Prostatic carcinosarcoma 15 years after combined external beam radiation and brachytherapy for prostatic adenocarcinoma: a case report

Tseng, Timothy Y.; Sevilla, Deborah W.; Moul, Judd W.; Maloney, Kelly E.

doi:10.1038/sj.pcan.4500870

Cited by 14 publications

(6 citation statements)

References 11 publications

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“…Since most prostate cancer-related deaths are due to metastases (9–11) it is of pivotal importance to understand how therapeutic intervention can influence metastatic development of irradiated cancer cells. Furthermore, cases of radiation-induced metastasis in prostate cancer patients have been reported (74–77). Since clinical trials, using optimized settings for carbon ion treatment, have shown high survival rates and good local control (8,12–15), carbon ion irradiation has been approved as a valid treatment for prostate cancers (8).…”

Section: Discussionmentioning

confidence: 99%

Carbon ion irradiation of the human prostate cancer cell line PC3: A whole genome microarray study

Suetens

Moreels

Quintens

et al. 2014

International Journal of Oncology

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Hadrontherapy is a form of external radiation therapy, which uses beams of charged particles such as carbon ions. Compared to conventional radiotherapy with photons, the main advantage of carbon ion therapy is the precise dose localization along with an increased biological effectiveness. The first results obtained from prostate cancer patients treated with carbon ion therapy showed good local tumor control and survival rates. In view of this advanced treatment modality we investigated the effects of irradiation with different beam qualities on gene expression changes in the PC3 prostate adenocarcinoma cell line. For this purpose, PC3 cells were irradiated with various doses (0.0, 0.5 and 2.0 Gy) of carbon ions (LET=33.7 keV/μm) at the beam of the Grand Accélérateur National d’Ions Lourds (Caen, France). Comparative experiments with X-rays were performed at the Belgian Nuclear Research Centre. Genome-wide gene expression was analyzed using microarrays. Our results show a downregulation in many genes involved in cell cycle and cell organization processes after 2.0 Gy irradiation. This effect was more pronounced after carbon ion irradiation compared with X-rays. Furthermore, we found a significant downregulation of many genes related to cell motility. Several of these changes were confirmed using qPCR. In addition, recurrence-free survival analysis of prostate cancer patients based on one of these motility genes (FN1) revealed that patients with low expression levels had a prolonged recurrence-free survival time, indicating that this gene may be a potential prognostic biomarker for prostate cancer. Understanding how different radiation qualities affect the cellular behavior of prostate cancer cells is important to improve the clinical outcome of cancer radiation therapy.

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Section: Discussionmentioning

confidence: 99%

Carbon ion irradiation of the human prostate cancer cell line PC3: A whole genome microarray study

Suetens

Moreels

Quintens

et al. 2014

International Journal of Oncology

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“…Although the majority of cases have occurred after external beam radiotherapy [3, 16], only two previous cases of radiation-induced prostatic sarcoma after permanent brachytherapy are known [17, 18]. The latent periods were 8 and 9 years, and total RTx doses were 270 and 145 Gy, respectively.…”

Section: Discussionmentioning

confidence: 99%

Radiation-Induced Leiomyosarcoma of the Prostate after Brachytherapy for Prostatic Adenocarcinoma

Horiguchi¹,

Takada²,

Kamihara³

et al. 2014

Case Rep Oncol

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Radiation therapy (RTx) has been employed as a curative therapy for prostatic adenocarcinoma. RTx-induced sarcomas (RISs) are rare, late adverse events, representing less than 0.2% of all irradiated patients. RISs are more aggressive tumors than prostatic adenocarcinomas. Herein, we present a case with RTx-induced prostatic leiomyosarcoma after permanent brachytherapy for prostatic adenocarcinoma. A 69-year-old male presented with dysuria and gross hematuria. Six years previously, he had been diagnosed with localized prostate cancer and was treated by permanent brachytherapy. Urethroscopy showed stenosis by a tumor at the prostate. Transurethral prostatectomy was performed for a diagnosis. Based on pathological findings, the diagnosis was leiomyosarcoma of the prostate. He was treated with three cycles of neoadjuvant chemotherapy (CTx) that consisted of doxorubicin and ifosfamide (AI), followed by a prostatocystectomy with intrapelvic lymphadenectomy. The tumor extended from the prostate and infiltrated the bladder wall and serosa with lymphatic and venous invasion. The surgical margin was negative, and no residual prostatic adenocarcinoma was observed. The proportion of necrotic tumor cells by neoadjuvant CTx was around 50%. Subsequently, adjuvant CTx was offered, but the patient chose a follow-up without CTx. Local recurrence and lung metastasis were detected by computed tomography 3 months after the surgery. He was treated again with AI. However, CTx was not effective and he died 6 months after the operation. In conclusion, an effective treatment strategy for prostatic sarcoma should be developed in the near future, although the clinical feature of prostatic sarcoma remains unclear due to its rare incidence.

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“…Current practice pattern may be also contributed to current finding. It was reported 50% of carcinosarcoma of the prostate cases were found in case of prostate adenocarcinoma previously treated with hormone or radiation therapy [4,7,24,25]. Re-biopsies are seldom performed in patients with prostate cancer, due to the perception that the re-biopsy of these patients in the face of known prostate cancer is not warranted, especially in the case of elderly patients with advance stage disease.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Radical Prostatectomy on the Survival of Patients with Carcinosarcoma of the Prostate

Wang¹,

Wang²

2011

JCT

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Prostatic carcinosarcoma 15 years after combined external beam radiation and brachytherapy for prostatic adenocarcinoma: a case report

Cited by 14 publications

References 11 publications

Carbon ion irradiation of the human prostate cancer cell line PC3: A whole genome microarray study

Carbon ion irradiation of the human prostate cancer cell line PC3: A whole genome microarray study

Radiation-Induced Leiomyosarcoma of the Prostate after Brachytherapy for Prostatic Adenocarcinoma

The Impact of Radical Prostatectomy on the Survival of Patients with Carcinosarcoma of the Prostate

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