Association of Bone Metastatic Burden With Survival Benefit From Prostate Radiotherapy in Patients With Newly Diagnosed Metastatic Prostate Cancer

Ali, Adnan; Hoyle, Alex; Haran, Áine; Brawley, Christopher D.; Cook, Adrian; Amos, Claire; Calvert, Joanna; Douis, Hassan; Mason, Malcolm David; Dearnaley, David P.; Attard, Gerhardt; Gillessen, Silke; Parmar, Mahesh; Parker, Christopher; Sydes, Matthew R.; James, Nicholas D.

doi:10.1001/jamaoncol.2020.7857

Cited by 84 publications

(63 citation statements)

References 24 publications

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“…These numbers are supported by other reports covering the same period for Danish and international cohorts [8][9][10][11][12][13]. Survival rates are likely to have improved since then [14][15][16], but bone metastasis remains an incurable condition. Contributing to the poor prognosis are the consequences of bone metastases such as anemia, increased susceptibility to infection, life-threatening hypercalcemia, spinal cord compression, severe pain, fatigue, increased risk of skeletal fractures, and decreased mobility [17][18][19][20].…”

Section: Introductionsupporting

confidence: 66%

Osteosarcoma and Metastasis Associated Bone Degradation—A Tale of Osteoclast and Malignant Cell Cooperativity

Nørregaard

Jürgensen

Gårdsvoll

et al. 2021

IJMS

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Cancer-induced bone degradation is part of the pathological process associated with both primary bone cancers, such as osteosarcoma, and bone metastases originating from, e.g., breast, prostate, and colon carcinomas. Typically, this includes a cancer-dependent hijacking of processes also occurring during physiological bone remodeling, including osteoclast-mediated disruption of the inorganic bone component and collagenolysis. Extensive research has revealed the significance of osteoclast-mediated bone resorption throughout the course of disease for both primary and secondary bone cancer. Nevertheless, cancer cells representing both primary bone cancer and bone metastasis have also been implicated directly in bone degradation. We will present and discuss observations on the contribution of osteoclasts and cancer cells in cancer-associated bone degradation and reciprocal modulatory actions between these cells. The focus of this review is osteosarcoma, but we will also include relevant observations from studies of bone metastasis. Additionally, we propose a model for cancer-associated bone degradation that involves a collaboration between osteoclasts and cancer cells and in which both cell types may directly participate in the degradation process.

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Section: Introductionsupporting

confidence: 66%

Osteosarcoma and Metastasis Associated Bone Degradation—A Tale of Osteoclast and Malignant Cell Cooperativity

Nørregaard

Jürgensen

Gårdsvoll

et al. 2021

IJMS

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“…Aa survival benefit was found in favor of primary prostate radiotherapy in men with ≤3 metastases (HR 0.68, 95% CI 0.52-0.90, p=0.0098). A secondary analysis of this trial demonstrated a significant survival benefit in patients with lymph node only metastases (HR 0.60, 95% CI 0.33-1.09) as well as a failure-free survival benefit beyond 4 bone metastases up to 8 bone metastases (93). Overall, these are encouraging results but need to be further evaluated prospectively, particularly with new imaging modalities.…”

Section: Advances In Radiotherapy Techniques Treatment Deliverymentioning

confidence: 81%

Current State of Personalized Genitourinary Cancer Radiotherapy in the Era of Precision Medicine

Kamran

Efstathiou

2021

Front. Oncol.

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Radiation therapy plays a crucial role for the management of genitourinary malignancies, with technological advancements that have led to improvements in outcomes and decrease in treatment toxicities. However, better risk-stratification and identification of patients for appropriate treatments is necessary. Recent advancements in imaging and novel genomic techniques can provide additional individualized tumor and patient information to further inform and guide treatment decisions for genitourinary cancer patients. In addition, the development and use of targeted molecular therapies based on tumor biology can result in individualized treatment recommendations. In this review, we discuss the advances in precision oncology techniques along with current applications for personalized genitourinary cancer management. We also highlight the opportunities and challenges when applying precision medicine principles to the field of radiation oncology. The identification, development and validation of biomarkers has the potential to personalize radiation therapy for genitourinary malignancies so that we may improve treatment outcomes, decrease radiation-specific toxicities, and lead to better long-term quality of life for GU cancer survivors.

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“…13 14 Randomised trials of patients with distant metastases of prostate cancer showed that additional radiation therapy to the primary lesion resulted in better overall survival and failure-free survival in patients with low metastatic burden. 15 However, patient selection in such cases with DTC has not been established. Brierley and Sherman advocated that patients with uncontrolled cervical lesions are good candidates for high-dose radiation therapy because these patients may survive longer, despite metastatic DTC.…”

Section: Discussionmentioning

confidence: 99%

Case of papillary thyroid cancer presenting with an inoperable cervical mass successfully treated with high-dose radiation therapy

et al. 2021

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External-beam radiation therapy (EBRT) for differentiated thyroid cancer has been controversial. Palliative irradiation is usually recommended for patients with treatment-resistant relapse and/or distant metastases, but high-dose EBRT is not often indicated in this situation. A 50-year-old man had treatment-resistant recurrence of an inoperable cervical mass and multiple lung metastases after total thyroidectomy and neck dissection. Because the patient had good performance status and no other life-threatening metastases, he received high-dose intensity-modulated radiation therapy (IMRT). Remarkably, the tumour shrank during treatment. After 3 months, he had bleeding from the internal carotid artery. The bleeding was outside the high-dose irradiation site and was likely due to infection; emergency interventional radiology was performed. The post-EBRT clinical course was favourable and the cervical mass almost disappeared. The patient remained alive for 3 years post treatment. It is possible to extend the indication of high-dose intensity-IMRT in selected patients with differentiated thyroid cancer.

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Association of Bone Metastatic Burden With Survival Benefit From Prostate Radiotherapy in Patients With Newly Diagnosed Metastatic Prostate Cancer

Abstract: This exploratory analysis of a randomized clinical trial evaluates the association of bone metastasis count and location with survival benefit from prostate radiotherapy in patients with newly diagnosed metastatic prostate cancer.

Cited by 84 publications

References 24 publications

Osteosarcoma and Metastasis Associated Bone Degradation—A Tale of Osteoclast and Malignant Cell Cooperativity

Osteosarcoma and Metastasis Associated Bone Degradation—A Tale of Osteoclast and Malignant Cell Cooperativity

Current State of Personalized Genitourinary Cancer Radiotherapy in the Era of Precision Medicine

Case of papillary thyroid cancer presenting with an inoperable cervical mass successfully treated with high-dose radiation therapy

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