Surgical Treatments of Benign Prostatic Hyperplasia and Prostate Cancer Stereotactic Radiotherapy: Impact on Long-Term Genitourinary Toxicity

Huck, Constance; Achard, Vérane; Zilli, Thomas

doi:10.1016/j.clon.2022.05.021

Cited by 8 publications

(4 citation statements)

References 33 publications

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“…Long-term BPH can also lead to complications such as infection and stone formation, and may even worsen into prostate cancer, posing a further threat to patients' health. The treatment methodologies for BPH mainly include drug therapy and surgical treatment (Ahani et al, 2022;Huck et al, 2022). Commonly utilized drugs currently include α1-adrenergic receptor blockers, 5α-reductase inhibitors, and β3-adrenergic receptor agonists.…”

Section: Discussionmentioning

confidence: 99%

Effect of Lactobacillus rhamnosus GG Supplementation on the Growth Performance, Survival rate and Morphometry of Grass Carp (Ctenopharyngodon idella)

Farooq¹

2023

PJZ

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The objective of this study was to demonstrate the effect of ubiquitin ligase tumor necrosis factor receptorassociated factor 6 (TRAF6) on promoting proliferation (Pro) of prostate transitional zone (TZ) and peripheral zone (PZ) cells by activating the insulin-like growth factor 1-protein kinase/mammalian target of rapamycin (IGF1-Akt/mTOR) signaling, providing a research basis for benign prostatic hyperplasia (BPH) therapy. In vitro proliferative prostate tissue specimens from patients with BPH were collected and classified into PZ and TZ tissues. A TRAF6 interference lentivirus was utilized to measure the expression levels of IGF1 and TRAF6 in the prostatic tissue matrix. The impact of TRAF6 on cell growth in the matrix of TZ and PZ tissues was analyzed, the TRAF6 level in the matrix of TZ and PZ tissues was explored, and its role in the phosphorylation process under growth factor stimulation was demonstrated. IGF1 and TRAF6 levels in the matrix of TZ tissue were superior to those in PZ tissue. After TRAF6 expression was inhibited, the Pro activity of TZ matrix cells slowed down, while after it was enhanced, the Pro activity of PZ matrix cells was dramatically increased. The TRAF6 in the inhibition group of TZ tissue was greatly lower, while that in the enhancement group of PZ tissue was greatly higher. It was concluded that TRAF6 promotes Pro of prostate TZ and PZ cells by activating the IGF1-Akt/mTOR signaling.

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Section: Discussionmentioning

confidence: 99%

Effect of Lactobacillus rhamnosus GG Supplementation on the Growth Performance, Survival rate and Morphometry of Grass Carp (Ctenopharyngodon idella)

Farooq¹

2023

PJZ

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“…Fibroblast proliferation, replacement of elastic tissue and muscle fibers following TURP, combined with radiation-induced intravascular coagulation, extensive tissue degeneration and necrosis, represent the main pathophysiological mechanisms increasing the risk of late GU toxicity [17] , [18] , [19] . Interestingly, in favor of this hypothesis, a linear correlation between the volume of the intraprostatic post-surgical cavity and the occurrence of severe GU toxicity has been observed in the study by Huck et al [12] . Using multiparametric magnetic resonance (MR) imaging to delineate the intraprostatic post-surgical cavity, among the 24 SBRT patients analyzed, the five who developed grade 3 GU toxicities had a mean post-surgical intraprostatic cavity volume of 6.3 cc, six-fold larger than the cavity of patients without severe toxicity (1 cc).…”

Section: Mechanisms Mitigation and Management Of Urinary Toxicity Pos...mentioning

confidence: 94%

“…At least one episode of transient hematuria was observed in more than 50 % of the patients [11] . In another single-institution series of 24 patients with a history of surgery for BPH treated with a 5-fraction SBRT, cumulative late grade 2 and 3 GU toxicities were observed in 8 (33 %) and 4 (16.7 %) patients, respectively [12] . Notably, patients with a prior adenomectomy or multiple TURPs were at a higher risk of developing severe GU toxicities.…”

Section: Prostate Sbrt and Turp: Current Evidencementioning

confidence: 94%

“…Even if the majority of the analyzed studies used SBRT treatments delivering doses between 33.5 Gy and 40 Gy with state of the art daily image-guidance mostly using cone beam computed tomography imaging [8] , [9] , [12] , strict comparison of the results of these studies remains challenging ( Table 1 ). The different time intervals between TURP and SBRT could possibly have impacted the healing capacity of the surgical cavity [14] and different optimization strategies to the urethra could have influenced the development of long-term GU toxicity.…”

Section: Prostate Sbrt and Turp: Current Evidencementioning

confidence: 99%

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Stereotactic body radiation therapy for prostate cancer after surgical treatment of prostatic obstruction: Impact on urinary morbidity and mitigation strategies

Huck,

Achard,

Maitre

et al. 2024

Clinical and Translational Radiation Oncology

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State of the art and future challenges of urethra-sparing stereotactic body radiotherapy for prostate cancer: a systematic review of literature

Le Guevelou,

Bosetti,

Castronovo

et al. 2023

World J Urol

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Purpose Doses delivered to the urethra have been associated with an increased risk to develop long-term urinary toxicity in patients undergoing stereotactic body radiotherapy (SBRT) for prostate cancer (PCa). Aim of the present systematic review is to report on the role of urethra-sparing SBRT (US-SBRT) techniques for prostate cancer, with a focus on outcome and urinary toxicity. Method A systematic review of the literature was performed on the PubMed database on May 2023. Based on the urethra-sparing technique, 13 studies were selected for the analysis and classified in the two following categories: “urethra-steering” SBRT (restriction of hotspots to the urethra) and “urethra dose-reduction” SBRT (dose reduction to urethra below the prescribed dose). Results By limiting the urethra Dmax to 90GyEQD2 (α/β = 3 Gy) with urethra-steering SBRT techniques, late genitourinary (GU) grade 2 toxicity remains mild, ranging between 12.1% and 14%. With dose-reduction strategies decreasing the urethral dose below 70 GyEQD2, the risk of late GU toxicity was further reduced (< 8% at 5 years), while maintaining biochemical relapse-free survival rates up to 93% at 5 years. Conclusion US-SBRT techniques limiting maximum doses to urethra below a 90GyEQD2 (α/β = 3 Gy) threshold result in a low rate of acute and late grade ≥ 2 GU toxicity. A better understanding of clinical factors and anatomical substructures involved in the development of GU toxicity, as well as the development and use of adapted dose constraints, is expected to further reduce the long-term GU toxicity of prostate cancer patients treated with SBRT.

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Surgical Treatments of Benign Prostatic Hyperplasia and Prostate Cancer Stereotactic Radiotherapy: Impact on Long-Term Genitourinary Toxicity

Cited by 8 publications

References 33 publications

Effect of Lactobacillus rhamnosus GG Supplementation on the Growth Performance, Survival rate and Morphometry of Grass Carp (Ctenopharyngodon idella)

Effect of Lactobacillus rhamnosus GG Supplementation on the Growth Performance, Survival rate and Morphometry of Grass Carp (Ctenopharyngodon idella)

Stereotactic body radiation therapy for prostate cancer after surgical treatment of prostatic obstruction: Impact on urinary morbidity and mitigation strategies

State of the art and future challenges of urethra-sparing stereotactic body radiotherapy for prostate cancer: a systematic review of literature

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