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Radionuclide-based Diagnosis and Therapy of Prostate Cancer
Published in Michael Ljungberg, Handbook of Nuclear Medicine and Molecular Imaging for Physicists, 2022
Sven-Erik Strand, Mohamed Altai, Joanna Strand, David Ulmert
Localized PCa is treated with surgery and/or EBRT. For those patients having advanced androgen sensitive disease, the standard treatment is usually different forms of androgen deprivation therapy. If the disease progresses to castration-resistant PCa (CRPC), the prognosis becomes poor, with an expected survival of less than 19 months for patients with metastases. Commonly, CRPC is treated with the continuation of androgen deprivation, chemotherapy, and EBRT. When the tumour progresses to a lethal form, there are no effective long-term treatments.
Therapeutic Options for Prostate Cancer: A Contemporary Update
Published in Surinder K. Batra, Moorthy P. Ponnusamy, Gene Regulation and Therapeutics for Cancer, 2021
Sakthivel Muniyan, Jawed A. Siddiqui, Surinder K. Batra
Androgen deprivation is achieved by either surgical (bilateral orchiectomy) or chemical castration (systemic administration). The goal of the ADT is to reduce the circulating androgens to the level of 20–50 ng/dl, which prevents the nourishment of proliferative PCa cells [35, 36]. Orchiectomy was a primary androgen deprivation strategy and was received well in the clinic until the advent of GnRH targeting agents. Castration will bring down the circulating testosterone into the castrate level within 24 hours of the therapy and is permanent. One caveat is that not all the patient population are eligible for surgery (Radical Prostatectomy (RP)) due to other age-related comorbidities. In 1960, Veterans Administration Cooperative Urologic Research Group (VACURG) randomized a trial to compare the efficacy of surgical castration and diethylstilbestrol (DES) [37]. This trial resulted in showing that high-dose diethylstilbestrol (DES) is as effective as ADT, and it opened an alternative option for orchiectomy [37].
Imaging and Principles of Uro-Radiology
Published in Manit Arya, Taimur T. Shah, Jas S. Kalsi, Herman S. Fernando, Iqbal S. Shergill, Asif Muneer, Hashim U. Ahmed, MCQs for the FRCS(Urol) and Postgraduate Urology Examinations, 2020
Anuj Goyal, Beth Hickerton, Rebecca Tregunna
Which of the following statements in relation to dual energy X-ray absorptiometry (DEXA) scans is CORRECT?An initial DEXA T-score of below −2.5 is considered low risk and no further scanning is required in patients receiving ADT for prostate cancer.An initial DEXA T-score between −1 and −2.5 is classified as intermediate risk in patients receiving ADT for prostate cancer and requires further DEXA scans every year.Risk of sustaining a bone fracture after five years of androgen deprivation therapy is 50%.DEXA scans are whole body scans and are safe in pregnancy.A DEXA scan requires approximately 90 minutes scan time.
Stereotactic Ablative Radiation Therapy in 3 Fractions Induces a Favorable Systemic Immune Cell Profiling in Prostate Cancer Patients
Published in OncoImmunology, 2023
Belinda Palermo, Marta Bottero, Mariangela Panetta, Adriana Faiella, Isabella Sperduti, Serena Masi, Giuseppe Frisullo, Maria Laura Foddai, Iole Cordone, Paola Nisticò, Giuseppe Sanguineti
This prospective study was conducted at a single Institution between February 2019 and May 2021 (Clinicaltrials.gov NCT04774133). The study was approved by the Institutional Review Board (RS1163/18). Eligibility criteria were: histologically confirmed PCa undergoing RT, age >18 years. Exclusion criteria were: previous malignancies, chemotherapy, autoimmune and hematological disease in leukemic phase. All accrued patients were treated according to our Institutional guidelines/ongoing research protocol: SBRT (40 Gy/3 fractions (FRX); Group-1); definitive moderately hypofractionationated RT (62 Gy/20FRX; Group-2); post-operative conventionally fractionated RT (66–69 Gy/30FRX; Group-3). Target volumes were: prostate only (Group-1), prostate + seminal vesicles (SV) (Group-2), prostate bed + pelvic lymph nodes (Group-3), including bilateral internal, external and common iliac lymph nodes as well as pre-sacral lymph nodes. Androgen deprivation (AD) was prescribed to selected patients. RT was delivered as follow: SBRT, every other day; definitive moderately hypofractionationated RT, four days per week; conventionally fractionated RT, five days per week.
Utilizing clinical, pathological and radiological information to guide postoperative radiotherapy in prostate cancer
Published in Expert Review of Anticancer Therapy, 2023
Jerusha Padayachee, Simone Chaudhary, Brian Shim, Jonathan so, Remy Lim, Srinivas Raman
There is ongoing interest to explore means to further optimize the outcomes of salvage radiotherapy through dose escalation, inclusion of pelvic nodal volumes, and use of systemic therapy. In particular, recent publications provide support for use of androgen deprivation treatment. Further clarification is required, though, around the identification of a subgroup of patients who would benefit more from ADT use, as well as the recommended total duration of ADT. The SPPORT trial showed that 6 months ADT was preferred over no ADT. Preliminary results from RADICALS-HD suggest that patients with multiple high risk factors serve better with long course ADT. Trials to date have placed emphasis on clinicopathological features to guide therapy decisions, including T-stage, grade, and pre-SRT PSA. An area that is garnering interest is the use of genomic classifiers. In particular, multiple studies have demonstrated the prognostic utility of the Decipher tool. Its potential application appears to be multifaceted; including aiding in decisions on ADT use, as well the utilization of adjuvant radiotherapy. Prospective randomized clinical trials primarily designed to evaluate the application of GC in the postoperative setting appear to be lacking and is a worthwhile consideration moving forward to more robustly validate its clinical application and to better support individualized treatment strategies.
Inhibitory effect of roburic acid in combination with docetaxel on human prostate cancer cells
Published in Journal of Enzyme Inhibition and Medicinal Chemistry, 2022
Xiao Wang, Xu Xuetao, Mengshuo Wu, Panpan Wu, Zhaojun Sheng, Wenfeng Liu, Yan-Yan Ma, Den-Gao Zhao, Kun Zhang, Dongli Li, Xi Zheng, Susan Goodin
Prostate cancer is the most prevalent male urogenital malignancy and the second leading cause of cancer death in US men1. Risk factors including advancing age, race, geographical distribution, diet and family history are contributing to the incidence of this disease2,3. For the treatment options of prostate cancer, early stages of the disease can be managed with active surveillance, radical prostatectomy, or radiation therapy. Patients who are not suitable for surgical intervention can be treated with androgen deprivation4. However, prostate cancer cells lose their hormone dependence and therapeutic responsiveness during disease progression5,6. When the disease progresses to the hormone-refractory stage (also referred to as androgen-independent), chemotherapy is the only option left for these patients7,8.