Increased risk of disease progression in younger men: Analysis of factors predicting biochemical failure and castration-resistant prostate cancer after high-dose intensity-modulated radiation therapy for nonmetastatic prostate cancer

Aizawa, Rihito; Takayama, Kenji; Nakamura, Kiyonao; Inoue, Takahiro; Yamasaki, Toshinari; Kobayashi, Takashi; Akamatsu, Shusuke; Ogawa, Osamu; Mizowaki, Takashi

doi:10.1016/j.urolonc.2020.09.026

Cited by 4 publications

(2 citation statements)

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“…Multivariable analysis (MVA) using Fine and Gray's regression model was performed to evaluate the impact of the presence of IDC‐P on BF. Along with the presence of IDC‐P, the following reported predictive factors were included as covariates: GG (continuous), iPSA (>20 vs. ≤20 ng/ml), clinical T stage (T3–4 vs. T1–2), rate of positive core (continuous), and age at the initiation of IMRT (continuous) 13 . Due to the small number of events of PCa‐specific mortality, CF, or CRPC, MVA was conducted only for BF.…”

Section: Methodsmentioning

confidence: 99%

“…Along with the presence of IDC-P, the following reported predictive factors were included as covariates: GG (continuous), iPSA (>20 vs. ≤20 ng/ml), clinical T stage (T3-4 vs. T1-2), rate of positive core (continuous), and age at the initiation of IMRT (continuous). 13 Due to the small number of events of PCa-specific mortality, CF, or CRPC, MVA was conducted only for BF. Prior to MVA for BF, we performed TA B L E 1 Patients and treatment characteristics of the entire cohort and the cohorts stratified by the presence of IDC-P Spearman's rank-order correlation between the presence of IDC-P and GG (continuous) to eliminate the risk of multicollinearity in MVA.…”

Section: Statistical Analysesmentioning

confidence: 99%

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Clinical significance of IDC‐P as predictive factor after intensity‐modulated radiation therapy

et al. 2022

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The clinical significance of intraductal carcinoma of the prostate (IDC‐P) in men with nonmetastatic prostate cancer (PCa) treated with high‐dose external‐beam radiation therapy remains unclear. The aim of this study was to evaluate the impact of IDC‐P in men who received intensity‐modulated radiation therapy (IMRT) for nonmetastatic PCa. All patients with high‐risk (H‐R) and very high–risk (VH‐R) PCa who received IMRT between September 2000 and December 2013 at our institution were analyzed retrospectively. We re‐reviewed biopsy cores for the presence of IDC‐P. Treatment consisted of IMRT (median: 78 Gy at 2 Gy per fraction) plus 6‐month neoadjuvant hormonal therapy (HT). In total, 154 consecutive patients with H‐R and VH‐R PCa were analyzed. Intraductal carcinoma of the prostate was present in 27.9% (n = 43). The median follow‐up period was 8.4 years. The 10‐year PCa‐specific survival, biochemical failure (BF), clinical failure, and castration‐resistant PCa rates were 90.0%, 47.8%, 27.5%, and 24.5% in patients with IDC‐P, and 96.6%, 32.6%, 10.8%, and 7.0% in those without IDC‐P, respectively (p = 0.12, 0.04, 0.0031, and 0.012, respectively). In multivariable analysis, IDC‐P was not identified as an independent predictive factor for BF (p = 0.26). The presence of IDC‐P was correlated with a significantly higher incidence of disease progression in men with H‐R and VH‐R PCa who received IMRT, although it was not identified as an independent predictive factor for BF. Further investigations are needed to determine the significance of IDC‐P as an independent predictive factor for survival outcomes.

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Section: Methodsmentioning

confidence: 99%

Section: Statistical Analysesmentioning

confidence: 99%

Clinical significance of IDC‐P as predictive factor after intensity‐modulated radiation therapy

et al. 2022

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Long-term safety of high-dose whole pelvic IMRT for high-risk localized prostate cancer through 10-year follow-up

et al. 2021

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Background:The aim of this study was to evaluate the long-term efficacy and safety of whole pelvic intensity-modulated radiation therapy with a simultaneous-integrated boost (WP-SIB-IMRT) for locally advanced prostate cancer (LAPCa). Methods:All patients with cT3-4N0M0 prostate cancer treated with WP-SIB-IMRT between February 2006 and September 2009 at our institution were analyzed retrospectively. The prescribed dose was 78 Gy to the prostate and 58.5 Gy to the prophylactic pelvic lymph nodal area in 39 fractions delivered using the simultaneous-integrated boost technique.All patients received short-term neoadjuvant androgen-deprivation therapy alone (median: 8.3 months). Propensity-score matching (PSM) analysis was performed to evaluate the additional benefit of prophylactic whole pelvic radiation therapy (WPRT), using the cohort of 203 LAPCa patients treated with prostate-only IMRT (PO-IMRT).

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Management of prostate cancer in older patients

Narita

Sakamoto

Kato³

et al. 2022

Japanese Journal of Clinical Oncology

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The incidence of prostate cancer among older men has increased in many countries, including Asian countries. However, older patients are ineligible for inclusion in large randomized trials, and the existing guidelines for the management of patients with prostate cancer do not provide specific treatment recommendations for older men. Therefore, generation of evidence for older patients with prostate cancer is a key imperative. The International Society of Geriatric Oncology has produced and updated several guidelines for management of prostate cancer in older men since 2010. Regarding localized prostate cancer, both surgery and radiotherapy are considered as feasible treatment options for intermediate- and high-risk prostate cancer even in older men, whereas watchful waiting and active surveillance are useful options for a proportion of these patients. With regard to advanced disease, androgen-receptor axis targets and taxane chemotherapy are standard treatment modalities, although dose modification and prevention of adverse events need to be considered. Management strategy for older patients with prostate cancer should take cognizance of not only the chronological age but also psychological and physical condition, socio-economic status and patient preferences. Geriatric assessment and patient-reported health-related quality of life are important tools for assessing health status of older patients with prostate cancer; however, there is a paucity of evidence of the impact of these tools on the clinical outcomes. Personalized management according to the patient’s health status and tumour characteristics as well as socio-economic condition may be necessary for treatment of older patients with prostate cancer.

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Increased risk of disease progression in younger men: Analysis of factors predicting biochemical failure and castration-resistant prostate cancer after high-dose intensity-modulated radiation therapy for nonmetastatic prostate cancer

Cited by 4 publications

References 23 publications

Clinical significance of IDC‐P as predictive factor after intensity‐modulated radiation therapy

Clinical significance of IDC‐P as predictive factor after intensity‐modulated radiation therapy

Long-term safety of high-dose whole pelvic IMRT for high-risk localized prostate cancer through 10-year follow-up

Management of prostate cancer in older patients

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