The role of brachytherapy in organ preservation for penile cancer: A meta-analysis and review of the literature

Hasan, Shaakir; Francis, Asha; Hagenauer, Andrew; Hirsh, Aaron; Kaminsky, Deborah A.; Traughber, Bryan; Abouassaly, Robert; Ellis, Rodney J.

doi:10.1016/j.brachy.2015.03.008

Cited by 46 publications

(25 citation statements)

References 47 publications

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“…Treatment of primary lesion requires surgery, with organ-sparing procedures now a standard of care whenever feasible and oncologically safe [24,25]. There are also alternatives to surgery, including topical treatments or laser ablation in low-stage and low-grade cases or radiation therapy in cases with small lesions [26][27][28][29]. Lymph node status and management have the strongest impact on patients' survival [22].…”

Section: Penile Cancermentioning

confidence: 99%

TGF-β and microRNA Interplay in Genitourinary Cancers

Bogusławska¹,

Kryst

Poletajew

et al. 2019

Cells

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Genitourinary cancers (GCs) include a large group of different types of tumors localizing to the kidney, bladder, prostate, testis, and penis. Despite highly divergent molecular patterns, most GCs share commonly disturbed signaling pathways that involve the activity of TGF-β (transforming growth factor beta). TGF-β is a pleiotropic cytokine that regulates key cancer-related molecular and cellular processes, including proliferation, migration, invasion, apoptosis, and chemoresistance. The understanding of the mechanisms of TGF-β actions in cancer is hindered by the “TGF-β paradox” in which early stages of cancerogenic process are suppressed by TGF-β while advanced stages are stimulated by its activity. A growing body of evidence suggests that these paradoxical TGF-β actions could result from the interplay with microRNAs: Short, non-coding RNAs that regulate gene expression by binding to target transcripts and inducing mRNA degradation or inhibition of translation. Here, we discuss the current knowledge of TGF-β signaling in GCs. Importantly, TGF-β signaling and microRNA-mediated regulation of gene expression often act in complicated feedback circuits that involve other crucial regulators of cancer progression (e.g., androgen receptor). Furthermore, recently published in vitro and in vivo studies clearly indicate that the interplay between microRNAs and the TGF-β signaling pathway offers new potential treatment options for GC patients.

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Section: Penile Cancermentioning

confidence: 99%

TGF-β and microRNA Interplay in Genitourinary Cancers

Bogusławska¹,

Kryst

Poletajew

et al. 2019

Cells

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“…V několika málo porovnáních chirurgické léčby a RT jsou výsledky chirurgie mírně lepší. V metaanalýze porovnávající chirurgický zákrok a RT bylo 5leté celkové přežití (over all survival -OS) a lokální kontrola (local control -LC) 76 a 84 % pro chirurgickou léčbu a 73 a 79 % pro RT [7]. RT byla spojena se zachováním orgánu v 74 % a nebyl statisticky signifikantní rozdíl v přežití.…”

Section: úVodunclassified

“…Porovnání BT a chirurgické léčby bylo předmětem metaanalýzy Hasana et al [7]. Metaanalýza zahrnovala 2 178 pa cientů, z nichž 1 505 bylo léčeno chirurgicky, 676 BT.…”

Section: Obr 3 Definitivní Nález S Odstupem čAsu Od Brachyterapieunclassified

High-Dose Rate Brachytherapy in the Treatment of Early Stages of Penile Carcinoma

Pohanková¹,

Sirák²,

Kašaová³

et al. 2019

Klin Onkol

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1 Klinika onkologie a radioterapie LF UK a FN Hradec Králové 2 Urologická klinika LF UK a FN Hradec Králové 3 Urologické oddělení, Oblastní nemocnice Náchod Souhrn Východiska: Intersticiální brachyterapie s nízkým dávkovým příkonem je ověřená orgán šetřící léčba T1-T2 karcinomu penisu. Zkušenosti s brachyterapií s vysokým dávkovým příkonem jsou v této indikaci limitované. Materiál a metody: V období 2002-2018 bylo na Klinice onkologie a radioterapie LF UK a FN Hradec Králové léčeno 26 pa cientů s časným stadiem karcinomu penisu brachyterapií s vysokým dávkovým příkonem dávkou 18 × 3 Gy aplikovanou 2× denně.Mammární intersticiální můstek byl použit k fixaci a precizní geometrii brachyterapeutických aplikačních jehel. Výsledky: Medián doby sledování byl 85 měsíců (7 vs. 200 měsíců). Akutní toxicita obvykle spočívala v mukozitidě stupně 2, která zpravidla odezněla do 8 týdnů po léčbě. Lokální recidiva se vyskytla u 6 pa cientů, u 5 z nich byla úspěšně léčena parciální amputací. Jeden pa cient měl uzlinový relaps úspěšně řešený lymfadenektomií. U jednoho pa cienta vznikla postradiační nekróza glandu vyžadující parciální amputaci. V současné době žije 24 pa cientů bez známek onemocnění. Jeden pa cient zemřel na kardiální komorbiditu, jeden na duplicitní karcinom plic. Celkem 19 pa cientů má zachovaný penis (73 %), z toho 18 sexuálně aktivních před léčbou udává plnohodnotný pohlavní styk. Závěr: Brachyterapie s vysokým dávkovým příkonem s dávkou 18 × 3 Gy aplikovaných 2× denně je slibná metoda orgán zachovávající léčby u vybraných pa cientů s karcinomem penisu a zaslouží si zhodnocení ve větší prospektivní studii. Klíčová slovanovotvary penisu -konzervativní léčba -brachyterapie Summary Background: Interstitial low dose rate brachyther apy is established organ spar ing treatment of T1-T2 penile carcinoma. Experience with high-dose rate brachyther apy is limited in this indication. Materials and methods: Twenty-six patients with early penile carcinoma were treated by high-dose rate brachyther apy at dose 18 × 3 Gy per fraction twice daily between 2002-2018 at the Department of Oncology and Radiother apy, University Hospital in Hradec Kralove. Breast interstitial brachyther apy template was used for fixation and precise geometry reconstruction of stainless hollow needles. Results: Median follow up was 85 months (range 7-200 months). Acute reaction usually consisted of grade 2 mucositis that dissolved dur ing 8 weeks after the treatment. Local recurrence occurred in 6 patients, 5 of them were successfully treated with partial amputation. One patient had a nodal recurrence successfully salvaged by lymphadenectomy. One patient developed necrosis of the glans requir ing partial amputation. Currently, there are 24 patients alive without signs of dis ease. One patient died of cardiac comorbidity, one died of duplicate lung cancer. Nineteen patients have a preserved penis (73%), 18 of them sexually active before treatment report satisfactory intercourse. Conclusion: Hyperfractionated interstitial high--dose rate brachyther apy ...

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“…84 As a consequence, patients with favorable primary penile malignancies (in situ, Ta, and select T1 tumors of lower grade) may be suitable candidates to undergo penile-sparing treatment approaches, including topical therapy, wide local excision with primary reapproximation or reconstruction, and penile brachytherapy (at centers with expertise in this area). [85][86][87][88] Prior studies have similarly refuted the previously held belief that 2-cm surgical margins are required to ensure tumor eradication in favor of less than 5-mm margins. The smaller margin is adequate without compromising oncological outcomes and has corroborated the merits of penile sparing surgery in many cases.…”

Section: Clinical Updates In Penile Cancermentioning

confidence: 99%

Pathophysiological basis of human papillomavirus in penile cancer: Key to prevention and delivery of more effective therapies

Spiess

Dhillon

Baumgarten

et al. 2016

CA A Cancer J Clinicians

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Answer questions and earn CME/CNE Squamous cell carcinoma (SCC) of the penis is a rare malignancy in the United States, with a significantly higher incidence-up to 20 to 30 times greater-in areas of Africa and South America. This can be explained in part by the significantly greater prevalence of sexually transmitted diseases among high-risk males often having unprotected sex with multiple sexual partners. Human papillomavirus (HPV) has been implicated as the infectious pathway by which several these penile neoplasms originate from precursor lesions. In this regard, a fundamental understanding of HPV in penile carcinogenesis can have meaningful implications in understanding 1) the diagnosis of HPV-related precursor penile lesions, 2) targeting HPV-specific molecular pathways, and 3) cancer prevention. Using vaccination programs not only may improve patient outcomes but also may minimize the need for highly aggressive and often debilitating surgical resection. CA Cancer J Clin 2016. © 2016 American Cancer Society.

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The role of brachytherapy in organ preservation for penile cancer: A meta-analysis and review of the literature

Cited by 46 publications

References 47 publications

TGF-β and microRNA Interplay in Genitourinary Cancers

TGF-β and microRNA Interplay in Genitourinary Cancers

High-Dose Rate Brachytherapy in the Treatment of Early Stages of Penile Carcinoma

Pathophysiological basis of human papillomavirus in penile cancer: Key to prevention and delivery of more effective therapies

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