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Biochemical relapse of prostate cancer

Stéphane Supiot, Loic Campion, Pascal Pommier, Mélanie Dore, Clément Palpacuer, Séverine Racadot, Emmanuel Rio, Gérard A Milano, Céline Mahier-Ait Oukhatar, Christian Carrie
Background: To establish the maximum tolerated dose of abiraterone acetate plus prednisone (AA) combined with salvage radiotherapy (SRT) and goserelin in a phase 1 study in men with rising PSA following radical prostatectomy. Methods: AA was given during one month before SRT at 1000 mg PO once daily, then 750 mg (Dose Level 1, DL1) or 1000 mg (DL2) during 5 months combined with 6-months goserelin by injection on the first day of irradiation (scheme NEO) or one month before starting SRT (scheme CONCO)...
April 24, 2018: Oncotarget
Iosif Strouthos, Georgios Chatzikonstantinou, Nikolaos Zamboglou, Natasa Milickovic, Sokratis Papaioannou, Dimitra Bon, Constantinos Zamboglou, Claus Rödel, Dimos Baltas, Nikolaos Tselis
PURPOSE: To report the clinical outcomes and treatment-related toxicities after combined high-dose-rate (HDR) brachytherapy (BRT) with external beam radiotherapy (EBRT) for patients with clinically localised high-risk prostate cancer. MATERIAL AND METHODS: Between 2008 and 2012, three hundred and three consecutive patients with organ-confined high-risk prostate cancer were treated with definitive radiotherapy consisting of HDR-BRT followed by supplemental EBRT. The transrectal 3D-ultrasound-based HDR-BRT boost consisted of two single-fraction implants of 10...
May 12, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Bin S Teh, Gary D Lewis, Weiyuan Mai, Ramiro Pino, Hiromichi Ishiyama, Edward Brian Butler
BACKGROUND: Technical advances in radiotherapy delivery have simultaneously enabled dose escalation and enhanced bladder and rectal sparing. However, the optimal radiation fractionation regimen for localized prostate cancer is unclear. Laboratory and clinical evidence suggest that hypofractionation may improve the therapeutic ratio of radiotherapy. We report our institutional outcomes using moderately hypofractionated, intensity-modulated radiotherapy (IMRT), and an endorectal balloon, with emphasis on long-term biochemical control and treatment-related adverse events in patients with localized prostate cancer...
April 17, 2018: Cancer communications
Giulia Marvaso, Giulia Riva, Delia Ciardo, Sara Gandini, Cristiana Fodor, Dario Zerini, Sarah Pia Colangione, Giorgia Timon, Stefania Comi, Raffaella Cambria, Federica Cattani, Ottavio De Cobelli, Roberto Orecchia, Barbara A Jereczek-Fossa
Ultra-hypofractionated radiotherapy (RT) is given over a shorter time with larger doses with respect to conventional fractionation in patients with localized prostate cancer (PCa). The use of hypofractionation is supported both from the radiobiological point of view (the low α/β-ratio in PCa and dose escalation) and from the rising number of clinical evidences. The aim of this study is to review our data regarding oncological outcomes, namely biochemical progression-free survival (b-PFS) and clinical progression-free survival (c-PFS), acute and long-term toxicities in patients treated with a ultra-hypofractionated RT...
May 10, 2018: Medical Oncology
Andries Van Huele, Filip Poelaert, Valérie Fonteyne, Karel Decaestecker, Piet Ost, Nicolaas Lumen
BACKGROUND: To evaluate the morbidity of different surgical approaches for pelvic lymph node dissection (PLND), to evaluate the influence of morbidity on radiotherapy (RT) planning and to evaluate a possible therapeutic effect of a more extensive yield of PLND. METHODS: From 2000-2016, 228 patients received staging PLND before primary RT in a single tertiary care center. Nine patients were excluded for the evaluation of morbidity. Fifty patients were operated in an open approach, 96 laparoscopic and 73 robot-assisted (RA)...
May 8, 2018: Acta Chirurgica Belgica
Teppei Okubo, Koji Mitsuzuka, Takuya Koie, Senji Hoshi, Shigeki Matsuo, Seiichi Saito, Norihiko Tsuchiya, Tomonori Habuchi, Chikara Ohyama, Yoichi Arai
Background: Salvage treatments for biochemical relapse (BCR) after radical prostatectomy (RP) have several problems in terms of indications or adverse events. We studied the possibility of 2 years of bicalutamide monotherapy for BCR after RP. Methods: Patients who showed BCR (prostate-specific antigen (PSA) ≥ 0.2 ng/ml) after RP were recruited. Protocol treatment was planned as 2 years of bicalutamide (80 mg/day) followed by observation. Protocol treatment failure was defined as PSA re-elevation of ≥0...
April 28, 2018: Japanese Journal of Clinical Oncology
Francesco Tramacere, Stefano Arcangeli, Antonietta Pignatelli, Stefano Bracci, Marcello Vinella, Maurizio Portaluri
AIM: To retrospectively investigate outcomes, and acute and late complications following postoperative hypofractionated 3D conformal radiotherapy. PATIENTS AND METHODS: Sixty-nine consecutive patients underwent radical prostatectomy. Radiotherapy was delivered to the prostatic fossa by means of a7-fieldLINACwith 6-15 MV to a total dose of 62.5 Gy in 25 fractions (2.5 Gy per fraction) in five consecutive weeks. RESULTS: Median follow-up was 54...
May 2018: Anticancer Research
M M Cherrier, D J Cross, C S Higano, S Minoshima
OBJECTIVE: Androgen deprivation therapy (ADT) is a common treatment option for men with biochemical relapse from prostate cancer. ADT is associated with changes in mood, cognition, and quality of life, and most recently with increased risk for Alzheimer's disease (AD). This study examined changes in brain metabolism using positron emission tomography (PET) in men undergoing intermittent ADT. METHODS: Nine men with prostate cancer and a rising PSA (biochemical recurrence) without evidence of metastases were treated with intermittent ADT consisting of 9 months of complete androgen blockade achieved with combined leuprolide acetate and flutamide...
April 27, 2018: Prostate Cancer and Prostatic Diseases
Berardino De Bari, Rosario Mazzola, Dario Aiello, Sergio Fersino, Fabiana Gregucci, Pierpaolo Alongi, Maurizio Nicodemo, Stefano Cavalleri, Matteo Salgarello, Filippo Alongi
AIM: To evaluate the impact of gallium68 PSMA-11 (HBED-CC)-PET/CT on decision-making strategy of patients with relapsing prostate cancer (PC) presenting a second biochemical relapse after radical prostatectomy (RP) and salvage RT or salvage androgen deprivation therapy (ADT). MATERIALS AND METHODS: 40 patients were retrospectively analyzed. All of them had received prostatectomy. Thirteen out of 40 were addressed to gallium68 PSMA-11 (HBED-CC)-PET/CT for a biochemical relapse after RP, 14/40 after a salvage RT and 13/40 after salvage or adjuvant ADT...
April 23, 2018: La Radiologia Medica
Mauro Loi, Luca Incrocci, Isacco Desideri, Pierluigi Bonomo, Beatrice Detti, Gabriele Simontacchi, Daniela Greto, Emanuela Olmetto, Giulio Francolini, Icro Meattini, Lorenzo Livi
BACKGROUND: Whole pelvic irradiation in prostate cancer patients might prevent metastatic spread of cancer cells through lymphatic drainages in patients eligible for definitive radiotherapy, but its use has declined in the last decades in favor of prostate-only irradiation (POI). The aim of our study is to assess the incidence of pelvic lymph nodal relapse and outcome in prostate cancer patients receiving POI. MATERIALS AND METHODS: Data from 207 consecutive patients were collected...
April 12, 2018: La Radiologia Medica
Per Munck Af Rosenschold, Michael J Zelefsky, Aditya P Apte, Andrew Jackson, Jung Hun Oh, Elliot Shulman, Neil Desai, Margie Hunt, Pirus Ghadjar, Ellen Yorke, Joseph O Deasy
BACKGROUND: To determine if reduced dose delivery uncertainty is associated with daily image-guidance (IG) and Prostate Specific Antigen Relapse Free Survival (PRFS) in intensity-modulated radiotherapy (IMRT) of high-risk prostate cancer (PCa). METHODS: Planning data for consecutive PCa patients treated with IMRT (n = 67) and IG-IMRT (n = 35) was retrieved. Using computer simulations of setup errors, we estimated the patient-specific uncertainty in accumulated treatment dose distributions for the prostate and for posterolateral aspects of the gland that are at highest risk for extra-capsular disease...
April 12, 2018: Radiation Oncology
Zaina T Al-Salama
Apalutamide (ErleadaTM ) is a next-generation oral androgen receptor (AR) inhibitor that is being developed by Janssen for the treatment of prostate cancer (PC). It binds directly to the ligand-binding domain of the AR and blocks the effects of androgens. In February 2018, apalutamide received its first global approval in the USA for the treatment of non-metastatic castration-resistant PC (nmCRPC). Apalutamide is undergoing phase III investigation in chemotherapy-naive patients with metastatic CRPC (in combination with abiraterone acetate plus prednisone), patients with high-risk localized or locally advanced PC receiving primary radiation therapy, and in patients with metastatic hormone-sensitive PC and biochemically-relapsed PC...
April 6, 2018: Drugs
Shuichi Nishimura, Toshio Ohashi, Tetsuo Momma, Masanori Sakayori, Takahisa Eriguchi, Tomoki Tanaka, Shoji Yamashita, Takeo Kosaka, Mototsugu Oya, Naoyuki Shigematsu
Prostate-specific antigen nadir (nPSA) after radiotherapy for localized prostate cancer has been investigated as a predictor. However, nPSA usually requires several years, limiting its clinical utility. We investigated the significance of nPSA within 12 months (nPSA12) after low-dose-rate prostate brachytherapy (LDR-PB) or external beam radiotherapy (EBRT) on treatment outcomes. Between 2006 and 2014, 663 patients with prostate cancer were treated with LDR-PB or EBRT at two institutions. Four hundred and seventy-four men received LDR-PB and 189 men received EBRT, without androgen deprivation therapy...
March 25, 2018: Cancer Medicine
A Durán-Rivera, A Montoliu García, J Juan Escudero, P Garrido Abad, M Fernández Arjona, E López Alcina
INTRODUCTION: The treatment of localised prostate cancer seeks to minimise the impact on sexual function and urinary continence. In this respect, therapy with high-intensity focused ultrasound offers important results. We present our experience with this technique in 2 Spanish centres. MATERIAL AND METHODS: We conducted a retrospective review of 75 patients with localised prostate cancer treated with high-intensity focused ultrasound between March 2007 and July 2016...
March 21, 2018: Actas Urologicas Españolas
Thorsten Frenzel, Milena Tienken, Merve Abel, Christoph Berliner, Susanne Klutmann, Dirk Beyersdorff, Rudolf Schwarz, Andreas Krüll, Peter Bannas
PURPOSE: To determine the impact of Gallium-68-labled prostate-specific membrane antigen positron-emission tomography/computed tomography ([68 Ga]PSMA PET/CT) on radiotherapy planning for primary disease, biochemical cancer relapse, and advanced disease of prostate cancer. METHODS: A total of 106 patients with prostate cancer scheduled for radiation therapy underwent 120 [68 Ga]PSMA PET/CT scans prior to radiotherapy treatment. In 20 cases, patients underwent [68 Ga]PSMA PET/CT for primary therapy (PT), 75 cases were referred for biochemical relapse after surgery (RL), and 25 cases were intended for palliative treatment of localized metastases (MD)...
March 23, 2018: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
Rihito Aizawa, Kenji Takayama, Kiyonao Nakamura, Takahiro Inoue, Takashi Kobayashi, Shusuke Akamatsu, Toshinari Yamasaki, Osamu Ogawa, Takashi Mizowaki
BACKGROUND: Although definitive external-beam radiotherapy (EBRT) is one of the treatment options for non-metastatic castration-resistant prostate cancer (NM-CRPC), there are limited data on the long-term outcomes of this treatment. METHODS: We retrospectively evaluated 31 NM-CRPC patients consecutively treated with definitive EBRT. The median age was 74 years upon EBRT initiation. The initial T stage distribution was as follows: T1c in 3, T2 in 11, T3 in 14, and T4 in 3 cases, respectively...
March 19, 2018: International Journal of Clinical Oncology
Kambiz Rahbar, Ali Afshar-Oromieh, Martin Bögemann, Stefan Wagner, Michael Schäfers, Lars Stegger, Matthias Weckesser
PURPOSE: PSMA-targeted PET in patients with prostate cancer (PCa) has a significant impact on treatment decisions. By far the most frequently used PSMA ligand is 68 Ga-labelled PSMA-11. However, due to the availability of larger amounts of activity, 18 F-labelled PSMA ligands are of major interest. The aim of the present study was to evaluate the biodistribution and performance of the novel 18 F-labelled ligand PSMA-1007 at two different time points. METHODS: This retrospective analysis included 40 consecutive patients (mean age 68...
March 14, 2018: European Journal of Nuclear Medicine and Molecular Imaging
T Steuber, C Jilg, P Tennstedt, A De Bruycker, D Tilki, K Decaestecker, T Zilli, B A Jereczek-Fossa, U Wetterauer, A L Grosu, W Schultze-Seemann, H Heinzer, M Graefen, A Morlacco, R J Karnes, P Ost
BACKGROUND: Most prostate cancer (PCa) patients with a biochemical failure following primary multimodality treatment (surgery and postoperative radiotherapy) relapse in the nodes. OBJECTIVE: To perform a matched-case analysis in men with lymph node recurrent PCa comparing standard of care (SOC) with metastasis-directed therapy (MDT). DESIGN, SETTING, AND PARTICIPANTS: PCa patients with a prostate-specific antigen (PSA) progression following multimodality treatment were included in this retrospective multi-institutional analysis...
March 10, 2018: European Urology Focus
Christoph Oing, Pierre Tennstedt, Ronald Simon, Jennifer Volquardsen, Kerstin Borgmann, Carsten Bokemeyer, Cordula Petersen, Ekkehard Dikomey, Kai Rothkamm, Wael Y Mansour
Here we report that BCL2 blocks DNA double strand break (DSB) repair via nonhomologous end-joining (NHEJ), through sequestration of KU80 protein outside the nucleus. We find that this effect is associated with a repair switch to the error-prone PARP1-dependent end-joining (PARP1-EJ). We present in-vitro proof-of-concept for therapeutic targeting of this switch using PARP inhibitor to specifically enhance the radiosensitivity of BCL2-overexpressing cells. Given its erroneous behavior, PARP1-EJ might allow for the accumulation of genetic alterations and tumor progression...
June 1, 2018: Cancer Letters
Alessandro Magli, Eugenia Moretti, Annarita Tullio, Gianluca Giannarini, Fabrizio Tonetto, Mauro Urpis, Margherita Crespi, Claudio Foti, Agnese Prisco, Margherita Polsinelli, Gioacchino De Giorgi, Giulia Bravo, Paolo Scalchi, Marco Trovò
OBJECTIVE: The approach for treating high-risk prostate cancer still presents different unresolved issues. We report the safety and efficacy of a radiation therapy strategy based on the combination of moderate hypofractioned simultaneous integrated boost (SIB) and Image Guidance. MATERIALS AND METHODS: In this phase II trial of patients with high-risk prostate cancer, Image Guided SIB-IMRT plans (Simultaneous Intensity Modulated - Intensity Modulated Radiotherapy) were delivered between 2009 and 2012...
March 8, 2018: Prostate Cancer and Prostatic Diseases
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