Department of Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Bradley C Carthon
- Department of Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - Mehmet A Bilen
- Department of Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | | | - Akinyemi A Akintayo
- Department of Radiology and Imaging Sciences, Emory University, Atlanta GA, USA
| | - Vishal R Dhere
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, GA, USA
| | - David M Schuster
- Department of Radiology and Imaging Sciences, Emory University, Atlanta GA, USA
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6
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Donath E, Alcaidinho A, Delouya G, Taussky D. The one hundred most cited publications in prostate brachytherapy. Brachytherapy 2021; 20:611-623. [PMID: 33674184 DOI: 10.1016/j.brachy.2021.01.008] [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: 08/13/2020] [Revised: 12/23/2020] [Accepted: 01/29/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE The aim of this study is to identify the leaders in research on prostate brachytherapy through a bibliometric analysis of the top 100 most cited publications in the field. METHODS AND MATERIALS A broad search was performed with the term "prostate brachytherapy" using the Web of Science database to generate wide-ranging results that were reviewed by reading the abstracts and, if necessary, the articles to select the top 100 most cited publications. RESULTS The median of the total citation count was 187 (range 132-1464). The median citation per year index (citations/year since publication) was 13.5 (range 6.3-379.0). In all publications, the first author was also the corresponding author. The top publishing countries of the first author included the United States (n = 78), Canada (n = 6), the UK (n = 5), and Germany (n = 4). The journal with the most publications was the International Journal of Radiation Oncology Biology Physics (n = 38). There were 27 more publications on low-dose-rate (LDR) than on high-dose-rate (HDR) (43 vs 16) among the top 100. HDR publications had only one first author that had three articles in comparison to LDR publications, which had four first authors, each with three articles on LDR. The United States was the leading country in 43.8% of HDR publications (n = 7) and 88.4% of LDR publications (n = 38). CONCLUSIONS Our bibliometric analysis of the top 100 most cited publications clearly demonstrates the North American dominance in the publications of prostate brachytherapy, especially in LDR. However, European first authors were more frequent in HDR publications.
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Affiliation(s)
- Elisheva Donath
- Department of Radiation Oncology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Alexandre Alcaidinho
- Department of Radiation Oncology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Guila Delouya
- Department of Radiation Oncology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada
| | - Daniel Taussky
- Department of Radiation Oncology, Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, Quebec, Canada.
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7
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Wang Y, Zhang J, Cai C, Lu W, Tang Y. Semiparametric estimation for proportional hazards mixture cure model allowing non-curable competing risk. J Stat Plan Inference 2021. [DOI: 10.1016/j.jspi.2020.06.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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8
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Tonry C, Finn S, Armstrong J, Pennington SR. Clinical proteomics for prostate cancer: understanding prostate cancer pathology and protein biomarkers for improved disease management. Clin Proteomics 2020; 17:41. [PMID: 33292167 PMCID: PMC7678104 DOI: 10.1186/s12014-020-09305-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 11/11/2020] [Indexed: 12/12/2022] Open
Abstract
Following the introduction of routine Prostate Specific Antigen (PSA) screening in the early 1990's, Prostate Cancer (PCa) is often detected at an early stage. There are also a growing number of treatment options available and so the associated mortality rate is generally low. However, PCa is an extremely complex and heterogenous disease and many patients suffer disease recurrence following initial therapy. Disease recurrence commonly results in metastasis and metastatic PCa has an average survival rate of just 3-5 years. A significant problem in the clinical management of PCa is being able to differentiate between patients who will respond to standard therapies and those who may benefit from more aggressive intervention at an earlier stage. It is also acknowledged that for many men the disease is not life threatenting. Hence, there is a growing desire to identify patients who can be spared the significant side effects associated with PCa treatment until such time (if ever) their disease progresses to the point where treatment is required. To these important clinical needs, current biomarkers and clinical methods for patient stratification and personlised treatment are insufficient. This review provides a comprehensive overview of the complexities of PCa pathology and disease management. In this context it is possible to review current biomarkers and proteomic technologies that will support development of biomarker-driven decision tools to meet current important clinical needs. With such an in-depth understanding of disease pathology, the development of novel clinical biomarkers can proceed in an efficient and effective manner, such that they have a better chance of improving patient outcomes.
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Affiliation(s)
- Claire Tonry
- UCD Conway Institute, University College Dublin, Dublin, Ireland
| | - Stephen Finn
- Department of Histopathology and Morbid Anatomy, Trinity Translational Medicine Institute, Trinity College Dublin, Dublin 8, Ireland
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9
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Wilding S, Downing A, Selby P, Cross W, Wright P, Watson EK, Wagland R, Kind P, Donnelly DW, Hounsome L, Mottram R, Allen M, Kearney T, Butcher H, Gavin A, Glaser A. Decision regret in men living with and beyond nonmetastatic prostate cancer in the United Kingdom: A population-based patient-reported outcome study. Psychooncology 2020; 29:886-893. [PMID: 32065691 PMCID: PMC7317932 DOI: 10.1002/pon.5362] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 01/28/2020] [Accepted: 02/11/2020] [Indexed: 11/26/2022]
Abstract
Objective Clinical options for managing nonmetastatic prostate cancer (PCa) vary. Each option has side effects associated with it, leading to difficulty in decision‐making. This study aimed to assess the relationship between patient involvement in treatment decision‐making and subsequent decision regret (DR), and quantify the impact of health‐related quality of life (HRQL) outcomes on DR. Methods Men living in the United Kingdom, 18 to 42 months after diagnosis of PCa, were identified from cancer registration data and sent a questionnaire. Measures included the Decision Regret Scale (DRS), Expanded Prostate cancer Index Composite short form (EPIC‐26), EQ‐5D‐5L, and an item on involvement in treatment decision‐making. Multivariable ordinal regression was utilized, with DR categorized as none, mild, or moderate/severe regret. Results A total of 17 193 men with stage I‐III PCa completed the DRS: 36.6% reported no regret, 43.3% mild regret, and 20.0% moderate/severe regret. The odds of reporting DR were greater if men indicated their views were not taken into account odds ratio ([OR] = 6.42, 95% CI: 5.39‐7.64) or were involved “to some extent” in decision‐making (OR = 4.63, 95% CI: 4.27‐5.02), compared with men who were “definitely” involved. After adjustment, including for involvement, men reporting moderate/big problems with urinary, bowel, or sexual function were more likely to experience regret compared with men with no/small problems. Better HRQL scores were associated with lower levels of DR. Conclusions This large‐scale study demonstrates the benefit of patient involvement in treatment decision‐making for nonmetastatic PCa. However, men experiencing side effects and poorer HRQL report greater DR. Promoting engagement in clinical decision‐making represents good practice and may reduce the risk of subsequent regret.
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Affiliation(s)
- Sarah Wilding
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.,Leeds Institute for Data Analytics, University of Leeds, Leeds, UK.,School of Psychology, University of Leeds, Leeds, UK
| | - Amy Downing
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.,Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
| | - Peter Selby
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - William Cross
- Leeds Teaching Hospitals NHS Trust, University of Leeds, Leeds, UK
| | - Penny Wright
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - Eila K Watson
- Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, Oxford, UK
| | - Richard Wagland
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Paul Kind
- Academic Unit of Health Economics, University of Leeds, Leeds, UK
| | - David W Donnelly
- Northern Ireland Cancer Registry, Queen's University Belfast, Belfast, UK
| | - Luke Hounsome
- National Cancer Registration and Analysis Service, Public Health England, Bristol, UK
| | - Rebecca Mottram
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.,Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
| | - Majorie Allen
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.,Leeds Institute for Data Analytics, University of Leeds, Leeds, UK.,Leeds Teaching Hospitals NHS Trust, University of Leeds, Leeds, UK
| | - Therese Kearney
- Northern Ireland Cancer Registry, Queen's University Belfast, Belfast, UK
| | - Hugh Butcher
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK
| | - Anna Gavin
- Northern Ireland Cancer Registry, Queen's University Belfast, Belfast, UK
| | - Adam Glaser
- Leeds Institute of Medical Research at St James's, University of Leeds, Leeds, UK.,Leeds Institute for Data Analytics, University of Leeds, Leeds, UK.,Leeds Teaching Hospitals NHS Trust, University of Leeds, Leeds, UK
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10
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Advances of Zinc Signaling Studies in Prostate Cancer. Int J Mol Sci 2020; 21:ijms21020667. [PMID: 31963946 PMCID: PMC7014440 DOI: 10.3390/ijms21020667] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 01/16/2020] [Accepted: 01/17/2020] [Indexed: 12/16/2022] Open
Abstract
Prostate cancer (PCa) is one of the most common cancers and the second leading cause of cancer-related death among men worldwide. Despite progresses in early diagnosis and therapeutic strategies, prognosis for patients with advanced PCa remains poor. Noteworthily, a unique feature of healthy prostate is its highest level of zinc content among all soft tissues in the human body, which dramatically decreases during prostate tumorigenesis. To date, several reviews have suggested antitumor activities of zinc and its potential as a therapeutic strategy of PCa. However, an overview about the role of zinc and its signaling in PCa is needed. Here, we review literature related to the content, biological function, compounds and clinical application of zinc in PCa. We first summarize zinc content in prostate tissue and sera of PCa patients with their clinical relevance. We then elaborate biological functions of zinc signaling in PCa on three main aspects, including cell proliferation, death and tumor metastasis. Finally, we discuss clinical applications of zinc-containing compounds and proteins involved in PCa signaling pathways. Based on currently available studies, we conclude that zinc plays a tumor suppressive role and can serve as a biomarker in PCa diagnosis and therapies.
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11
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Wang Y, Tang Y, Zhang J. Bayesian approach for proportional hazards mixture cure model allowing non-curable competing risk. J STAT COMPUT SIM 2019. [DOI: 10.1080/00949655.2019.1695798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Yijun Wang
- KLATASDS-MOE, School of Statistics, East China Normal University, Shanghai, People's Republic of China
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA
| | - Yincai Tang
- KLATASDS-MOE, School of Statistics, East China Normal University, Shanghai, People's Republic of China
| | - Jiajia Zhang
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA
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12
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Shah S, Young HN, Cobran EK. Comparative Effectiveness of Conservative Management Compared to Cryotherapy in Localized Prostate Cancer Patients. Am J Mens Health 2018; 12:1681-1691. [PMID: 29877137 PMCID: PMC6142136 DOI: 10.1177/1557988318781731] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
The high frequency of treatment-related side effects for men with localized prostate cancer creates uncertainty for treatment outcomes. This study assessed the comparative effectiveness of treatment-related side effects associated with conservative management and cryotherapy in patients with localized prostate cancer. A retrospective longitudinal cohort study was conducted, using the linked data of the Surveillance, Epidemiology, and End Results and Medicare, which included patients diagnosed from 2000 through year 2013, and their Medicare claims information from 2000 through 2014. To compare the differences in baseline characteristics and treatment-related side effects between the study cohorts, χ2 tests were conducted. Multivariate logistic regression was used to assess the association between treatment selection and side effects. There were 7,998 and 3,051 patients in the conservative management and cryotherapy cohort, respectively. The likelihood of erectile dysfunction, lower urinary tract obstruction, urinary fistula, urinary incontinence, and hydronephrosis was reported to be significantly lower (53%, 35%, 69%, 65%, and 36%, respectively) in the conservative management cohort. Conservative management had a lower likelihood of treatment-related side effects compared to cryotherapy. However, further research is needed to compare other significant long-term outcomes such as costs associated with these treatment choices and quality of life.
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Affiliation(s)
- Surbhi Shah
- 1 Department of Clinical and Administrative Pharmacy, Division of Pharmaceutical Health Services, Outcomes, and Policy, College of Pharmacy, University of Georgia, Athens, GA, USA
| | - Henry N Young
- 1 Department of Clinical and Administrative Pharmacy, Division of Pharmaceutical Health Services, Outcomes, and Policy, College of Pharmacy, University of Georgia, Athens, GA, USA
| | - Ewan K Cobran
- 1 Department of Clinical and Administrative Pharmacy, Division of Pharmaceutical Health Services, Outcomes, and Policy, College of Pharmacy, University of Georgia, Athens, GA, USA
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13
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Yeoh E(E, Botten R, Di Matteo A, Tippett M, Hutton J, Fraser R, Dinning PG, Wattchow D. Pudendal nerve injury impairs anorectal function and health related quality of life measures ≥2 years after 3D conformal radiotherapy for prostate cancer. Acta Oncol 2018; 57:456-464. [PMID: 29139310 DOI: 10.1080/0284186x.2017.1400690] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
PURPOSE To compare GI symptoms, measures of generic and disease specific health related quality of life (HRQoL), anorectal and pudendal nerve function and anal sphincter morphology between (i) patients ≥2 years after 3D conformal radiotherapy (3D-CRT)±high dose rate (HDR) brachytherapy for carcinoma of the prostate and aged matched patients before radiotherapy and (ii) symptomatic and asymptomatic patients ≥2 years after 3D-CRT ± HDR brachytherapy. MATERIAL AND METHODS Methodology included: (i) modified LENT-SOMA scales for GI symptoms, (ii) EORTC QLQ-C30 and EORTC QLQ-PR25 questionnaires for generic and disease specific HRQoL, (iii) anorectal manometry and terminal motor latency for anorectal and pudendal nerve function and (iv) endorectal ultrasound for anal sphincter morphology. GI symptoms, parameters of HRQoL, anorectal and pudendal nerve function and anal sphincter morphology were compared using Mann-Whitney's U, unpaired t and χ2 tests. RESULTS Impairment of HRQoL bowel symptoms in the patients ≥2 years after 3D-CRT ± HDR brachytherapy was associated with worse anorectal motor and sensory function, internal and external anal sphincter morphology and 5× greater prevalence of pudendal nerve dysfunction compared with age matched patients before radiotherapy. Symptomatic patients had worse (i) HRQoL measures including global quality of life and bowel and urinary symptom scores, (ii) rectal bleeding, fecal urgency and incontinence scores and (iii) a 2× higher prevalence of pudendal nerve dysfunction compared with asymptomatic patients. Rectal and anal (i) V 40 Gy >65%, (ii) Dmax >60 Gy, (iii) pudendal nerve Dmax >60 Gy and (iv) Anal V 60 Gy >40% were associated with a greater prevalence of pudendal nerve dysfunction. CONCLUSIONS 3D-CRT ± HDR brachytherapy for prostate carcinoma, impairs late functional measures including HRQoL, anorectal and pudendal nerve function. Rectal, anal and pudendal nerve radiation dose constraints are proposed for reducing the prevalence of pudendal nerve dysfunction.
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Affiliation(s)
- Eng (Eric) Yeoh
- Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide, Australia
- Discipline of Medicine, University of Adelaide, Adelaide, Australia
| | - Rochelle Botten
- Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide, Australia
| | | | - Marcus Tippett
- Department of Gastroenterology, Gut Function Laboratory, Royal Adelaide Hospital, Adelaide, Australia
| | - Jonathon Hutton
- Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide, Australia
| | - Robert Fraser
- Department of Gastroenterology, Flinders Medical Centre & School of Medicine, Flinders University, Adelaide, Australia
| | - Phillip G. Dinning
- Department of Gastroenterology, Flinders Medical Centre & School of Medicine, Flinders University, Adelaide, Australia
| | - David Wattchow
- Department of Surgery, Flinders Medical Centre & School of Surgery, Flinders University, Adelaide, Australia
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14
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Ye F, Moon DH, Carpenter WR, Reeve BB, Usinger DS, Green RL, Spearman K, Sheets NC, Pearlstein KA, Lucero AR, Waddle MR, Godley PA, Chen RC. Comparison of Patient Report and Medical Records of Comorbidities: Results From a Population-Based Cohort of Patients With Prostate Cancer. JAMA Oncol 2017; 3:1035-1042. [PMID: 28208186 DOI: 10.1001/jamaoncol.2016.6744] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Importance The comorbid conditions of patients with cancer affect treatment decisions, which in turn affect survival and health-related quality-of-life outcomes. Comparative effectiveness research studies must account for these conditions via medical record abstraction or patient report. Objective To examine the agreement between medical records and patient reports in assessing comorbidities. Design, Setting, and Participants Patient-reported information and medical records were prospectively collected as part of the North Carolina Prostate Cancer Comparative Effectiveness & Survivorship Study, a population-based cohort of 881 patients with newly diagnosed localized prostate cancer enrolled in the North Carolina Central Cancer Registry from January 1, 2011, through June 30, 2013. The presence or absence of 20 medical conditions was compared based on patient report vs abstraction of medical records. Main Outcomes and Measures Agreement between patient reports and medical records for each condition was assessed using the κ statistic. Subgroup analyses examined differences in κ statistics based on age, race, marital status, educational level, and income. Logistic regression models for each condition examined factors associated with higher agreement. Results A total of 881 patients participated in the study (median age, 65 years; age range, 41-80 years; 633 white [71.9%]). In 16 of 20 conditions, there was agreement between patient reports and medical records for more than 90% of patients; agreement was lowest for hyperlipidemia (68%; κ = 0.36) and arthritis (66%; κ = 0.14). On multivariable analysis, older age (≥70 years old) was significantly associated with lower agreement for myocardial infarction (odds ratio [OR], 0.31; 95% CI, 0.12-0.80), cerebrovascular disease (OR, 0.10; 95% CI, 0.01-0.78), coronary artery disease (OR, 0.37; 95% CI, 0.20-0.67), arrhythmia (OR, 0.44; 95% CI, 0.25-0.79), and kidney disease (OR, 0.18; 95% CI, 0.06-0.52). Race and educational level were not significantly associated with κ in 18 of 19 modeled conditions. Conclusions and Relevance Overall, patient reporting provides information similar to medical record abstraction without significant differences by patient race or educational level. Use of patient reports, which are less costly than medical record audits, is a reasonable approach for observational comparative effectiveness research.
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Affiliation(s)
- Fan Ye
- Department of Radiation Oncology, the University of North Carolina at Chapel Hill, Chapel Hill
| | - Dominic H Moon
- Department of Radiation Oncology, the University of North Carolina at Chapel Hill, Chapel Hill
| | - William R Carpenter
- Lineberger Comprehensive Cancer Center, the University of North Carolina at Chapel Hill, Chapel Hill.,Department of Health Policy and Management, the University of North Carolina at Chapel Hill, Chapel Hill.,Cecil G. Sheps Center for Health Services Research, the University of North Carolina at Chapel Hill, Chapel Hill
| | - Bryce B Reeve
- Lineberger Comprehensive Cancer Center, the University of North Carolina at Chapel Hill, Chapel Hill.,Department of Health Policy and Management, the University of North Carolina at Chapel Hill, Chapel Hill.,Cecil G. Sheps Center for Health Services Research, the University of North Carolina at Chapel Hill, Chapel Hill
| | - Deborah S Usinger
- Department of Radiation Oncology, the University of North Carolina at Chapel Hill, Chapel Hill
| | - Rebecca L Green
- Department of Radiation Oncology, the University of North Carolina at Chapel Hill, Chapel Hill
| | - Kiayni Spearman
- Department of Radiation Oncology, the University of North Carolina at Chapel Hill, Chapel Hill
| | - Nathan C Sheets
- Department of Radiation Oncology, the University of North Carolina at Chapel Hill, Chapel Hill
| | - Kevin A Pearlstein
- Department of Radiation Oncology, the University of North Carolina at Chapel Hill, Chapel Hill
| | - Angela R Lucero
- Department of Radiation Oncology, the University of North Carolina at Chapel Hill, Chapel Hill
| | - Mark R Waddle
- Department of Radiation Oncology, the University of North Carolina at Chapel Hill, Chapel Hill
| | - Paul A Godley
- Lineberger Comprehensive Cancer Center, the University of North Carolina at Chapel Hill, Chapel Hill
| | - Ronald C Chen
- Department of Radiation Oncology, the University of North Carolina at Chapel Hill, Chapel Hill.,Lineberger Comprehensive Cancer Center, the University of North Carolina at Chapel Hill, Chapel Hill
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15
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Wadhwa B, Dumbre R. Achieving resistance specificity in prostate cancer. Chem Biol Interact 2016; 260:243-247. [PMID: 27720870 DOI: 10.1016/j.cbi.2016.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 10/03/2016] [Indexed: 11/24/2022]
Abstract
Prostate (CaP) cancer is the second-leading cause of cancer-related mortality in men in Western societies. Androgen receptor (AR) signaling is a critical survival pathway for prostate cancer cells, and androgen-deprivation therapy (ADT) remains the principal treatment for patients with locally advanced and metastatic disease. Although a majority of patients initially respond to ADT, most will eventually develop castrate resistance. The recent discovery that AR signaling persists during systemic castration via intratumoral production of androgens led to the development of novel anti-androgen therapies. Although these therapies effectively palliate symptoms and prolong life, metastatic castration-resistant prostate cancer remains incurable. Recent studies suggest that epithelial plasticity, which covers a range of changes in differentiation and cell behavior, with full epithelial integrity at one end and epithelial-mesenchymal Transition (EMT) as the full realization of a plasticity is regulated by microRNAs (miRNAs). MicroRNAs are involved in human tumourigenesis and are aberrantly expressed in CaP cell lines, xenografts and clinical tissues and is associated with enhanced survival signaling, proliferation, migration, invasion, integrin-mediated adhesion, EMT, and drug resistance. Due to the oncogenic or tumor suppressive properties of CaP-related miRNAs, they are likely to be of clinical use as therapeutic targets for prostate cancer treatment in the near future. This review summarizes our current understanding of CaP and castration-recurrent CaP (CR-CaP) to earlier studies that characterized ADT and the molecular mechanisms that facilitate the transition from androgen-stimulated CaP to CR-CaP.
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Affiliation(s)
- Bhumika Wadhwa
- Academy of Scientific and Innovative Research (AcSIR), New Delhi 110001, India; Cancer Pharmacology Division, Indian Institute of Integrative Medicine, CSIR, Jammu 180001, India.
| | - Rashmi Dumbre
- Centre for Biotechnology, Pravara Institute of Medical Sciences, Loni, India
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16
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Zhang N, Li S, Hua H, Liu D, Song L, Sun P, Huang W, Tang Y, Zhao Y. Low density lipoprotein receptor targeted doxorubicin/DNA-Gold Nanorods as a chemo- and thermo-dual therapy for prostate cancer. Int J Pharm 2016; 513:376-386. [DOI: 10.1016/j.ijpharm.2016.09.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 06/08/2016] [Accepted: 09/02/2016] [Indexed: 01/29/2023]
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17
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Pan B, Zhong W, Deng Z, Lai C, Chu J, Jiao G, Liu J, Zhou Q. Inhibition of prostate cancer growth by solanine requires the suppression of cell cycle proteins and the activation of ROS/P38 signaling pathway. Cancer Med 2016; 5:3214-3222. [PMID: 27726305 PMCID: PMC5119977 DOI: 10.1002/cam4.916] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 08/21/2016] [Accepted: 08/23/2016] [Indexed: 12/20/2022] Open
Abstract
Solanine, a naturally steroidal glycoalkaloid in nightshade (Solanum nigrum Linn.), can inhibit proliferation and induce apoptosis of tumor cells. However, the mechanism of solanine-suppressing prostate cancer cell growth remains to be elucidated. This study investigates the inhibition mechanism of solanine on cancer development in vivo and in cultured human prostate cancer cell DU145 in vitro. Results show that solanine injection significantly suppresses the tumor cell growth in xenograft athymic nude mice. Solanine regulates the protein levels of cell cycle proteins, including Cyclin D1, Cyclin E1, CDK2, CDK4, CDK6, and P21 in vivo and in vitro. Also, in cultured DU145 cell, solanine significantly inhibits cell growth. Moreover, the administration of NAC, an active oxygen scavenger, markedly reduces solanine-induced cell death. Blockade of P38 MAPK kinase cannot suppress reactive oxygen species (ROS), but can suppress solanine-induced cell apoptosis. Also, inhibition of ROS by NAC inactivates P38 pathway. Taken together, the data suggest that inhibition of prostate cancer growth by solanine may be through blocking the expression of cell cycle proteins and inducing apoptosis via ROS and activation of P38 pathway. These findings indicate an attractive therapeutic potential of solanine for suppression of prostate cancer.
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Affiliation(s)
- Bin Pan
- Department of Urology, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Weifeng Zhong
- Sun Yat-sen Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, China
| | - Zhihai Deng
- Department of Urology, Gao Zhou People's Hospital, Gaozhou, China
| | - Caiyong Lai
- Department of Urology, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jing Chu
- Department of Urology, Zhuhai People's Hospital, Zhuhai, China
| | - Genlong Jiao
- Department of Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Junfeng Liu
- Department of Urology, Inner Mongolia People's Hospital, Hohhot, China
| | - Qizhao Zhou
- Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
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18
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Jani AB, Schreibmann E, Rossi PJ, Shelton J, Godette K, Nieh P, Master VA, Kucuk O, Goodman M, Halkar R, Cooper S, Chen Z, Schuster DM. Impact of 18F-Fluciclovine PET on Target Volume Definition for Postprostatectomy Salvage Radiotherapy: Initial Findings from a Randomized Trial. J Nucl Med 2016; 58:412-418. [PMID: 27609792 DOI: 10.2967/jnumed.116.176057] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 08/18/2016] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was to evaluate the role of the synthetic amino acid PET radiotracer 18F-fluciclovine in modifying the defined clinical and treatment-planning target volumes in postprostatectomy patients undergoing salvage radiotherapy and to evaluate the resulting dosimetric consequences to surrounding organs at risk. Methods: Ninety-six patients were enrolled in a randomized, prospective intention-to-treat clinical trial for potential salvage radiotherapy for recurrent prostate cancer after prostatectomy. The initial treatment plan was based on the results from conventional abdominopelvic CT and MRI. The 45 patients in the experimental arm also underwent abdominopelvic 18F-fluciclovine PET/CT, and the images were registered with the conventional images to determine whether the results would modify the initial treatment plan. The 51 patients in the control arm did not undergo 18F-fluciclovine PET/CT. For each patient, the clinical and treatment-planning target volumes that would have been treated before 18F-fluciclovine registration were compared with those after registration. For organs at risk (rectum, bladder, and penile bulb), the volumes receiving 40 Gy and 65 Gy before registration were compared with those after registration. Statistical comparisons were made using the paired t test. Acute genitourinary and gastrointestinal toxicity as defined by the Radiation Therapy Oncology Group was compared between the control and experimental arms using the χ2 test. Results: In 24 cases, radiotherapy was planned to a clinical target volume consisting of the prostate bed alone (CTV) (64.8-66.6 Gy). In 21 cases, radiotherapy was planned to a clinical target volume consisting of the pelvis (CTV1) (45.0 Gy) followed by a boost to the prostate bed (CTV2) (19.8-25.2 Gy). In each case, the respective treatment-planning target volume expansion (PTV, PTV1, or PTV2) was 0.8 cm (0.6 cm posterior). With the exception of PTV2, all postregistration volumes were significantly larger than the corresponding preregistration volumes. Analysis of the rectum, bladder, and penile bulb volumes receiving 40 Gy and 60 Gy demonstrated that only the penile bulb volumes were significantly higher after registration. No significant differences in acute genitourinary or gastrointestinal toxicity were observed. Conclusion: Including information from 18F-fluciclovine PET in the treatment-planning process led to significant differences in the defined target volume, with higher doses to the penile bulb but no significant differences in rectal or bladder dose or in acute genitourinary or gastrointestinal toxicity. Longer follow-up is needed to determine the impact of 18F-fluciclovine PET on cancer control and late toxicity endpoints.
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Affiliation(s)
- Ashesh B Jani
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia
| | - Eduard Schreibmann
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia
| | - Peter J Rossi
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia
| | - Joseph Shelton
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia
| | - Karen Godette
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia
| | - Peter Nieh
- Department of Urology, Emory University, Atlanta, Georgia
| | - Viraj A Master
- Department of Urology, Emory University, Atlanta, Georgia
| | - Omer Kucuk
- Department of Hematology/Oncology, Emory University, Atlanta, Georgia
| | - Mark Goodman
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia; and
| | - Raghuveer Halkar
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia; and
| | - Sherrie Cooper
- Department of Radiation Oncology, Winship Cancer Institute of Emory University, Atlanta, Georgia
| | - Zhengjia Chen
- Department of Biostatistics and Bioinformatics, Emory University, Atlanta, Georgia
| | - David M Schuster
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia; and
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19
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Bremner KE, Chong CAKY, Tomlinson G, Alibhai SMH, Krahn MD. A Review and Meta-Analysis of Prostate Cancer Utilities. Med Decis Making 2016; 27:288-98. [PMID: 17502448 DOI: 10.1177/0272989x07300604] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background. Health-related quality of life is a key issue in prostate cancer (PC) management. The authors summarized published utilities for common health-related quality of life outcomes of PC and determined how methodological factors affect them. Methods. In their systematic review, the authors identified 23 articles in English, providing 173 unique utilities for PC health states, each obtained from 2 to 422 respondents. Data were pooled using linear mixed-effects modeling with utilities clustered within the study, weighted by the number of respondents divided by the variance of each utility. Results. In the base model, the estimated utility of the reference case (scenario of a metastatic PC patient with severe sexual symptoms, rated by non-PC patients using time tradeoff) was 0.76. Disease stage, symptom type and severity, source of utility, and scaling method were associated with utility differences of 0.10 to 0.32 (P < 0.05). Utilities from PC patients rating their own health were 0.14 higher than those from the reference case, but utilities from PC patients rating scenarios were lowest. Time tradeoff yielded the highest utilities. Computer administration yielded lower utilities than personal interview (P = 0.02). Neither the scale's high anchor nor study purpose had significant effects on utilities. Conclusions. This study provides pooled utility estimates for common PC health states and describes how clinical and methodological factors can significantly affect these values. When possible, utility estimates for a modeling application should be derived similarly. Formal data synthesis methods might be useful to researchers integrating utility data from heterogeneous sources. Further exploration of these methods for this purpose is warranted.
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Affiliation(s)
- Karen E Bremner
- Toronto General Research Institute University Health Network, Canada.
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20
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Tonry CL, Leacy E, Raso C, Finn SP, Armstrong J, Pennington SR. The Role of Proteomics in Biomarker Development for Improved Patient Diagnosis and Clinical Decision Making in Prostate Cancer. Diagnostics (Basel) 2016; 6:E27. [PMID: 27438858 PMCID: PMC5039561 DOI: 10.3390/diagnostics6030027] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 06/28/2016] [Accepted: 07/07/2016] [Indexed: 02/06/2023] Open
Abstract
Prostate Cancer (PCa) is the second most commonly diagnosed cancer in men worldwide. Although increased expression of prostate-specific antigen (PSA) is an effective indicator for the recurrence of PCa, its intended use as a screening marker for PCa is of considerable controversy. Recent research efforts in the field of PCa biomarkers have focused on the identification of tissue and fluid-based biomarkers that would be better able to stratify those individuals diagnosed with PCa who (i) might best receive no treatment (active surveillance of the disease); (ii) would benefit from existing treatments; or (iii) those who are likely to succumb to disease recurrence and/or have aggressive disease. The growing demand for better prostate cancer biomarkers has coincided with the development of improved discovery and evaluation technologies for multiplexed measurement of proteins in bio-fluids and tissues. This review aims to (i) provide an overview of these technologies as well as describe some of the candidate PCa protein biomarkers that have been discovered using them; (ii) address some of the general limitations in the clinical evaluation and validation of protein biomarkers; and (iii) make recommendations for strategies that could be adopted to improve the successful development of protein biomarkers to deliver improvements in personalized PCa patient decision making.
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Affiliation(s)
- Claire L Tonry
- UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin 4, Ireland.
| | - Emma Leacy
- UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin 4, Ireland.
| | - Cinzia Raso
- UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin 4, Ireland.
| | - Stephen P Finn
- School of Medicine, Trinity College Dublin, Dublin 2, Ireland.
| | | | - Stephen R Pennington
- UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin 4, Ireland.
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21
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Jani AB, Gratzle J, Muresan E, Martel MK. Impact on Late Toxicity of using Transabdominal Ultrasound for Prostate Cancer Patients Treated with Intensity Modulated Radiotherapy. Technol Cancer Res Treat 2016; 4:115-20. [PMID: 15649095 DOI: 10.1177/153303460500400115] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
An analysis of the effects of using the B-mode ultrasound Acquisition and Targeting (BAT) system for positioning of prostate cancer patients receiving external beam radiotherapy (EBRT) on late gastrointestinal (GI) and genitourinary (GU) toxicity is provided. The records of 49 consecutive patients treated using the BAT were reviewed; additionally, a comparison (No-BAT) group treated in a similar manner was identified, consisting of 49 patients treated immediately prior to this BAT group. There were no other fundamental differences between the two groups. The daily BAT movements were charted and late toxicity was scored for all patients using established toxicity scales. The results demonstrated similar GU toxicity rates between the two groups, but slightly lower rates of GI toxicity in the BAT group vs. the No-BAT group. However, regression analyses revealed that no factors, including BAT use, were significantly correlated with late GI or GU toxicity. Further efforts, perhaps better undertaken in a multi-institutional setting, are needed to determine whether BAT use can significantly reduce late GI toxicity.
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Affiliation(s)
- Ashesh B Jani
- Department of Radiation and Cellular Oncology, University of Chicago Hospitals, 5758 S. Maryland Ave., MC 9006, Chicago, IL 60637 USA.
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22
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Yu T, Zhang Q, Zheng T, Shi H, Liu Y, Feng S, Hao M, Ye L, Wu X, Yang C. The Effectiveness of Intensity Modulated Radiation Therapy versus Three-Dimensional Radiation Therapy in Prostate Cancer: A Meta-Analysis of the Literatures. PLoS One 2016; 11:e0154499. [PMID: 27171271 PMCID: PMC4865138 DOI: 10.1371/journal.pone.0154499] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 04/14/2016] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND AND PURPOSE Intensity modulated radiation therapy (IMRT) can deliver higher doses with less damage of healthy tissues compared with three-dimensional radiation therapy (3DCRT). However, for the scenarios with better clinical outcomes for IMRT than 3DCRT in prostate cancer, the results remain ambiguous. We performed a meta-analysis to assess whether IMRT can provide better clinical outcomes in comparison with 3DCRT in patients diagnosed with prostate cancer. MATERIALS AND METHODS We conducted a meta-analysis of 23 studies (n = 9556) comparing the clinical outcomes, including gastrointestinal (GI) toxicity, genitourinary (GU) toxicity, biochemical controland overall survival (OS). RESULTS IMRT was significantly associated with decreased 2-4 grade acute GI toxicity [risk ratio (RR) = 0.59 (95% confidence interval (CI), 0.44, 0.78)], late GI toxicity [RR = 0.54, 95%CI (0.38, 0.78)], late rectal bleeding [RR = 0.48, 95%CI (0.27, 0.85)], and achieved better biochemical control[RR = 1.17, 95%CI (1.08, 1.27)] in comparison with 3DCRT. IMRT and 3DCRT remain the same in regard of grade 2-4 acute rectal toxicity [RR = 1.03, 95%CI (0.45, 2.36)], late GU toxicity [RR = 1.03, 95%CI (0.82, 1.30)] and overall survival [RR = 1.07, 95%CI (0.96, 1.19)], while IMRT slightly increased the morbidity of grade 2-4 acute GU toxicity [RR = 1.08, 95%CI (1.00, 1.17)]. CONCLUSIONS Although some bias cannot be ignored, IMRT appears to be a better choice for the treatment of prostate cancer when compared with 3DCRT.
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Affiliation(s)
- Ting Yu
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, PRC
| | - Qiongwen Zhang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, PRC
- State Key Laboratory of Biotherapy and Department of Head and Neck Oncology, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, PRC
| | - Tianying Zheng
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, PRC
| | - Huashan Shi
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, PRC
- State Key Laboratory of Biotherapy and Department of Head and Neck Oncology, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, PRC
| | - Yang Liu
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, PRC
| | - Shijian Feng
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, PRC
| | - Meiqin Hao
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, PRC
| | - Lei Ye
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, PRC
| | - Xueqian Wu
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, PRC
| | - Cheng Yang
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, West China Medical School, Sichuan University, Chengdu, Sichuan, PRC
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Yeoh EK, Krol R, Dhillon VS, Botten R, Di Matteo A, Butters J, Brock AR, Esterman A, Salisbury C, Fenech M. Predictors of radiation-induced gastrointestinal morbidity: A prospective, longitudinal study following radiotherapy for carcinoma of the prostate. Acta Oncol 2016; 55:604-10. [PMID: 27046049 DOI: 10.3109/0284186x.2015.1118658] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background Chronic gastrointestinal (GI) morbidity occurs in ≥50% of patients after external beam radiotherapy (EBRT) for carcinoma of prostate (CaP). This prospective, longitudinal study examines which baseline measurements of: 1) homocysteine and micronutrients in plasma; 2) chromosome damage/misrepair biomarkers; and 3) anal and rectal dose volume metrics predict GI morbidity after EBRT. Patients and methods In total, 106 patients with CaP had evaluations of GI symptoms (modified LENT-SOMA questionnaires) before EBRT and at one month, one, two and three years after its completion. Other variables measured before EBRT were: 1) plasma concentrations of homocysteine and micronutrients including caroteinoids and selenium; 2) chromosome damage/DNA misrepair (micronuclei/nucleoplasmic bridge) indices; and 3) mean anal and rectal wall doses and volumes of anal and rectal walls receiving ≥40 Gy and ≥60 Gy. Univariate and multivariate analyzes examined the relationships among: 1) plasma levels of homocysteine and micronutrients; 2) indices of chromosome damage/DNA misrepair; and 3) mean anal and rectal wall doses and volumes of anal and rectal walls receiving ≥40 Gy and ≥60 Gy and total GI symptom scores from one month to three years after EBRT. Results Increased frequency and urgency of defecation, rectal mucous discharge and bleeding after EBRT resulted in sustained rises in total GI symptom scores above baseline at three years. On univariate analysis, total GI symptom scores were significantly associated with: 1) plasma selenium and α tocopherol; 2) micronuclei indices of DNA damage; 3) mean anal and rectal wall doses; and 4) volumes of anal and rectal wall receiving ≥40 Gy and ≥60 Gy (p = 0.08-<0.001). On multivariate analysis, only volume of anal wall receiving ≥40 Gy was significant for increased GI symptoms after EBRT (p < 0.001). Conclusion The volume of anal wall receiving ≥40 Gy predicts chronic GI morbidity after EBRT for CaP.
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Affiliation(s)
- Eric K. Yeoh
- Department of Radiation Oncology, Royal Adelaide Hospital (RAH) and Discipline of Medicine, University of Adelaide, Adelaide, Australia
| | - Robin Krol
- Department of Gastroenterology and Hepatology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Varinderpal S. Dhillon
- Genome Health and Personalised Nutrition Laboratory, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Division of Food and Nutrition and School of Health Sciences, University of South Australia, Adelaide, Australia
| | - Rochelle Botten
- Department of Radiation Oncology, Royal Adelaide Hospital (RAH) and Discipline of Medicine, University of Adelaide, Adelaide, Australia
| | - Addolorata Di Matteo
- Department of Radiation Oncology, Royal Adelaide Hospital (RAH) and Discipline of Medicine, University of Adelaide, Adelaide, Australia
| | - Julie Butters
- Department of Radiation Oncology, Royal Adelaide Hospital (RAH) and Discipline of Medicine, University of Adelaide, Adelaide, Australia
| | - Aleisha R. Brock
- Samson Institute of Health Research, University of South Australia, Adelaide, Australia
| | - Adrian Esterman
- Samson Institute of Health Research, University of South Australia, Adelaide, Australia
| | - Carolyn Salisbury
- Genome Health and Personalised Nutrition Laboratory, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Division of Food and Nutrition and School of Health Sciences, University of South Australia, Adelaide, Australia
| | - Michael Fenech
- Genome Health and Personalised Nutrition Laboratory, Commonwealth Scientific and Industrial Research Organisation (CSIRO), Division of Food and Nutrition and School of Health Sciences, University of South Australia, Adelaide, Australia
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Ramsay CR, Adewuyi TE, Gray J, Hislop J, Shirley MDF, Jayakody S, MacLennan G, Fraser C, MacLennan S, Brazzelli M, N'Dow J, Pickard R, Robertson C, Rothnie K, Rushton SP, Vale L, Lam TB. Ablative therapy for people with localised prostate cancer: a systematic review and economic evaluation. Health Technol Assess 2016; 19:1-490. [PMID: 26140518 DOI: 10.3310/hta19490] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND For people with localised prostate cancer, active treatments are effective but have significant side effects. Minimally invasive treatments that destroy (or ablate) either the entire gland or the part of the prostate with cancer may be as effective and cause less side effects at an acceptable cost. Such therapies include cryotherapy, high-intensity focused ultrasound (HIFU) and brachytherapy, among others. OBJECTIVES This study aimed to determine the relative clinical effectiveness and cost-effectiveness of ablative therapies compared with radical prostatectomy (RP), external beam radiotherapy (EBRT) and active surveillance (AS) for primary treatment of localised prostate cancer, and compared with RP for salvage treatment of localised prostate cancer which has recurred after initial treatment with EBRT. DATA SOURCES MEDLINE (1946 to March week 3, 2013), MEDLINE In-Process & Other Non-Indexed Citations (29 March 2013), EMBASE (1974 to week 13, 2013), Bioscience Information Service (BIOSIS) (1956 to 1 April 2013), Science Citation Index (1970 to 1 April 2013), Cochrane Central Register of Controlled Trials (CENTRAL) (issue 3, 2013), Cochrane Database of Systematic Reviews (CDSR) (issue 3, 2013), Database of Abstracts of Reviews of Effects (DARE) (inception to March 2013) and Health Technology Assessment (HTA) (inception to March 2013) databases were searched. Costs were obtained from NHS sources. REVIEW METHODS Evidence was drawn from randomised controlled trials (RCTs) and non-RCTs, and from case series for the ablative procedures only, in people with localised prostate cancer. For primary therapy, the ablative therapies were cryotherapy, HIFU, brachytherapy and other ablative therapies. The comparators were AS, RP and EBRT. For salvage therapy, the ablative therapies were cryotherapy and HIFU. The comparator was RP. Outcomes were cancer related, adverse effects (functional and procedural) and quality of life. Two reviewers extracted data and carried out quality assessment. Meta-analysis used a Bayesian indirect mixed-treatment comparison. Data were incorporated into an individual simulation Markov model to estimate cost-effectiveness. RESULTS The searches identified 121 studies for inclusion in the review of patients undergoing primary treatment and nine studies for the review of salvage treatment. Cryotherapy [3995 patients; 14 case series, 1 RCT and 4 non-randomised comparative studies (NRCSs)], HIFU (4000 patients; 20 case series, 1 NRCS) and brachytherapy (26,129 patients; 2 RCTs, 38 NRCSs) studies provided limited data for meta-analyses. All studies were considered at high risk of bias. There was no robust evidence that mortality (4-year survival 93% for cryotherapy, 99% for HIFU, 91% for EBRT) or other cancer-specific outcomes differed between treatments. For functional and quality-of-life outcomes, the paucity of data prevented any definitive conclusions from being made, although data on incontinence rates and erectile dysfunction for all ablative procedures were generally numerically lower than for non-ablative procedures. The safety profiles were comparable with existing treatments. Studies reporting the use of focal cryotherapy suggested that incontinence rates may be better than for whole-gland treatment. Data on AS, salvage treatment and other ablative therapies were too limited. The cost-effectiveness analysis confirmed the uncertainty from the clinical review and that there is no technology which appears superior, on the basis of current evidence, in terms of average cost-effectiveness. The probabilistic sensitivity analyses suggest that a number of ablative techniques are worthy of further research. LIMITATIONS The main limitations were the quantity and quality of the data available on cancer-related outcomes and dysfunction. CONCLUSIONS The findings indicate that there is insufficient evidence to form any clear recommendations on the use of ablative therapies in order to influence current clinical practice. Research efforts in the use of ablative therapies in the management of prostate cancer should now be concentrated on the performance of RCTs and the generation of standardised outcomes. STUDY REGISTRATION This study is registered as PROSPERO CRD42012002461. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
- Craig R Ramsay
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | | | - Joanne Gray
- Faculty of Health & Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Jenni Hislop
- Health Economics Group, Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Mark D F Shirley
- School of Biology, Newcastle University, Newcastle upon Tyne, UK
| | | | - Graeme MacLennan
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Cynthia Fraser
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Sara MacLennan
- Academic Urology Unit, University of Aberdeen, Aberdeen, UK
| | - Miriam Brazzelli
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - James N'Dow
- Academic Urology Unit, University of Aberdeen, Aberdeen, UK
| | - Robert Pickard
- Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Clare Robertson
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Kieran Rothnie
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | | | - Luke Vale
- Health Economics Group, Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Thomas B Lam
- Academic Urology Unit, University of Aberdeen, Aberdeen, UK
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25
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Fawzy MS, Elfayoumi AR, Mohamed RH, Fatah IRA, Saadawy SF. Cyclooxygenase 2 (rs2745557) Polymorphism and the Susceptibility to Benign Prostate Hyperplasia and Prostate Cancer in Egyptians. Biochem Genet 2016; 54:326-336. [PMID: 26920155 DOI: 10.1007/s10528-016-9722-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Accepted: 02/14/2016] [Indexed: 10/22/2022]
Abstract
Cyclooxygenase-2 (COX-2), an inducible isoform of cyclooxygenase, has been reported to be correlated with tumorigenesis, tumor progression, and metastasis. We aimed to evaluate the association between COX-2 (rs2745557) polymorphism and prostate cancer (PCa), benign prostate hyperplasia (BPH) risk. We also assessed the influence of other risk factors such as obesity, smoking, diabetes in modulating the risk of PCa in Egyptian men. COX-2 (rs2745557) was genotyped in 112 PC patients, 111 BPH and 120 subjects as a control group. COX-2 and PSA levels were measured by ELISA. We found that GG genotype was associated with a 17-fold increased risk for PCa and 20-fold increased the risk for BPH more than AA genotype. Also, G allele carriers of COX-2 were associated with metastatic cancer (OR = 1.3, P < 0.05) and disease aggressiveness (OR = 3.5, P < 0.001). The coexistence of obesity, smoking, or diabetes with GG genotype may lead to increasing the risk of developing BPH (OR = 3.3, 4, and 2.7, respectively) and of developing PCa (OR = 2.9, 4.9, and 3.2, respectively). Our results showed evidence suggesting the involvement of the COX-2 (rs2745557) polymorphism and its protein in PCa or BPH initiation and progression. Also, the coexistence of COX-2 (rs2745557) and obesity, smoking, or diabetes may lead to the development of PCa or BPH.
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Affiliation(s)
- Mohamed S Fawzy
- Medical Biochemistry Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | | | - Randa H Mohamed
- Medical Biochemistry Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
| | - Ihab R Abdel Fatah
- Urology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Sara F Saadawy
- Medical Biochemistry Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
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26
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Qin M, Peng S, Liu N, Hu M, He Y, Li G, Chen H, He Y, Chen A, Wang X, Liu M, Chen Y, Yi Z. LG308, a Novel Synthetic Compound with Antimicrotubule Activity in Prostate Cancer Cells, Exerts Effective Antitumor Activity. J Pharmacol Exp Ther 2015; 355:473-83. [PMID: 26377911 DOI: 10.1124/jpet.115.225912] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 09/14/2015] [Indexed: 01/07/2023] Open
Abstract
Microtubule plays many different essential roles in the process of tumorigenesis in many eukaryotes, and targeting mitotic progression by disturbing microtubule dynamics is used as a common strategy for cancer treatment. Microtubule-targeted drugs, including paclitaxel and Vinca alkaloids, were previously considered to work primarily by increasing or decreasing the cellular microtubule mass. The tubulin/microtubule system, which is an integral component of the cytoskeleton, is a therapeutic target for prostate cancer. In this study, we found a novel synthetic compound, 8-fluoro-N-phenylacetyl-1, 3, 4, 9-tetrahydro-β-carboline (LG308), which disrupted the microtubule organization via inhibiting the polymerization of microtubule in PC-3M and LNCaP prostate cancer cell lines. Further study proved that LG308 induced mitotic phase arrest and inhibited G2/M progression significantly in LNCaP and PC-3M cell lines in a dose-dependent manner, and these were associated with the upregulation of cyclin B1 and mitotic marker MPM-2 and the dephosphorylation of cdc2. Besides, the cell proliferation and colony formation of PC-3M and LNCaP cells were effectively inhibited by LG308. Furthermore, LG308 induced apoptosis and cell death in PC-3M and LNCaP cell lines in vitro. In vivo, LG308 dramatically suppressed the growth and metastasis of prostate cancer in both xenograft and orthotopic models. All these data indicate that LG308 is a promising anticancer candidate with antimitotic activity for the treatment of prostate cancer.
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Affiliation(s)
- Min Qin
- Shanghai Key Laboratory of Regulatory Biology, Institute of Biomedical Sciences and School of Life Sciences, East China Normal University, Shanghai, China (M.Q., S.P., N.L., M.H., Y.H., G.L., H.C., Y.H., A.C., X.W., M.L., Y.C., Z.Y.); and Center for Cancer and Stem Cell Biology, Institute of Biosciences and Technology and Department of Molecular and Cellular Medicine, Texas A & M University Health Science Center, Houston, Texas (M.L.)
| | - Shihong Peng
- Shanghai Key Laboratory of Regulatory Biology, Institute of Biomedical Sciences and School of Life Sciences, East China Normal University, Shanghai, China (M.Q., S.P., N.L., M.H., Y.H., G.L., H.C., Y.H., A.C., X.W., M.L., Y.C., Z.Y.); and Center for Cancer and Stem Cell Biology, Institute of Biosciences and Technology and Department of Molecular and Cellular Medicine, Texas A & M University Health Science Center, Houston, Texas (M.L.)
| | - Ning Liu
- Shanghai Key Laboratory of Regulatory Biology, Institute of Biomedical Sciences and School of Life Sciences, East China Normal University, Shanghai, China (M.Q., S.P., N.L., M.H., Y.H., G.L., H.C., Y.H., A.C., X.W., M.L., Y.C., Z.Y.); and Center for Cancer and Stem Cell Biology, Institute of Biosciences and Technology and Department of Molecular and Cellular Medicine, Texas A & M University Health Science Center, Houston, Texas (M.L.)
| | - Meichun Hu
- Shanghai Key Laboratory of Regulatory Biology, Institute of Biomedical Sciences and School of Life Sciences, East China Normal University, Shanghai, China (M.Q., S.P., N.L., M.H., Y.H., G.L., H.C., Y.H., A.C., X.W., M.L., Y.C., Z.Y.); and Center for Cancer and Stem Cell Biology, Institute of Biosciences and Technology and Department of Molecular and Cellular Medicine, Texas A & M University Health Science Center, Houston, Texas (M.L.)
| | - Yundong He
- Shanghai Key Laboratory of Regulatory Biology, Institute of Biomedical Sciences and School of Life Sciences, East China Normal University, Shanghai, China (M.Q., S.P., N.L., M.H., Y.H., G.L., H.C., Y.H., A.C., X.W., M.L., Y.C., Z.Y.); and Center for Cancer and Stem Cell Biology, Institute of Biosciences and Technology and Department of Molecular and Cellular Medicine, Texas A & M University Health Science Center, Houston, Texas (M.L.)
| | - Guoliang Li
- Shanghai Key Laboratory of Regulatory Biology, Institute of Biomedical Sciences and School of Life Sciences, East China Normal University, Shanghai, China (M.Q., S.P., N.L., M.H., Y.H., G.L., H.C., Y.H., A.C., X.W., M.L., Y.C., Z.Y.); and Center for Cancer and Stem Cell Biology, Institute of Biosciences and Technology and Department of Molecular and Cellular Medicine, Texas A & M University Health Science Center, Houston, Texas (M.L.)
| | - Huang Chen
- Shanghai Key Laboratory of Regulatory Biology, Institute of Biomedical Sciences and School of Life Sciences, East China Normal University, Shanghai, China (M.Q., S.P., N.L., M.H., Y.H., G.L., H.C., Y.H., A.C., X.W., M.L., Y.C., Z.Y.); and Center for Cancer and Stem Cell Biology, Institute of Biosciences and Technology and Department of Molecular and Cellular Medicine, Texas A & M University Health Science Center, Houston, Texas (M.L.)
| | - Yuan He
- Shanghai Key Laboratory of Regulatory Biology, Institute of Biomedical Sciences and School of Life Sciences, East China Normal University, Shanghai, China (M.Q., S.P., N.L., M.H., Y.H., G.L., H.C., Y.H., A.C., X.W., M.L., Y.C., Z.Y.); and Center for Cancer and Stem Cell Biology, Institute of Biosciences and Technology and Department of Molecular and Cellular Medicine, Texas A & M University Health Science Center, Houston, Texas (M.L.)
| | - Ang Chen
- Shanghai Key Laboratory of Regulatory Biology, Institute of Biomedical Sciences and School of Life Sciences, East China Normal University, Shanghai, China (M.Q., S.P., N.L., M.H., Y.H., G.L., H.C., Y.H., A.C., X.W., M.L., Y.C., Z.Y.); and Center for Cancer and Stem Cell Biology, Institute of Biosciences and Technology and Department of Molecular and Cellular Medicine, Texas A & M University Health Science Center, Houston, Texas (M.L.)
| | - Xin Wang
- Shanghai Key Laboratory of Regulatory Biology, Institute of Biomedical Sciences and School of Life Sciences, East China Normal University, Shanghai, China (M.Q., S.P., N.L., M.H., Y.H., G.L., H.C., Y.H., A.C., X.W., M.L., Y.C., Z.Y.); and Center for Cancer and Stem Cell Biology, Institute of Biosciences and Technology and Department of Molecular and Cellular Medicine, Texas A & M University Health Science Center, Houston, Texas (M.L.)
| | - Mingyao Liu
- Shanghai Key Laboratory of Regulatory Biology, Institute of Biomedical Sciences and School of Life Sciences, East China Normal University, Shanghai, China (M.Q., S.P., N.L., M.H., Y.H., G.L., H.C., Y.H., A.C., X.W., M.L., Y.C., Z.Y.); and Center for Cancer and Stem Cell Biology, Institute of Biosciences and Technology and Department of Molecular and Cellular Medicine, Texas A & M University Health Science Center, Houston, Texas (M.L.)
| | - Yihua Chen
- Shanghai Key Laboratory of Regulatory Biology, Institute of Biomedical Sciences and School of Life Sciences, East China Normal University, Shanghai, China (M.Q., S.P., N.L., M.H., Y.H., G.L., H.C., Y.H., A.C., X.W., M.L., Y.C., Z.Y.); and Center for Cancer and Stem Cell Biology, Institute of Biosciences and Technology and Department of Molecular and Cellular Medicine, Texas A & M University Health Science Center, Houston, Texas (M.L.)
| | - Zhengfang Yi
- Shanghai Key Laboratory of Regulatory Biology, Institute of Biomedical Sciences and School of Life Sciences, East China Normal University, Shanghai, China (M.Q., S.P., N.L., M.H., Y.H., G.L., H.C., Y.H., A.C., X.W., M.L., Y.C., Z.Y.); and Center for Cancer and Stem Cell Biology, Institute of Biosciences and Technology and Department of Molecular and Cellular Medicine, Texas A & M University Health Science Center, Houston, Texas (M.L.)
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Camarata AS, Nickleach DC, Jani AB, Rossi PJ. Locoregional prostate cancer treatment pattern variation in independent cancer centers: policy effect, patient preference, or physician incentive? Health Serv Insights 2015; 8:1-8. [PMID: 25922580 PMCID: PMC4401240 DOI: 10.4137/hsi.s24092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 02/18/2015] [Accepted: 02/19/2015] [Indexed: 11/06/2022] Open
Abstract
Surveillance, Epidemiologic, and End Results (SEER) registry data abstracted from a priority 2 or higher reporting source from 2006 to 2008 were used to compare treatment patterns in 45–64-year old men diagnosed with locoregional prostate cancer (LRPC) across states with or without radiation therapy-directed certificate of need (CON) laws and across independent cancer centers (ICCs) compared to large multi-specialty groups (LMSGs). Adjusted treatment percentages for the five most common LRPC treatments (surgery, external beam radiation therapy (EBRT), combination brachytherapy with EBRT, brachytherapy, and observation) were compared using cross-sectional logistic regression between CON-unregulated and -regulated states and between LMSGs and ICCs. LRPC EBRT rates were no different across CON regions, but are increased in ICCs compared to LMSGs (37.00% vs. 13.23%, P < 0.001). Variation in LRPC treatment patterns by reporting source merits further scrutiny under the Affordable Care Act of 2010, considering the intent of incentivized accountable care organizations (ACOs) established by the Patient Protection and Affordable Care Act of 2010 (PPACA) and the implications of early descriptions of these new healthcare provider organizations on prostate cancer treatment patterns.
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Affiliation(s)
- Andrew S Camarata
- Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, GA, USA. ; United States Navy, Medical Corps, USA
| | - Dana C Nickleach
- Biostatistics and Bioinformatics Shared Resource, Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Ashesh B Jani
- Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Peter J Rossi
- Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, GA, USA
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28
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Shen MJ, Nelson CJ, Peters E, Slovin SF, Hall SJ, Hall M, Herrera PC, Leventhal EA, Leventhal H, Diefenbach MA. Decision-making Processes among Prostate Cancer Survivors with Rising PSA Levels: Results from a Qualitative Analysis. Med Decis Making 2014; 35:477-86. [PMID: 25385751 DOI: 10.1177/0272989x14558424] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 10/10/2014] [Indexed: 01/02/2023]
Abstract
BACKGROUND Prostate cancer survivors with a rising prostate-specific antigen (PSA) level have few treatment options, experience a heightened state of uncertainty about their disease trajectory that might include the possibility of cancer metastasis and death, and often experience elevated levels of distress as they have to deal with a disease they thought they had conquered. Guided by self-regulation theory, the present study examined the cognitive and affective processes involved in shared decision making between physicians and patients who experience a rising PSA after definitive treatment for prostate cancer. METHODS In-depth interviews were conducted with 34 prostate cancer survivors who had been diagnosed with a rising PSA (i.e., biochemical failure) within the past 12 months. Survivors were asked about their experiences and affective responses after being diagnosed with a rising PSA and while weighing potential treatment options. In addition, patients were asked about their decision-making process for the initial prostate cancer treatment. RESULTS Compared with the initial diagnosis, survivors with a rising PSA reported increased negative affect following their diagnosis, concern about the treatability of their disease, increased planning and health behavior change, heightened levels of worry preceding doctor appointments (especially prior to the discussion of PSA testing results), and a strong reliance on physicians' treatment recommendations. CONCLUSIONS Prostate cancer survivors' decision-making processes for the treatment of a rising PSA are markedly different from those of the initial diagnosis of prostate cancer. Because patients experience heightened distress and rely more heavily on their physicians' recommendations with a rising PSA, interactions with the health care provider provide an excellent opportunity to address and assist patients with managing the uncertainty and distress inherent with rising PSA levels.
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Affiliation(s)
- Megan Johnson Shen
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY (MJS, CJN)
| | - Christian J Nelson
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY (MJS, CJN)
| | - Ellen Peters
- Department of Psychology, Ohio State University, Columbus, OH (EP)
| | - Susan F Slovin
- Department of Medicine; Memorial Sloan-Kettering Cancer Center, New York, NY (SFS)
| | - Simon J Hall
- Department of Urology, Mount Sinai, New York, NY (SJH, MH, PCH, MAD)
| | - Matt Hall
- Department of Urology, Mount Sinai, New York, NY (SJH, MH, PCH, MAD)
| | | | - Elaine A Leventhal
- Department of Medicine, Robert Wood Johnson Medical School, Rutgers, New Brunswick, NJ (EAL, HL)
| | - Howard Leventhal
- Department of Medicine, Robert Wood Johnson Medical School, Rutgers, New Brunswick, NJ (EAL, HL)
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29
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Abstract
Targeting prostate cancer metastasis has very high therapeutic potential. Prostate cancer is the second most common cause of cancer death among men in the USA, and death results from the development of metastatic disease. In order to metastasize, cancer cells must complete a series of steps that together constitute the metastatic cascade. Each step therefore offers the opportunity for therapeutic targeting. However, practical limitations have served as limiting roadblocks to successfully targeting the metastatic cascade. They include our still-emerging understanding of the underlying biology, as well as the fact that many of the dysregulated processes have critical functionality in otherwise normal cells. We provide a discussion of the underlying biology, as it relates to therapeutic targeting. Therapeutic inroads are rapidly being made, and we present a series of case studies to highlight key points. Finally, future perspectives related to drug discovery for antimetastatic agents are discussed.
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30
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Silk KJ, Perrault EK, Nazione S, Pace K, Hager P, Springer S. Localized prostate cancer treatment decision-making information online: improving its effectiveness and dissemination for nonprofit and government-supported organizations. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2013; 28:709-716. [PMID: 23907786 DOI: 10.1007/s13187-013-0515-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The current study reports findings from evaluation research conducted to identify how online prostate cancer treatment decision-making information can be both improved and more effectively disseminated to those who need it most. A multi-method, multi-target approach was used and guided by McGuire's Communication Matrix Model. Focus groups (n = 31) with prostate cancer patients and their family members, and in-depth interviews with physicians (n = 8), helped inform a web survey (n = 89). Results indicated that physicians remain a key information source for medical advice and the Internet is a primary channel used to help make informed prostate cancer treatment decisions. Participants reported a need for more accessible information related to treatment options and treatment side effects. Additionally, physicians indicated that the best way for agencies to reach them with new information to deliver to patients is by contacting them directly and meeting with them one-on-one. Advice for organizations to improve their current prostate cancer web offerings and further ways to improve information dissemination are discussed.
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Affiliation(s)
- Kami J Silk
- Michigan State University, 404 Wilson Road-CAS 477, East Lansing, MI, 48824, USA,
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31
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Zhang J, Jing H, Han X, Huang Z, Cao Z, Liu Q. Diffusion-weighted imaging of prostate cancer on 3T MR: Relationship between apparent diffusion coefficient values and Ki-67 expression. Acad Radiol 2013; 20:1535-41. [PMID: 24200480 DOI: 10.1016/j.acra.2013.09.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Revised: 09/08/2013] [Accepted: 09/08/2013] [Indexed: 02/08/2023]
Abstract
RATIONALE AND OBJECTIVES To investigate the relationship between apparent diffusion coefficient (ADC) values and the Ki-67 staining index (Ki-67 SI), a tumor proliferation marker, in prostate cancer (PCa). MATERIALS AND METHODS Forty-three patients with PCa and thirty-six patients with benign prostatic hyperplasia (BPH) underwent diffusion-weighted (DW) imaging on 3T magnetic resonance (MR) with pelvic phased-array coil. The ADC values of PCa were calculated from two DW images (b = 0, 800 s/mm(2)). Immunohistochemical staining for Ki-67 was used to determine the Ki-67 SI of PCa and BPH. The Pearson correlation test was used to examine the relationship between ADC values and the Ki-67 SI. The ADC values of PCa with different level of Ki-67 SI were compared using an independent-sample t-test. RESULTS The mean (±standard deviation [SD]) Ki-67 SI of PCa (7.23 ± 5.29%) was higher than that of BPH (2.11 ± 1.90%) (P < .001). The mean (±SD) ADC value (10(-3) mm(2)/s) of PCa (0.850 ± 0.155) was lower than that of BPH (1.173 ± 0.245) (P < .001). The ADC values of PCa were negatively correlated with the Ki-67 SI (r = -0.459, P = .002). The mean ADC values of PCa with Ki-67 >3.5% and ≤3.5% were (0.803 ± 0.094) and (0.936 ± 0.208), respectively. The former was significantly lower than the latter (P = .031). The ADC values of PCa with Ki-67 >7.1% and ≤7.1% were (0.779 ± 0.081) and (0.906 ± 0.178), respectively. The difference was significant (P = .004). CONCLUSION The ADC values of PCa could reflect the tumor proliferative activity and the differentiated degree of PCa.
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Parr K. Nutritional Management In Prostate Cancer. Nutr Cancer 2013. [DOI: 10.1002/9781118788707.ch18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Argon plasma coagulation therapy versus topical formalin for intractable rectal bleeding and anorectal dysfunction after radiation therapy for prostate carcinoma. Int J Radiat Oncol Biol Phys 2013; 87:954-9. [PMID: 24113059 DOI: 10.1016/j.ijrobp.2013.08.034] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Revised: 08/23/2013] [Accepted: 08/25/2013] [Indexed: 12/13/2022]
Abstract
PURPOSE To evaluate and compare the effect of argon plasma coagulation (APC) and topical formalin for intractable rectal bleeding and anorectal dysfunction associated with chronic radiation proctitis. METHODS AND MATERIALS Thirty men (median age, 72 years; range, 49-87 years) with intractable rectal bleeding (defined as ≥1× per week and/or requiring blood transfusions) after radiation therapy for prostate carcinoma were randomized to treatment with APC (n=17) or topical formalin (n=13). Each patient underwent evaluations of (1) anorectal symptoms (validated questionnaires, including modified Late Effects in Normal Tissues-Subjective, Objective, Management, and Analytic and visual analogue scales for rectal bleeding); (2) anorectal motor and sensory function (manometry and graded rectal balloon distension); and (3) anal sphincteric morphology (endoanal ultrasound) before and after the treatment endpoint (defined as reduction in rectal bleeding to 1× per month or better, reduction in visual analogue scales to ≤25 mm, and no longer needing blood transfusions). RESULTS The treatment endpoint was achieved in 94% of the APC group and 100% of the topical formalin group after a median (range) of 2 (1-5) sessions of either treatment. After a follow-up duration of 111 (29-170) months, only 1 patient in each group needed further treatment. Reductions in rectal compliance and volumes of sensory perception occurred after APC, but no effect on anorectal symptoms other than rectal bleeding was observed. There were no differences between APC and topical formalin for anorectal symptoms and function, nor for anal sphincteric morphology. CONCLUSIONS Argon plasma coagulation and topical formalin had comparable efficacy in the durable control of rectal bleeding associated with chronic radiation proctitis but had no beneficial effect on anorectal dysfunction.
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Ramsey SD, Zeliadt SB, Blough DK, Moinpour CM, Hall IJ, Smith JL, Ekwueme DU, Fedorenko CR, Fairweather ME, Koepl LM, Thompson IM, Keane TE, Penson DF. Impact of prostate cancer on sexual relationships: a longitudinal perspective on intimate partners' experiences. J Sex Med 2013; 10:3135-43. [PMID: 24118980 DOI: 10.1111/jsm.12295] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
INTRODUCTION In this prospective study of localized prostate cancer patients and their partners, we analyzed how partner issues evolve over time, focusing on satisfaction with care, influence of cancer treatment, and its impact on relationship with patient, cancer worry, and personal activities. AIMS Our study aims were twofold: (i) to determine whether the impact of treatment on patients and partners moderate over time and (ii) if receiving surgery (i.e., radical prostatectomy) influences partner issues more than other treatments. METHODS Patients newly diagnosed with localized prostate cancer and their female partners were recruited from three states to complete surveys by mail at three time points over 12 months. MAIN OUTCOME MEASURES The four primary outcomes assessed in the partner analysis included satisfaction with treatment, cancer worry, and the influence of cancer and its treatment on their relationship (both general relationship and sexual relationship). RESULTS This analysis included 88 patient-partner pairs. At 6 months, partners reported that cancer had a negative impact on their sexual relationship (39%--somewhat negative and 12%--very negative). At 12 months, this proportion increased substantially (42%--somewhat negative and 29%--very negative). Partners were significantly more likely to report that their sexual relationship was worse when the patient reported having surgery (P = 0.0045, odds ratio = 9.8025, 95% confidence interval 2.076-46.296). A minority of partners reported significant negative impacts in other areas involving their personal activities (16% at 6 months and 25% at 12 months) or work life (6% at 6 months, which increased to 12% at 12 months). CONCLUSION From partners' perspectives, prostate cancer therapy has negative impact on sexual relationships and appears to worsen over time.
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Affiliation(s)
- Scott D Ramsey
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
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Mu D, Gao Z, Guo H, Zhou G, Sun B. Sodium butyrate induces growth inhibition and apoptosis in human prostate cancer DU145 cells by up-regulation of the expression of annexin A1. PLoS One 2013; 8:e74922. [PMID: 24086397 PMCID: PMC3781143 DOI: 10.1371/journal.pone.0074922] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 08/06/2013] [Indexed: 01/05/2023] Open
Abstract
Background Sodium butyrate, a histone deacetylase inhibitor, has emerged as a promising anticancer drug for multiple cancers. Recent studies have indicated that sodium butyrate could inhibit the progression of prostate cancer; however, the exact mechanism is still unclear. The aim of this study was to investigate the mechanism of sodium butyrate action in prostate cancer DU145 cells. Methods The inhibitory effects of NaB on cell growth were detected by the 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrrazolium bromide assay. Cell apoptosis was determined by flow cytometric analysis of DU145 cells stained with annexin V and PI. Hoechst 33258 and fluorescence microscopes were used to observe the nuclear morphology of DU145 cells after treatment with NaB. ANXA1 knockdown cells were established through transfection with ANXA1 siRNA. ANXA1 mRNA levels were measured by qRT-PCR. Bcl-2, Bax, ANXA1, ERK1/2 and pERK1/2 were detected by western blot. Results NaB significantly inhibited the growth and induction apoptosis of DU145 and PC3 cells in a dose-dependent manner. Expression of the anti-apoptosis gene Bcl-xl and Bcl-2 in DU145 cells are decreased and expression of the pro-apoptosis gene Bax and Bak increased after NaB treatment. Further studies have demonstrated that NaB up-regulated the expression of ANXA1 and that the tumor inhibition action of NaB was reduced markedly through knockdown of the ANXA1 gene in DU145 cells. Moreover, the siANXA1 cells showed that cell proliferation increased and cell apoptosis was induced by the inactivation of extracellular regulated kinase (ERK). Conclusion Our results support a significant correlation between NaB functions and ANXA1 expression in prostate cancer, and pave the way for further studying the molecular mechanism of NaB actions in cancers.
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Affiliation(s)
- Dawei Mu
- Department of Urology, Air Force General Hospital, Beijing, China
| | - Zhuo Gao
- Department of Nephrology, Air Force General Hospital, Beijing, China
| | - Heqing Guo
- Department of Urology, Air Force General Hospital, Beijing, China
- * E-mail:
| | - Gaobiao Zhou
- Department of Urology, Air Force General Hospital, Beijing, China
| | - Bin Sun
- Department of Urology, Air Force General Hospital, Beijing, China
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Wong A, Glaister J, Cameron A, Haider M. Correlated diffusion imaging. BMC Med Imaging 2013; 13:26. [PMID: 23924150 PMCID: PMC3750835 DOI: 10.1186/1471-2342-13-26] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Accepted: 08/01/2013] [Indexed: 11/25/2022] Open
Abstract
Background Prostate cancer is one of the leading causes of cancer death in the male population. Fortunately, the prognosis is excellent if detected at an early stage. Hence, the detection and localization of prostate cancer is crucial for diagnosis, as well as treatment via targeted focal therapy. New imaging techniques can potentially be invaluable tools for improving prostate cancer detection and localization. Methods In this study, we introduce a new form of diffusion magnetic resonance imaging called correlated diffusion imaging, where the tissue being imaged is characterized by the joint correlation of diffusion signal attenuation across multiple gradient pulse strengths and timings. By taking into account signal attenuation at different water diffusion motion sensitivities, correlated diffusion imaging can provide improved delineation between cancerous tissue and healthy tissue when compared to existing diffusion imaging modalities. Results Quantitative evaluation using receiver operating characteristic (ROC) curve analysis, tissue class separability analysis, and visual assessment by an expert radiologist were performed to study correlated diffusion imaging for the task of prostate cancer diagnosis. These results are compared with that obtained using T2-weighted imaging and standard diffusion imaging (via the apparent diffusion coefficient (ADC)). Experimental results suggest that correlated diffusion imaging provide improved delineation between healthy and cancerous tissue and may have potential as a diagnostic tool for cancer detection and localization in the prostate gland. Conclusions A new form of diffusion magnetic resonance imaging called correlated diffusion imaging (CDI) was developed for the purpose of aiding radiologists in cancer detection and localization in the prostate gland. Preliminary results show CDI shows considerable promise as a diagnostic aid for radiologists in the detection and localization of prostate cancer.
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Affiliation(s)
- Alexander Wong
- Department of Systems Design Engineering, U. of Waterloo, Waterloo, Canada.
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Eccles BK, Cross W, Rosario DJ, Doble A, Parker C, Logue J, Little L, Stanton L, Bottomley D. SABRE 1 (Surgery Against Brachytherapy - a Randomised Evaluation): feasibility randomised controlled trial (RCT) of brachytherapy vs radical prostatectomy in low-intermediate risk clinically localised prostate cancer. BJU Int 2013; 112:330-7. [PMID: 23826842 DOI: 10.1111/bju.12127] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine the feasibility of a phase III randomised controlled trial of brachytherapy vs radical prostatectomy (RP) in men with low-intermediate risk localised prostate cancer. PATIENTS AND METHODS This parallel, two-group, multicentre, randomised controlled feasibility trial enrolled men with histologically confirmed localised, low-risk prostate cancer and good performance status from five UK hospitals. Participants were randomly allocated (1:1) by remote computer allocation to receive a decision aid (DA) DVD or standard information (control group), followed by a second randomisation (1:1) to brachytherapy or RP. There was no 'blinding' of staff or patients. Primary outcome was feasibility: a recruitment rate of six patients per centre over the last 6 months of recruitment would deem a phase III trial feasible. RESULTS Between May 2009 and May 2011, 30 patients were randomised (15 in the DA group and 15 in the control group), and four continued to the second treatment randomisation (one from the DA group and three from the control group). One patient was allocated and received brachytherapy and three RP. SABRE 1 closed early due to poor recruitment. All patients were analysed. Screening logbook analysis showed that the main reasons for declining trial entry were a wish to choose treatment or opting for active monitoring. Results from the DA questionnaire (completed by 10 men) showed that four of the men 'felt surgery and radiotherapy had been proven in a high quality trial' and seven felt 'they should make their treatment decision while knowing their doctors opinion'. CONCLUSION Recruitment to a RP vs brachytherapy trial in localised prostate cancer was not feasible by the use of this two-step randomisation using a DA and previous trials in early prostate cancer have had similar difficulties in recruitment, with only a few achieving their accrual target. The best treatment method for treating low-risk prostate cancer is still unproven in a head-to-head trial and the increasing number of options will make choices correspondingly more difficulty without good quality comparative research. More sophisticated techniques for recruitment may be more successful in future trials in this patient population.
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Affiliation(s)
- Bryony K Eccles
- University of Southampton Clinical Trials Unit, Southampton, UK
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Hall WA, Nickleach DC, Master VA, Prabhu RS, Rossi PJ, Godette K, Cooper S, Jani AB. The association between C-reactive protein (CRP) level and biochemical failure-free survival in patients after radiation therapy for nonmetastatic adenocarcinoma of the prostate. Cancer 2013; 119:3272-9. [PMID: 23818401 DOI: 10.1002/cncr.28185] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 04/07/2013] [Accepted: 04/12/2013] [Indexed: 01/08/2023]
Abstract
BACKGROUND C-reactive protein (CRP) has been associated with outcomes in patients with metastatic adenocarcinoma of the prostate. Associations between prostate adenocarcinoma-specific endpoints and CRP in patients who are treated for localized disease remain unknown. METHODS In total, 206 patients who received radiation therapy for adenocarcinoma of the prostate had at least 1 CRP measured in follow-up and were analyzed. The primary outcome was biochemical failure-free survival. In addition, associations were examined between CRP and prostate-specific antigen (PSA). RESULTS On univariate analysis, higher CRP levels were associated significantly with shorter biochemical failure-free survival for patients who received radiation therapy after undergoing radical prostatectomy. For patients who were managed with definitive radiation therapy alone, higher CRP levels also were associated significantly with shorter biochemical failure-free survival on univariate and multivariable analyses (hazard ratio, 2.03; 95% confidence interval, 1.19-3.47; P = .009). In addition, CRP levels were associated significantly with PSA after radical prostatectomy for patients who had Gleason scores ≥ 8 (P = .037), for high-risk patients (P = .008), and for those with pretreatment PSA levels > 20 ng/mL (P = .05). In patients who received definitive radiation therapy, CRP levels also were associated with PSA both for those with pretreatment PSA levels > 20 ng/mL (P < .001), and for the intermediate-risk (P = .029) and high-risk (P = .009) subgroups. CONCLUSIONS A higher CRP level was associated with shorter biochemical failure-free survival on univariate and multivariable analyses in patients who received definitive radiation therapy. CRP was also associated with PSA in exploratory subgroups. These findings warrant further exploration in a prospectively enrolled patient cohort.
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Affiliation(s)
- William A Hall
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia
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Baade PD, Youlden DR, Cramb SM, Dunn J, Gardiner RA. Epidemiology of prostate cancer in the Asia-Pacific region. Prostate Int 2013; 1:47-58. [PMID: 24223402 PMCID: PMC3814115 DOI: 10.12954/pi.12014] [Citation(s) in RCA: 123] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Accepted: 01/10/2013] [Indexed: 11/24/2022] Open
Abstract
The purpose of this paper was to examine and compare available data on incidence, mortality and survival for countries in the Asia-Pacific region. Incidence data were obtained from GLOBOCAN 2008, other online data sources and individual cancer registries. Country-specific mortality statistics by individual year were sourced from the World Health Organization Statistical Information System Mortality Database. All incidence and mortality rates were directly age-standardised to the Segi World Standard population and joinpoint models were used to assess trends. Data on survival were obtained from country-specific published reports where available. Approximately 14% (122,000) of all prostate cancers diagnosed worldwide in 2008 were within the Asia-Pacific region (10 per 100,000 population), with three out of every four of these prostate cancer cases diagnosed in either Japan (32%), China (28%) or Australia (15%). There were also about 42,000 deaths due to prostate cancer in the Asia-Pacific region (3 per 100,000). For the nine countries with incidence trend data available, eight showed recent significant increases in prostate cancer incidence. In contrast, recent decreases in prostate cancer mortality have been reported for Australia, Japan and New Zealand, but mortality has increased in several other countries. The lack of population-based data across most of the countries in this region limits the ability of researchers to understand and report on the patterns and distribution of this important cancer. Governments and health planners typically require quantitative evidence as a motivation for change. Unless there is a widespread commitment to improve the collection and reporting of data on prostate cancer it is likely that the burden of prostate cancer will continue to increase. Enhancing knowledge transfer between countries where there are differentials in capacity, policy and experience may provide the necessary impetus and opportunity to overcome at least some of the existing barriers.
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Affiliation(s)
- Peter D. Baade
- Cancer Council Queensland, Brisbane,
Australia
- Griffith Health Institute, Griffith University, Gold Coast,
Australia
- School of Public Health, Queensland University of Technology, Brisbane,
Australia
| | | | - Susanna M. Cramb
- Cancer Council Queensland, Brisbane,
Australia
- School of Mathematics, Queensland University of Technology, Brisbane,
Australia
| | - Jeff Dunn
- Cancer Council Queensland, Brisbane,
Australia
- Griffith Health Institute, Griffith University, Gold Coast,
Australia
- School of Social Science, University of Queensland, Brisbane,
Australia
| | - Robert A. Gardiner
- University of Queensland, Centre for Clinical Research, Royal Brisbane Hospital, Brisbane,
Australia
- Department of Urology, Royal Brisbane Hospital, Brisbane,
Australia
- Health and Wellness Institute, Edith Cowan University, Perth,
Australia
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Wang Y, Liu T, Rossi PJ, Watkins-Bruner D, Hsiao W, Cooper S, Yang X, Jani AB. Influence of vascular comorbidities and race on erectile dysfunction after prostate cancer radiotherapy. J Sex Med 2013; 10:2108-14. [PMID: 23742221 DOI: 10.1111/jsm.12215] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Vascular comorbidities (VC) (hypertension, diabetes, and hyperlipidemia) are known factors related to erectile dysfunction (ED) in men. However, no data are yet available for the effects of VC on ED incidence after prostate cancer radiotherapy (XRT). AIM To investigate the influence of VC on post-XRT ED incidence and to further characterize ED incidence by racial groups. MAIN OUTCOME MEASURES ED incidence. METHODS We reviewed 732 charts of patients (267 Caucasian and 465 African American [AA]) who received prostate XRT (external beam radiotherapy and/or brachytherapy) with or without hormone therapy between 1999 and 2010. The number of pre-XRT VC (0, 1, 2, or 3) was determined by medical history and medication list. ED (defined by use of erectile aids or by documentation of moderate or high sexual dysfunction on patient history) was determined pre-XRT as well as 1, 2, and 4 years post-XRT. RESULTS ED incidence progressively increased from 22% pre-XRT to 58% 4 years post-XRT (P < 0.01). Additionally, ED incidence significantly increased with number of VC-4-year incidence between patients with 1 vs. 0 (P = 0.02), 2 vs. 0 (P < 0.01), 3 vs. 0 (P < 0.01), 3 vs. 1 (P < 0.01), and 3 vs. 2 (P = 0.04) VC (2 vs. 1 VC was nonsignificant). Compared with the Caucasian patients, ED incidences were slightly higher for the AA group with 0, 1, 2, and 3 comorbidities at 4 years follow-up (but statistically nonsignificant). CONCLUSIONS The number of VCs have a significant effect on development of post-XRT ED. Pre- and post-XRT ED appear to be independent of race when number of VCs are considered. Our results can be used to guide physicians in counseling patients on the incidence of ED by number of VC and as preliminary data for prospective efforts aimed at reducing post-XRT ED.
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Affiliation(s)
- Yuefeng Wang
- Department of Radiation Oncology, Emory University, Atlanta, GA 30322, USA
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Yamamichi F, Shigemura K, Morishita S, Yamanaka K, Tanaka K, Miyake H, Fujisawa M. Significance of neoadjuvant hormonal therapy in radical retropubic prostatectomy: a retrospective single-surgeon study. Yonsei Med J 2013; 54:410-5. [PMID: 23364975 PMCID: PMC3575985 DOI: 10.3349/ymj.2013.54.2.410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
PURPOSE The purpose of this study was to evaluate whether neo-adjuvant hormonal therapy (NHT) prior to radical retropubic prostatectomy (RRP) for prostate cancer (PCa) is beneficial in terms of surgical outcomes and for preventing or delaying biochemical recurrence via single-surgeon case series study. MATERIALS AND METHODS Fifty-three men underwent RRP by a single surgeon. The patients were divided into two groups according to whether or not NHT was performed prior to RRP. The study was analyzed retrospectively. We evaluated clinical parameters, surgical parameters, and biochemical recurrence rate. Group 1 (n=34) was treated with RRP only, while Group 2 (n=19) underwent RRP along with NHT. RESULTS There were no significant differences in clinical, operation-related and pathological factors between the two groups (p>0.05). There was also no significant difference in biochemical recurrence rate between the two groups at the last follow-up, although Group 2 tended to have a lower PCa recurrence rate than Group 1 and the initial prostate-specific antigen (PSA) level was significantly higher in Group 2 than Group 1 (p=0.0496). CONCLUSION The present single-surgeon case series study revealed a trend toward a lower rate of PCa recurrence in NHT+RRP treated patients compared to those treated with RRP alone, but this did not reach statistical significance, despite the fact that NHT+RRP patients exhibited higher serum PSA levels preoperatively. Prospective studies with a longer duration of observation and a greater number of patients would be helpful in evaluating NHT more definitively.
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Affiliation(s)
- Fukashi Yamamichi
- Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan
- Department of Urology, Hyogo Prefectural Tsukaguchi Hospital, Amagasaki, Japan
| | - Katsumi Shigemura
- Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan
| | | | - Kunito Yamanaka
- Department of Urology, Akashi Municipal Hospital, Akashi, Japan
| | - Kazushi Tanaka
- Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Hideaki Miyake
- Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masato Fujisawa
- Department of Urology, Kobe University Graduate School of Medicine, Kobe, Japan
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Hall WA, Colbert L, Nickleach D, Shelton J, Marcus DM, Switchenko J, Rossi PJ, Godette K, Cooper S, Jani AB. Reduced acute toxicity associated with the use of volumetric modulated arc therapy for the treatment of adenocarcinoma of the prostate. Pract Radiat Oncol 2013; 3:e157-64. [PMID: 24674413 PMCID: PMC10388692 DOI: 10.1016/j.prro.2013.01.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Revised: 01/09/2013] [Accepted: 01/10/2013] [Indexed: 12/01/2022]
Abstract
PURPOSE Novel techniques to deliver intensity modulated radiation therapy (IMRT) have resulted in improved treatment efficiency and dosimetric endpoints. We aimed to compare acute gastrointestinal (GI) and genitourinary (GU) toxicity in patients treated for adenocarcinoma of the prostate (ACP) using volumetric modulated arc therapy (VMAT). METHODS AND MATERIALS A total of 122 (71 IMRT and 51 VMAT) ACP patients treated from 2004 to 2011 with definitive external beam radiation therapy were analyzed. Dose-volume histogram endpoints (V40, V65, V70, and V75 of the bladder and rectum) were collected for each patient. Median follow-up for patients treated with VMAT was 269 days versus IMRT was 1121 days. Acute Common Toxicity Criteria for Adverse Events (CTCAE) GI and GU toxicity scores, obtained during each weekly treatment check, were compared across cohorts. The univariate (UV) association between the covariates and outcomes was assessed and multivariable (MV) cumulative logit models were fit for each outcome. RESULTS Median patient age was 68 years and median prostate-specific antigen was 8.3. Both bladder and rectal V40, V65, V70, and V75 were all higher in the IMRT group versus the VMAT group (P < .05), which was likely influenced by larger planning target volumes in the IMRT group. The VMAT group had significantly lower rates of acute GU and acute GI CTCAE toxicity on UV association analysis. On MV analysis, VMAT remained independently associated with acute GU (odds ratio [OR], 0.18; 95% confidence interval [CI], 0.07-0.44; P < .001) and GI (OR, 0.16; 95% CI, 0.07-0.41; P < .001) toxicity. CONCLUSIONS VMAT appears to be independently associated with lower rates of acute GI and GU toxicity when compared with traditional IMRT. Further exploration of toxicity improvements associated with VMAT use in the definitive treatment of ACP is needed.
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Affiliation(s)
- William A Hall
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia.
| | - Lauren Colbert
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia
| | - Dana Nickleach
- Biostatistics & Bioinformatics Shared Resource at Winship Cancer Institute, Atlanta, Georgia
| | - Joseph Shelton
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia
| | - David M Marcus
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia
| | - Jeffrey Switchenko
- Biostatistics & Bioinformatics Shared Resource at Winship Cancer Institute, Atlanta, Georgia
| | - Peter J Rossi
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia
| | - Karen Godette
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia
| | - Sherrie Cooper
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia
| | - Ashesh B Jani
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia
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Yeoh EK, Holloway RH, Fraser RJ, Botten RJ, Di Matteo AC, Butters J. Pathophysiology and Natural History of Anorectal Sequelae Following Radiation Therapy for Carcinoma of the Prostate. Int J Radiat Oncol Biol Phys 2012; 84:e593-9. [DOI: 10.1016/j.ijrobp.2012.06.032] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Revised: 06/12/2012] [Accepted: 06/19/2012] [Indexed: 10/28/2022]
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Recent trends in prostate cancer incidence by age, cancer stage, and grade, the United States, 2001-2007. Prostate Cancer 2012; 2012:691380. [PMID: 23251806 PMCID: PMC3515924 DOI: 10.1155/2012/691380] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Revised: 10/25/2012] [Accepted: 10/31/2012] [Indexed: 12/22/2022] Open
Abstract
Objective. To examine prostate cancer trends by demographic and tumor characteristics because a comprehensive examination of recent prostate cancer incidence rates is lacking. Patients and Methods. We described prostate cancer incidence rates and trends using the 2001–2007 National Program of Cancer Registries and Surveillance, Epidemiology, and End Results Program data (representing over 93% of US population). Because of coding changes in cancer grade, we restricted analysis to 2004–2007. We conducted descriptive and trend analyses using SEER∗Stat. Results. The overall prostate cancer incidence rate was stable from 2001 to 2007; however, rates significantly increased among men aged 40–49 years (APC = 3.0) and decreased among men aged 70–79 years (APC = 2.3), and 80 years or older (APC = −4.4). About 42% of localized prostate cancers diagnosed from 2004 to 2007 were poorly differentiated. The incidence of poorly differentiated cancer significantly increased among localized (APC = 8.0) and regional stage (APC = 6.1) prostate cancers during 2004–2007. Conclusions. The recent trend in prostate cancer incidence was stable but varied dramatically by age. Given the large proportion of poorly differentiated disease among localized prostate cancers and its increasing trend in more recent years, continued monitoring of prostate cancer incidence and trends by demographic and tumor characteristics is warranted.
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King VJ, Davis MM, Gorman PN, Rugge JB, Fagnan L. Perceptions of shared decision making and decision aids among rural primary care clinicians. Med Decis Making 2012; 32:636-44. [PMID: 22247423 PMCID: PMC3665512 DOI: 10.1177/0272989x11431961] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Shared decision making (SDM) and decision aids (DAs) increase patients' involvement in health care decisions and enhance satisfaction with their choices. Studies of SDM and DAs have primarily occurred in academic centers and large health systems, but most primary care is delivered in smaller practices, and over 20% of Americans live in rural areas, where poverty, disease prevalence, and limited access to care may increase the need for SDM and DAs. OBJECTIVE To explore perceptions and practices of rural primary care clinicians regarding SDM and DAs. DESIGN Cross-sectional survey. Setting and Participants Primary care clinicians affiliated with the Oregon Rural Practice-based Research Network. RESULTS Surveys were returned by 181 of 231 eligible participants (78%); 174 could be analyzed. Two-thirds of participants were physicians, 84% practiced family medicine, and 55% were male. Sixty-five percent of respondents were unfamiliar with the term shared decision making, but following definition, 97% reported that they found the approach useful for conditions with multiple treatment options. Over 90% of clinicians perceived helping patients make decisions regarding chronic pain and health behavior change as moderate/hard in difficulty. Although 69% of respondents preferred that patients play an equal role in making decisions, they estimate that this happens only 35% of the time. Time was reported as the largest barrier to engaging in SDM (63%). Respondents were receptive to using DAs to facilitate SDM in print- (95%) or web-based formats (72%), and topic preference varied by clinician specialty and decision difficulty. CONCLUSIONS Rural clinicians recognized the value of SDM and were receptive to using DAs in multiple formats. Integration of DAs to facilitate SDM in routine patient care may require addressing practice operation and reimbursement.
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Affiliation(s)
- Valerie J. King
- Department of Family Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, Oregon 97239, 503-494-8694
| | - Melinda M. Davis
- Oregon Rural Practice-based Research Network (ORPRN), Research Instructor, Department of Family Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, Oregon 97239-3098, 503-494-4365
| | - Paul N. Gorman
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, Oregon 97239 503-494-4025
| | - J. Bruin Rugge
- Department of Family Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, Oregon 97239, 503-418-4229
| | - L.J. Fagnan
- Oregon Rural Practice-based Research Network (ORPRN), Department of Family Medicine, Oregon Clinical & Translational Science Institute, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, Oregon 97239-3098, 503-494-1582
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Ren J, Wang F, Wei G, Yang Y, Liu Y, Wei M, Huan Y, Larson AC, Zhang Z. MRl of prostate cancer antigen expression for diagnosis and immunotherapy. PLoS One 2012; 7:e38350. [PMID: 22761679 PMCID: PMC3384648 DOI: 10.1371/journal.pone.0038350] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2012] [Accepted: 05/03/2012] [Indexed: 12/03/2022] Open
Abstract
Background Tumor antigen (TA)–targeted monoclonal antibody (mAb) immunotherapy can be effective for the treatment of a broad range of cancer etiologies; however, these approaches have demonstrated variable clinical efficacy for the treatment of patients with prostate cancer (PCa). An obstacle currently impeding translational progress has been the inability to quantify the mAb dose that reaches the tumor site and binds to the targeted TAs. The coupling of mAb to nanoparticle-based magnetic resonance imaging (MRI) probes should permit in vivo measurement of patient-specific biodistributions; these measurements could facilitate future development of novel dosimetry paradigms wherein mAb dose is titrated to optimize outcomes for individual patients. Methods The prostate stem cell antigen (PSCA) is broadly expressed on the surface of prostate cancer (PCa) cells. Anti-human PSCA monoclonal antibodies (mAb 7F5) were bound to Au/Fe3O4 (GoldMag) nanoparticles (mAb 7F5@GoldMag) to serve as PSCA-specific theragnostic MRI probe permitting visualization of mAb biodistribution in vivo. First, the antibody immobilization efficiency of the GoldMag particles and the efficacy for PSCA-specific binding was assessed. Next, PC-3 (prostate cancer with PSCA over-expression) and SMMC-7721 (hepatoma cells without PSCA expression) tumor-bearing mice were injected with mAb 7F5@GoldMag for MRI. MRI probe biodistributions were assessed at increasing time intervals post-infusion; therapy response was evaluated with serial tumor volume measurements. Results Targeted binding of the mAb 7F5@GoldMag probes to PC-3 cells was verified using optical images and MRI; selective binding was not observed for SMMC-7721 tumors. The immunotherapeutic efficacy of the mAb 7F5@GoldMag in PC-3 tumor-bearing mice was verified with significant inhibition of tumor growth compared to untreated control animals. Conclusion Our promising results suggest the feasibility of using mAb 7F5@GoldMag probes as a novel paradigm for the detection and immunotherapeutic treatment of PCa. We optimistically anticipate that the approaches have the potential to be translated into the clinical settings.
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MESH Headings
- Animals
- Antibodies, Immobilized
- Antibodies, Monoclonal/pharmacokinetics
- Antibodies, Monoclonal/therapeutic use
- Antigens, Neoplasm/immunology
- Antigens, Neoplasm/metabolism
- Biomarkers, Tumor/immunology
- Biomarkers, Tumor/metabolism
- Cell Line, Tumor
- Ferric Compounds/chemistry
- GPI-Linked Proteins/immunology
- GPI-Linked Proteins/metabolism
- Gold/chemistry
- Humans
- Immunotherapy
- Magnetic Resonance Imaging
- Male
- Metal Nanoparticles
- Mice
- Mice, Inbred BALB C
- Mice, Nude
- Molecular Imaging
- Neoplasm Proteins/immunology
- Neoplasm Proteins/metabolism
- Prostatic Neoplasms/diagnosis
- Prostatic Neoplasms/immunology
- Prostatic Neoplasms/therapy
- Tissue Distribution
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Affiliation(s)
- Jing Ren
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xian, China
| | - Fang Wang
- Department of Microbiology, Fourth Military Medical University, Xian, China
| | - Guangquan Wei
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xian, China
| | - Yong Yang
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xian, China
| | - Ying Liu
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xian, China
| | - Mengqi Wei
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xian, China
| | - Yi Huan
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xian, China
- * E-mail: (YH); (ZZ)
| | - Andrew C. Larson
- Department of Radiology, Northwestern University. Chicago, Illinois, United States of America
- Robert H. Lurie Comprehensive Cancer Center, Chicago, Illinois, United States of America
| | - Zhuoli Zhang
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xian, China
- Department of Radiology, Northwestern University. Chicago, Illinois, United States of America
- Robert H. Lurie Comprehensive Cancer Center, Chicago, Illinois, United States of America
- * E-mail: (YH); (ZZ)
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Othus M, Li Y, Tiwari R. Change point-cure models with application to estimating the change-point effect of age of diagnosis among prostate cancer patients. J Appl Stat 2012; 39:901-911. [PMID: 22544992 DOI: 10.1080/02664763.2011.626849] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Previous research on prostate cancer survival trends in the United States National Cancer Institute's Surveillance Epidemiology and End Results database has indicated a potential change-point in the age of diagnosis of prostate cancer around age 50. Identifying a change-point value in prostate cancer survival and cure could have important policy and health care management implications. Statistical analysis of this data has to address two complicating features: (1) change-point models are not smooth functions and so present computational and theoretical difficulties; and (2) models for prostate cancer survival need to account for the fact that many men diagnosed with prostate cancer can be effectively cured of their disease with early treatment. We develop a cure survival model that allows for change-point effects in covariates to investigate a potential change-point in the age of diagnosis of prostate cancer. Our results do not indicate that age under 50 is associated with increased hazard of death from prostate cancer.
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Affiliation(s)
- Megan Othus
- 1100 Fairview Ave N, M3-C102, PO Box 19024, Seattle WA 98117-1024, USA
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Sato S, Takahashi S, Asamoto M, Nakanishi M, Wakita T, Ogura Y, Yatabe Y, Shirai T. Histone H1 expression in human prostate cancer tissues and cell lines. Pathol Int 2011; 62:84-92. [DOI: 10.1111/j.1440-1827.2011.02755.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Galbraith ME, Fink R, Wilkins GG. Couples Surviving Prostate Cancer: Challenges in Their Lives and Relationships. Semin Oncol Nurs 2011; 27:300-8. [DOI: 10.1016/j.soncn.2011.07.008] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Current research in prostate brachytherapy focuses on five key concepts covered in this review. Transrectal ultrasound-guided prostate brachytherapy assisted by intraoperative treatment planning is the most advanced form of image-guided radiation delivery. Prostate brachytherapy alone for low-risk prostate cancer achieves lower prostate-specific antigen (PSA) nadirs than intensity-modulated radiotherapy (IMRT) or protons while maintaining durable biochemical control in about 90% of patients without late failures seen in surgically treated patients. As an organ-conserving treatment option, seed implant results in a lower rate of erectile dysfunction and urinary incontinence than surgery that has been validated in several recent prospective studies. Combined IMRT and seed implant has emerged as a rational and highly effective approach to radiation-dose escalation for intermediate- and high-risk prostate cancer. Preliminary results suggest that seed implantation may play a role in improving outcomes for historically poor-prognosis locally advanced and recurrent prostate cancers.
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