A B S T R A C T PurposeHot flashes occur in approximately 80% of androgen-deprived men. Few intervention studies have been conducted to relieve hot flashes in men.
Patients and MethodsEligible androgen-deprived men were randomly assigned to one of four daily regimens (2 ϫ 2 factorial design) for 12 weeks: milk protein powder and placebo pill, venlafaxine and milk protein powder, soy protein powder and placebo pill, or venlafaxine and soy protein powder. The primary end point was hot flash symptom severity score (HFSSS), defined as number of hot flashes times severity. The secondary end point was quality of life (QoL), assessed by using the Functional Assessment of Cancer Therapy-Prostate.
ResultsIn all, 120 men age 46 to 91 years participated. Most were white (78%) and overweight or obese (83%). Toxicity was minimal. Neither venlafaxine nor soy protein alone or in combination had a significant effect on HFSSS. Soy protein, but not venlafaxine, improved measures of QoL.
ConclusionIn androgen-deprived men, neither venlafaxine nor soy proved effective in reducing hot flashes. Interventions that appear effective for decreasing hot flashes in women may not always turn out to be effective in men.
Our institution has used 3-dimensional conformal radiation therapy (3DCRT) to deliver whole breast irradiation (WBI) in the prone position since 1998 in order to address technical difficulties associated with treating large, pendulous breasts and/or large body habitus, and/or in patients with left-sided cancers to decrease radiation received by the heart. The goal of this study was to review our updated experience using prone breast WBI to determine whether the recurrence rates and survival patterns are acceptable in this set of patients. Materials/Methods: From 1998-2013, 397 women treated with breast conserving surgery underwent WBI in the prone position using 3DCRT. Patients were treated with a median of 50 Gy to the breast volume +/-a boost of 10 Gy to the lumpectomy planning target volume. All patients had >12 month follow-up. Results: Median follow-up was 43.6 mo. The median age was 59 (27-91); 67% were post-menopausal. Median BMI was 32.4 (18.6-64.6). Tumors were Tis-19.8%, T1-61.5%, T2-17.2%, T3-1.5%, and 3.3% had positive axillary nodes. Eight (2%) patients were diagnosed with an ipsilateral breast tumor (5-yr recurrence rateZ1.9%). Mean time to recurrence was 57.5 mo (19-127 mo). The original tumors were DCIS (2), infiltrating lobular (3), and invasive ductal (3). Focal DCIS margin was <2mm in 3 patients. The original tumor location and location of recurrence respectively was: lower outer quadrant (LOQ)-failed in UOQ, UIQ-failed in UIQ (2), central-failed central, UOQ-failed UOQ, LOQ-failed LOQ, UOQfailed LIQ, and UOQ-failed in skin and with distant metastases. Ipsilateral disease free survival was 97.6% at 5 yr. Distant metastasis free survival was 98.4% at 5 yr. Overall survival was 95.5% at 5 yr. Conclusion: In patients with large pendulous breasts, increased BMI and/ or left-sided tumors, delivering WBI in the prone position using 3DCRT results in recurrence rates and failure patterns similar to those anticipated using supine WBI. This series adds to the growing literature demonstrating prone WBI provides local control rates comparable to supine WBI with minimal toxicity to organs at risk.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.