The significance of post-irradiation prostate biopsy with long-term follow-up

Kuban, Deborah A.; El‐Mahdi, Anas M.; Schellhammer, Paul F.; Ladaga, Leopold E.

doi:10.1016/0360-3016(91)90572-l

Cited by 11 publications

(12 citation statements)

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“…Normal tissue tolerance has limited the ability to perform doseescalated radiation therapy for the prostate. 1,2 One motivation for increasing doses is the high incidence of positive postradiation prostate biopsies in patients treated with standard doses (70 Gy or less), [3][4][5][6][7] which have correlated with poor biochemical and prostate cancer-specific survival. Additionally, several prospective randomized trials have supported a role for dose escalation in patients with clinically localized cancer.…”

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confidence: 99%

Toxicity Analysis of Dose Escalation From 75.6 Gy to 81.0 Gy in Prostate Cancer

Rossi

Jani

2011

American Journal of Clinical Oncology

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confidence: 99%

Toxicity Analysis of Dose Escalation From 75.6 Gy to 81.0 Gy in Prostate Cancer

Rossi

Jani

2011

American Journal of Clinical Oncology

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“…Prostate biopsy outcome at ≥2 years after radiation therapy is highly prognostic for long-term outcome (22–24). Hence, short-term efficacy was assessed by a 12-core prostate biopsy analysis 2 years after completion of IMRT.…”

Section: Resultsmentioning

confidence: 99%

Prospective Randomized Phase 2 Trial of Intensity Modulated Radiation Therapy With or Without Oncolytic Adenovirus-Mediated Cytotoxic Gene Therapy in Intermediate-Risk Prostate Cancer

Freytag

Stricker

Lü

et al. 2014

International Journal of Radiation Oncology*Biology*Physics

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Purpose To assess the safety and efficacy of combining oncolytic adenovirus-mediated cytotoxic gene therapy (OAMCGT) with intensity modulated radiation therapy (IMRT) in intermediate-risk prostate cancer. Methods and Materials Forty-four men with intermediate-risk prostate cancer were randomly assigned to receive either OAMCGT plus IMRT (arm 1; n=21) or IMRT only (arm 2; n=23). The primary phase 2 endpoint was acute (≤90 days’) toxicity. Secondary endpoints included quality of life (QOL), prostate biopsy (12-core) positivity at 2 years, freedom from biochemical/clinical failure (FFF), freedom from metastases, and survival. Results Men in arm 1 exhibited a greater incidence of low-grade influenza-like symptoms, transaminitis, neutropenia, and thrombocytopenia than men in arm 2. There were no significant differences in gastrointestinal or genitourinary events or QOL between the two arms. Two-year prostate biopsies were obtained from 37 men (84%). Thirty-three percent of men in arm 1 were biopsy-positive versus 58% in arm 2, representing a 42% relative reduction in biopsy positivity in the investigational arm (P=.13). There was a 60% relative reduction in biopsy positivity in the investigational arm in men with <50% positive biopsy cores at baseline (P=.07). To date, 1 patient in each arm exhibited biochemical failure (arm 1, 4.8%; arm 2, 4.3%). No patient developed hormone-refractory or metastatic disease, and none has died from prostate cancer. Conclusions Combining OAMCGT with IMRT does not exacerbate the most common side effects of prostate radiation therapy and suggests a clinically meaningful reduction in positive biopsy results at 2 years in men with intermediate-risk prostate cancer.

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“…What is known is that positive postirradiation biopsies have been associated with clinical and PSA recurrence in most patients. 7,[12][13][14] Prostate specific antigen has become a more reliable indicator of disease progression. In addition, it has been shown to be the best predictor of biologically active tumor in positive biopsy cases.…”

Section: Discussionmentioning

confidence: 99%

“…Before the PSA era, biopsies were shown to correlate well with clinical recurrence and survival. 7 Although the use of PSA has provided powerful information in predicting clinical recurrence and, perhaps, has replaced biopsy as a method of assessing response, posttreatment prostate biopsies can still provide important information concerning residual or recurrent local disease. An analysis of posttreatment prostate biopsies after permanent radioactive seed prostate implantation was undertaken to test the effect of pretreatment disease parameters such as PSA, Gleason score, and classification as well as treatment-related factors such as the use of hormonal therapy (HT) and implant dose on biopsy results.…”

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confidence: 99%