Adjuvant or Salvage Radiation Therapy for Prostate Cancer after Prostatectomy: Current Status, Controversies and Perspectives

Terlizzi, Mario; Limkin, Elaine Johanna; Moukasse, Yasmina; Blanchard, Pierre

doi:10.3390/cancers14071688

Cited by 7 publications

(9 citation statements)

References 53 publications

(61 reference statements)

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“…The application of adjuvant treatment modalities or early salvage strategies has been a subject of debate in patients with a high risk of recurrence, such as those with a positive surgical margin and ≥pT3 cancer after radical prostatectomy (31). In this context, the use of estrogen receptor status in combination with other well-studied clinicopathological prognostic markers may help clinicians to select patients with a poor prognosis for adjuvant therapy.…”

Section: Univariate Analysis Multivariate Analysismentioning

confidence: 99%

Prognostic value of estrogen receptors in patients who underwent prostatectomy for non‑metastatic prostate cancer

et al. 2023

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Estrogen receptors in prostate cancer (PCa) are a subject of debate. The aim of the present study was to investigate whether estrogen receptor-α (ERα) and estrogen receptor-β (ERβ) impact the biochemical recurrence (BCR) of non-metastatic PCa after surgery. Following the application of the exclusion criteria, data from 108 patients who underwent laparoscopic radical prostatectomy between January 2011 and December 2019 were retrospectively evaluated. A total of 36 patients with BCR constituted the BCR group. The control group was formed using the Propensity Score Matching (PSM) method with a 1:2 ratio, including parameters with well-studied effects on BCR. The median follow-up time was 74.3 (range, 30-127.5) months in the BCR group and 66.6 (range, 31.5-130) months in the control group. Pathology specimens from the two groups were immunohistochemically stained with ERα and ERβ antibodies. Logistic regression analysis and survival analysis were performed. No differences in clinicopathological characteristics were detected between the two groups. The patients with ERα(-)/ERβ(+) staining results had a significantly fewer BCRs than other patients (P=0.024). In the logistic regression analysis, patients with ERα(-)/ERβ(+) PCa also had a significantly lower risk of recurrence (P= 0.048). In the survival analysis, the 5-year BCR-free survival rate of patients with ERα(-)/ERβ(+) PCa was higher than that of other patients (85.7 vs. 66.1%; P= 0.031). Excluding the effects of well-studied risk factors for recurrence by the PSM method, the present study showed that ERα and ERβ have prognostic value for non-metastatic PCa. The 5-year BCR-free survival rate is significantly higher in patients whose PCa tissue has ERα(-)/ERβ(+) staining results.

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Section: Univariate Analysis Multivariate Analysismentioning

confidence: 99%

Prognostic value of estrogen receptors in patients who underwent prostatectomy for non‑metastatic prostate cancer

et al. 2023

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“…With the use of prostate‐specific antigen (PSA) testing, more prostate cancers can be detected at an early stage, expanding the time window for the patients to receive appropriate treatment. Whole gland radiotherapy and prostatectomy are the two mainstay treatment options 2,3 . The 5‐year survival rate has greatly improved with early diagnosis and treatment.…”

Section: Introductionmentioning

confidence: 99%

“…Whole gland radiotherapy and prostatectomy are the two mainstay treatment options. 2,3 The 5-year survival rate has greatly improved with early diagnosis and treatment. However, there still exists an urgent unmet clinical need to optimize the therapeutic options.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a photodynamic therapy agent using a canine prostate cancer model

et al. 2023

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Background Male dogs can develop spontaneous prostate cancer, which is similar physiologically to human disease. Recently, Tweedle and coworkers have developed an orthotopic canine prostate model allowing implanted tumors and therapeutic agents to be tested in a more translational large animal model. We used the canine model to evaluate prostate‐specific membrane antigen (PSMA)‐targeted gold nanoparticles as a theranostic approach for fluorescence (FL) imaging and photodynamic therapy (PDT) of early stage prostate cancer. Methods Dogs (four in total) were immunosuppressed with a cyclosporine‐based immunosuppressant regimen and their prostate glands were injected with Ace‐1‐hPSMA cells using transabdominal ultrasound (US) guidance. Intraprostatic tumors grew in 4–5 weeks and were monitored by ultrasound (US). When tumors reached an appropriate size, dogs were injected intravenously (iv) with PSMA‐targeted nano agents (AuNPs‐Pc158) and underwent surgery 24 h later to expose the prostate tumors for FL imaging and PDT. Ex vivo FL imaging and histopathological studies were performed to confirm PDT efficacy. Results All dogs had tumor growth in the prostate gland as revealed by US. Twenty‐four hours after injection of PSMA‐targeted nano agents (AuNPs‐Pc158), the tumors were imaged using a Curadel FL imaging device. While normal prostate tissue had minimal fluorescent signal, the prostate tumors had significantly increased FL. PDT was activated by irradiating specific fluorescent tumor areas with laser light (672 nm). PDT bleached the FL signal, while fluorescent signals from the other unexposed tumor tissues were unaffected. Histological analysis of tumors and adjacent prostate revealed that PDT damaged the irradiated areas to a depth of 1–2 mms with the presence of necrosis, hemorrhage, secondary inflammation, and occasional focal thrombosis. The nonirradiated areas showed no visible damages by PDT. Conclusion We have successfully established a PSMA‐expressing canine orthotopic prostate tumor model and used the model to evaluate the PSMA‐targeted nano agents (AuNPs‐Pc158) in the application of FL imaging and PDT. It was demonstrated that the nano agents allowed visualization of the cancer cells and enabled their destruction when they were irradiated with a specific wavelength of light.

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“…Prognostication is ultimately important for determining the timing of salvage treatment. The challenge for clinicians lies in delaying the progression to metastatic disease without over-treating these men [ 23 , 24 ]. Results from the recent RAVES [ 25 ] and RADICALS [ 26 ] trials coupled with older salvage treatment studies [ 27 ] reveal a potential “sweet spot” for early salvage treatment between PSA 0.2 and 0.5 ng/mL for men with BCR post radical prostatectomy (RP).…”

Section: Introductionmentioning

confidence: 99%

PSMA PET-CT Imaging Predicts Treatment Progression in Men with Biochemically Recurrent Prostate Cancer—A Prospective Study of Men with 3 Year Follow Up

Ong

Pascoe

Kelly

et al. 2022

Cancers

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Prostate-specific membrane antigen (PSMA) positron emission tomography-computed tomography (PET-CT) is a novel imaging modality used to stage recurrent prostate cancer. It has the potential to improve prognostication and ultimately guide the timing of treatment for men with recurrent prostate cancer. This study aims to assess the clinical impact of PSMA PET-CT by analyzing its predictive value of treatment progression after 3 years of follow-up. In this prospective cohort study of 100 men, patients received a PSMA PET-CT for restaging of their disease which was used by a multi-disciplinary team to make a treatment decision. The primary endpoint was treatment progression. This was defined as the addition or change of any treatment modalities such as androgen deprivation therapy (ADT), radiation therapy or chemotherapy. The median follow-up time was 36 months (IQR 24–40 months). No treatment progression was found in 72 (75%) men and therefore 24 (25%) patients were found to have treatment progression. In men with a negative PSMA PET-CT result, 5/33 (15.1%) had treatment progression and 28/33 (84.8%) had no treatment progression. In conclusion, clinical decisions made with PSMA PET-CT results led to 75% of men having no treatment progression at 3 years of follow-up. In men with negative PSMA PET-CT results, this increased to 85% of men.

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Adjuvant or Salvage Radiation Therapy for Prostate Cancer after Prostatectomy: Current Status, Controversies and Perspectives

Cited by 7 publications

References 53 publications

Prognostic value of estrogen receptors in patients who underwent prostatectomy for non‑metastatic prostate cancer

Prognostic value of estrogen receptors in patients who underwent prostatectomy for non‑metastatic prostate cancer

Evaluation of a photodynamic therapy agent using a canine prostate cancer model

PSMA PET-CT Imaging Predicts Treatment Progression in Men with Biochemically Recurrent Prostate Cancer—A Prospective Study of Men with 3 Year Follow Up

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