Long-Term Outcome of High Dose Intensity Modulated Radiation Therapy for Patients With Clinically Localized Prostate Cancer

Zeléfsky, Michael J.; Chan, Heather; Hunt, Margie; Yamada, Yoshiya; Shippy, Alison M.; Amols, Howard

doi:10.1016/j.juro.2006.06.002

Cited by 420 publications

(277 citation statements)

References 16 publications

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“…The 5-and 8-year prostate cancer recurrence free survival (PRFS) for those taking a statin medication were 89% (95% CI=85%-92%) and 80% (95% CI=72%-86%), compared with 83% (95% CI=81%-85%) and 74% (95% CI=71% (38,39). A reduction in metastatic spread has the potential to improve patient quality of life, and consequently, the therapeutic window in radiation therapy.…”

Section: Resultsmentioning

confidence: 99%

Clinical Potential of Statins in Prostate Cancer Radiation Therapy

Hutchinson

Marignol

2017

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Abstract. Background The management of prostate cancer is a significant healthcare challenge. Many treatment options exist (1-3), with radiation therapy playing a prominent role. However, the morbidity and cost of treatment are not trivial (4, 5). Although risk classification schemes (6) and nomograms (7) attempt to identify men most likely to benefit from treatment, it remains difficult to balance the risks of disease progression against competing risks of mortality (8). This has resulted in controversy over prostate-specific antigen (PSA) screening (9, 10) and possible overtreatment leading to a decreased quality of life (5, 11). Therefore, it is of great interest to conduct research into cancer prevention strategies (12), identification of men who will benefit most from treatment, and effective therapies that limit treatment-related morbidity of prostate cancer.Statins or 3-hydroxyl-3-methylglutaryl-coenzyme A (HMGCoA) reductase inhibitors are widely used medications for hypercholesterolaemia. The demographics of prostate cancer and hypercholesterolaemia overlap. The prevalence of statin use in this older men population is high-approximately 24 million Americans in 2003-2004 (13). Thus, many prostate cancer patients are likely to have already been prescribed statins at the time of their cancer diagnosis and treatment.Initial interest in the use of statins in prostate cancer stemmed from epidemiological studies that investigated their chemopreventive properties. Two large case-control series reported a 50%-65% reduction in overall prostate cancer risk among statin users compared with non-users (14, 15

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Section: Resultsmentioning

confidence: 99%

Clinical Potential of Statins in Prostate Cancer Radiation Therapy

Hutchinson

Marignol

2017

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“…Recent results from the largest study so far of 561 men with prostate cancer treated with 15 MV IMRT (dMLC) show that, to date, none of the men developed secondary cancers as a result of the radiation therapy, after a median follow-up period of seven years [48]. This review shows no consistent dose difference between MLC based IMRT and conventional radiotherapy in the non-target tissue ( Figure 5), nor in the whole body dose (Figures 9 and 10).…”

Section: Discussionmentioning

confidence: 99%

A review of the impact of photon and proton external beam radiotherapy treatment modalities on the dose distribution in field and out-of-field; implications for the long-term morbidity of cancer survivors

Palm

Johansson

2007

Acta Oncologica

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“…The radiation techniques used for EBRT 10 and brachytherapy 11,12 have been previously described in detail. Briefly, patients treated with EBRT received a dose of 81 to 86.4 Gy in 1.8-Gy fractions using 15-MV photons.…”

Section: Treatmentmentioning

confidence: 99%

Long-term Impact of Androgen Deprivation Therapy on Cardiovascular Morbidity after Radiotherapy for Clinically Localized Prostate Cancer

Steinberger

Pei

Zhang

et al. 2014

International Journal of Radiation Oncology*Biology*Physics

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OBJECTIVE-To characterize the impact of androgen-deprivation therapy (ADT) on the incidence of cardiovascular events (CE) in prostate cancer patients treated with radiotherapy (RT).METHODS-2211 patients with localized prostate cancer were treated with RT from 1988-2008 at our institution. 991 patients (44.8%) received ADT at the time of RT for a median of 6.1 months. Salvage ADT was initiated prior to CE in 365 men (16.5%) at a median of 5.5 years (range, 0.6 to 18.4 years) after RT and continued for a median of 4.3 years. A nomogram was constructed to predict the 10-year risk of CE post-RT.RESULTS-Patients receiving ADT at the time of RT exhibited significantly higher 10-year incidence of CE (19.6%, 95% CI 17.0-22.6%) than those not receiving ADT (14.3%, 95% CI 12.2%-16.7%, P = .005). On multivariate analysis, both ADT at the time of RT (P= .007) and the time of salvage (P = .0004) were associated with increased CE risk, as were advanced age (P = . 02), smoking (P = .0007), history of diabetes (P = .0007), and history of CE before RT (P < . 0001). A nomogram using patient age, smoking status, history of pre-RT CE, history of diabetes, and ADT use at the time of RT predicted the rate of 10-year CE with a C-index of 0.81 (95% CI, 0.72-0.88).CONCLUSION-While ADT is often an essential part of prostate-cancer treatment, patients should be counseled regarding increased risks of CE and prophylactic efforts should be considered to mitigate that risk.

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Long-Term Outcome of High Dose Intensity Modulated Radiation Therapy for Patients With Clinically Localized Prostate Cancer

Cited by 420 publications

References 16 publications

Clinical Potential of Statins in Prostate Cancer Radiation Therapy

Clinical Potential of Statins in Prostate Cancer Radiation Therapy

A review of the impact of photon and proton external beam radiotherapy treatment modalities on the dose distribution in field and out-of-field; implications for the long-term morbidity of cancer survivors

Long-term Impact of Androgen Deprivation Therapy on Cardiovascular Morbidity after Radiotherapy for Clinically Localized Prostate Cancer

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