Prostate cancer news reports: Tuesday, July 21, 2009

In today’s news reports we comment on studies dealing with:

  • PSA level, body mass index, risk, and outcomes
  • External beam radiotherapy in treatment of Japanese patients
  • An endorectal balloon to prevent anal/rectal side effects of radiation?
  • The optimal period of neoadjuvant hormone therapy prior to radiation therapy

Bañez et al. have reported on a multi-institutional, retrospective analysis of data from 11,705 men who underwent radical prostatectomy between 1988 and 2007. They found no significant difference in the ability of of PSA levels to accurately predict either adverse pathological features or biochemical failure across increasing body mass index (BMI) categories. Sasaki et al. have reported data on the outcomes of patients with regionally localized prostate cancer patients treated with hormone therapy (HT) and external beam radiotherapy (EBRT) in Japan between 1996 and 2001 in a “patterns of care” study. The study encompassed 140 patients treated at 117 different institutions. The median age of the patients was 74 years, and their tumors were defined as well (n = 14), moderately (n = 51) or poorly (n = 54) differentiated, or of unknown differentiation (n = 21). Ninety-five patients had clinical T3-4 disease; 28 had regional lymph node metastases before treatment. The median PSA levels before the initial HT and before RT were 35.0 and 10.0 ng/mL, respectively. At a median follow-up of 20.7 months, the 5-year overall and clinical progression-free survival rates were 48.1 and 36.7 percent, respectively. Although there were distant metastases in 46 patients, only six had local progression. This study would appear to suggest that, at the time the patients were being treated, many Japanese prostate cancer patients were still being diagnosed with more advanced forms of prostate cancer. Smeenk et al. have suggested the possibility of using an endorectal balloon as a means to lower the risk of anal/rectal side effects of radiation of the prostate. No clinical trial data are available at this time, and the acceptability of the procedure to patients may also be an issue. Data from a study by Langenhuijsen et al. suggest that the optimal duration of neoadjuvant hormone therapy as a means to reduce the size of the prostate prior to radiation therapy in men with localized or locally advanced prostate cancer is 6 months, with 3 months being sufficient for men with smaller prostates (< 60 ml).

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