Systemic Therapies for Non-Metastatic Prostate Cancer: Review of the Literature

Jereczek‐Fossa, Barbara Alicja; Curigliano, Giuseppe; Orecchia, Roberto

doi:10.1159/000215713

Cited by 6 publications

(3 citation statements)

References 31 publications

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“…Needle biopsy confirmed nodular hyperplasia with focal chronic inflammation. focal prostate uptake is detected in PET/CT of cancer patients, further evaluation and treatment choice will be based on the severity of the underlying cancer, general condition, comorbidities, age and patient preference [37].…”

Section: Discussionmentioning

confidence: 99%

Significance of incidental focal uptake in prostate on 18-fluoro-2-deoxyglucose positron emission tomography CT images

Han

Choi²,

Yoo³

et al. 2010

BJR

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To evaluate the clinical significance of incidental focal prostate fluorodeoxyglucose (FDG) uptake, we reviewed 18-F-FDG positron emission tomography (PET)/CT scans from 2003 to 2007 and selected cases with focal FDG uptake in prostate. Cases of known prostate cancer were excluded. The maximum standardised uptake value (SUV(max)), site (central or peripheral) and pattern (discrete or ill-defined) of FDG uptake, calcification (present or absent) and prostate volume (<30 or ≥30 cc) were recorded. The PET/CT findings were correlated with serum prostate-specific antigen (PSA) levels, imaging studies, clinical follow-up and biopsy. Of a total of 5119 cases, 63 (1.2%) demonstrated focal FDG uptake in prostate. Eight cases were lost to follow-up. Among the 55 cases with follow-up, malignancy was confirmed by biopsy in 3 (5.4%). The three malignant cases had SUV(max) values of 3.3, 3.6 and 2.3, and all were noted in the peripheral portion of prostate; two of these cases had a discrete FDG uptake pattern, none had calcification corresponding to the FDG uptake area and one had a prostatic volume greater than 30 cc. The mean SUV(max) of 52 benign cases was 3.2 ± 1.7 and focal FDG uptake was noted in the peripheral portion in 34 (65%), 20 (38%) cases showed a discrete FDG uptake pattern, 35 (67%) were accompanied by calcification and 32 (62%) had a prostatic volume greater than 30 cc. The majority of cases demonstrating focal FDG uptake in prostate were benign and no PET/CT finding could reliably differentiate benign from malignant lesions; however, when discrete focal FDG uptake without coincidental calcification is seen, particularly in the peripheral zone of the prostate, further clinical evaluation is recommended.

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Section: Discussionmentioning

confidence: 99%

Significance of incidental focal uptake in prostate on 18-fluoro-2-deoxyglucose positron emission tomography CT images

Han

Choi²,

Yoo³

et al. 2010

BJR

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“…Acute and late GI and GU toxicities were tolerable without severe late side effects. Further research is necessary to assess definitive late toxicity and tumor control outcomes as well as the role of systemic therapy [30] in this setting.…”

Section: Discussionmentioning

confidence: 99%

Image-Guided Radiation Therapy Based on Helical Tomotherapy in Prostate Cancer: Minimizing Toxicity

Acevedo-Henao

Guerra²,

Matute³

et al. 2014

Oncol Res Treat

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Background: We report the clinical results and prognostic factors of image-guided radiation therapy (RT) with helical tomotherapy (HT) for localized and recurrent prostate cancer (PC). Patients and Methods: We evaluated 70 patients with PC (primary diagnosis, n = 48; adjuvant, n = 5; salvage, n = 17) treated with HT from May 2006 through January 2011. The dose prescribed to the prostate/surgical bed ranged between 60 and 78 Gy. Potential risk factors for genitourinary (GU) and gastrointestinal (GI) toxicity were assessed. Results: The median age was 68 years (range 51-87 years). The median follow-up was 37 months (range 3-74 months). The rates of acute grade 2 GI and GU toxicities were 10 and 13%, respectively. Only 1 patient experienced acute grade 3 GU toxicity. The rates of late grade ≥ 2 GI and GU toxicities were 1% each. Multivariate analysis showed an association between rectum mean dose > median (39 Gy) and bladder median dose > median (46 Gy) with a higher grade of acute GI (p = 0.017) and GU (p = 0.019) toxicity, respectively. Additionally, older age was associated with late GU toxicity (p = 0.026). Conclusion: Toxicity with HT is low and is associated with higher median/mean doses in organs at risk as well as with older age. A prospective validation would be necessary to confirm these results.

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“…To add to the number of possible choices, newer treatments such as robotic assisted surgery, internal brachytherapy, intensity modulated external beam radiation therapy, and the combined use of hormonal agents with radiation have all become available for the treatment of prostate cancer. [17][18][19] Even as the number of treatment options continues to expand, systematic reviews of treatment options have failed to determine a clear advantage of any single treatment. 19 Patients and providers are faced with a lack of clear guidelines regarding which treatment option offers the best long-term disease-free or survival benefit, and they often choose treatments based on potential side effects.…”

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confidence: 99%

Historical Prostate Cancer Screening and Treatment Outcomes from a Single Institution

Cross

Ritter

Reding

2012

Clinical Medicine & Research

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Objective: To quantify outcomes of individuals diagnosed and treated for prostate cancer in a single institution. Design: Retrospective electronic chart abstraction.Setting: Marshfield Clinic, the largest private multispecialty group practice in Wisconsin, and one of the largest in the United States, provides health care services annually to approximately 385,000 unique patients through 1.8 million annual patient encounters.Participants: Individuals within the Marshfield Clinic cancer registry who had been diagnosed with prostate cancer between 1960 and 2009. Methods:Electronic chart abstraction from the cancer registry and the electronic medical record was conducted (N=6,181). Data abstracted included age at diagnosis; stage and grade of tumor; prostate specific antigen (PSA) values before, at, and after diagnosis; initial cancer treatment; follow-up time; subsequent cancer treatments; evidence of metastasis; age of death; and cause of death, if known. Results:The average age of prostate cancer diagnosis has decreased from 70-71 years in the 1960's and 1970's to an average age at diagnosis of 67 years in the 2000's (P<0.001). This decrease in age occurred within the decades of implementation of PSA screening. Approximately 74% of men diagnosed with prostate cancer within the PSA screening era had at least one PSA test, and the presence of a PSA test did not appear to change treatment outcome. Age, grade, and stage were the biggest predictors of prostate cancer outcome. There was no difference in event-free survival between current treatment types (radical prostatectomy, brachytherapy, photon treatment, or intensity-modulated radiation therapy) (2003 or later) when stratified by age (greater than 85%, 5-year event-free survival P=0.85); however, more events occurred with older external beam radiation treatment regimens (1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)) (70% to 75%, 5-year event-free survival P=0.001).Conclusion: Individuals diagnosed and treated for prostate cancer within the Marshfield Clinic comprehensive care setting follow national trends with a decreased age of diagnosis since the advent of PSA screening. Outcomes for individuals treated within the Clinic system are also comparable to national trends.

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Systemic Therapies for Non-Metastatic Prostate Cancer: Review of the Literature

Cited by 6 publications

References 31 publications

Significance of incidental focal uptake in prostate on 18-fluoro-2-deoxyglucose positron emission tomography CT images

Significance of incidental focal uptake in prostate on 18-fluoro-2-deoxyglucose positron emission tomography CT images

Image-Guided Radiation Therapy Based on Helical Tomotherapy in Prostate Cancer: Minimizing Toxicity

Historical Prostate Cancer Screening and Treatment Outcomes from a Single Institution

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