The Histology of Radiation Therapy Effect on Prostate Adenocarcinoma as Assessed by Needle Biopsy After Brachytherapy Boost: Correlation With Biochemical Failure

Abstract

A b s t r a c t Brachytherapy boost with external radiation therapy (RT) allows safer delivery to the prostate than conventional techniques. We measured the degree of radiation effect of adenocarcinoma cells in post-Radiation therapy (RT) is a standard treatment option for clinically localized prostate adenocarcinoma. Long-term local control depends on tumor stage, Gleason score, pretreatment serum prostate-specific antigen (PSA) level, and the dose and method of radiation delivery. W1 One potential reason that treatment for some patients fails locally after definitive RT is that the prostate received an insufficient radiation dose. To improve on results achieved with conventional external beam RT, there is an ongoing effort to develop methods that increase the amount of RT dose delivered to the prostate without increasing RT-related adverse effects to adjacent organs. Brachytherapy, which consists of temporary or permanent implantation of radioactive seeds into the prostate, is one method that has been used to increase the intraprostatic dose. In the present study, a temporary high-dose rate (HDR) brachytherapy boost was used in addition to external pelvic RT for patients with prostate adenocarcinoma.Post-RT biopsy specimens are useful in evaluating the ability of RT to eliminate adenocarcinoma. Patients rarely develop local recurrences if the post-RT biopsy is devoid of carcinoma. -212 Earlier studies found that a high percentage of patients with adenocarcinoma in the post-RT biopsy developed recurrences, metastases, or biochemical failure, especially if the biopsy was performed because of an abnormal digital rectal examination or a rising serum PSA level. 13-29Recent studies have shown that not all patients with adenocarcinoma on a prospectively planned, routine post-RT biopsy develop biochemical failure, suggesting that some of these adenocarcinomas have been made biologically inert. 1212 -30 Recently, Crook et al 1 devised an RT-effect score for post-RT prostate adenocarcinoma. They suggested that patients with adenocarcinoma in the post-RT biopsy specimen who were unlikely to develop biochemical failure had a marked RT effect in the adenocarcinoma cells.

p53, p21 and mdm2 expression vs the response to radiotherapy in transitional cell carcinoma of the bladder

“…The histological evaluation of radioresponsiveness has been successfully applied in prostate cancer specimens [18]. We used the same principles for scoring the radiotherapy effect in the present series of bladder tumours.…”

Dose Escalation Improves Cancer-Related Events at 10 Years for Intermediate- and High-Risk Prostate Cancer Patients Treated With Hypofractionated High-Dose-Rate Boost and External Beam Radiotherapy

“…All patients underwent a prostate biopsy obtained by TRUS guidance. Pathology analyses of biopsy tissue as well as assignment of Gleason scores were performed at WBH by a single pathologist (18). Radioisotope bone scans and computed tomography scans of the abdomen and pelvis were also performed.…”

“…Stage migration or selection imbalances could account for the difference. The potential for changes in pathology interpretation over time were removed, since all cases were uniformly reviewed by the same pathologist (18), and, as such, Gleason score changes did not occur. Given this, all patients were clinically staged, and similar imaging studies were used for them during our study.…”

Prostate‐specific membrane antigen (PSMA) protein expression in normal and neoplastic tissues and its sensitivity and specificity in prostate adenocarcinoma: an immunohistochemical study using mutiple tumour tissue microarray technique

“…8 Others have shown that they might be reduced in expression in some treated cases. 10 In those situations, prostate-specific membrane antigen (PSMA), a new commercially available antibody with proven utility in the diagnosis of PaC, could be very helpful. [11][12][13][14][15][16] PSMA is a membrane-bound glycoprotein that functions as folate hydrolase with high specificity for benign and malignant prostatic tissue.…”