International journal of radiation oncology, biology, physics
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Int. J. Radiat. Oncol. Biol. Phys. · Jan 2004
Influence of hormonal therapy on late rectal function after permanent prostate brachytherapy with or without supplemental external beam radiotherapy.
Recent clinical studies have reported a relationship between the use of hormonal therapy and degradation in rectal function after external beam radiotherapy. Using a patient-administered quality-of-life instrument, we evaluated the effect of hormonal therapy on late rectal function after permanent prostate brachytherapy with or without supplemental external beam radiotherapy. ⋯ After permanent prostate brachytherapy, no statistically significant difference in bowel habits was discerned when stratified by hormonal status. In addition, only 12% of brachytherapy patients reported deterioration in bowel function after implantation.
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Int. J. Radiat. Oncol. Biol. Phys. · Jan 2004
Short-term androgen deprivation and PSA doubling time: their association and relationship to disease progression after radiation therapy for prostate cancer.
The goal of this study was to investigate the relationship between PSA doubling time (PSADT) and initial management of prostate cancer with short-term androgen deprivation (STAD) and the impact of these factors on disease progression after radiation therapy. ⋯ Longer TTBF, Gleason Score 2-6 tumors, and STAD were predictive of longer PSADT. Even after adjusting for these factors in the capacity of their predictive properties for PSADT, STAD and observed PSADT continued to be significant independent predictors of FDM, CSS, and OS. STAD appears to have a pronounced impact on disease progression, probably the result partly of the prolongation of PSADT.
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Int. J. Radiat. Oncol. Biol. Phys. · Jan 2004
Perineural invasion is associated with increased relapse after external beam radiotherapy for men with low-risk prostate cancer and may be a marker for occult, high-grade cancer.
To investigate the risk of postradiotherapy prostate-specific antigen (PSA) failure on the basis of pretreatment risk factors in prostate cancer patients with and without perineural invasion (PNI) in prostate biopsy specimens and to explain the observation that otherwise low-risk patients with PNI experience decreased freedom from PSA failure after external beam radiotherapy (RT). ⋯ A decrement in PSA outcome after RT for low-risk patients with PNI-positive biopsy specimens was found. The association between PNI and high Gleason score provides a possible explanation for the loss of statistical significance of PNI in the Cox regression multivariate analysis of the high-risk cohort. The data suggest that PNI found in the biopsy specimen of an otherwise low-risk patient predicts for occult high-grade disease that is missed owing to the sampling error associated with prostate biopsy. The association between PNI and a high Gleason score argues for the use of more aggressive therapy, such as hormonal therapy with RT and/or dose escalation, in these select patients.