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BACKGROUND:Success rates with salvage radiotherapy (SRT) in men who have a postprostatectomy biochemical relapse are suboptimal. One treatment‐intensification strategy includes elective irradiation of the pelvic lymph nodes with whole pelvis radiotherapy (WPRT).
METHODS:An inter‐institutional retrospective cohort study compared outcomes for patients who received SRT at 2 separate academic institutions...
BACKGROUND.Two recent chemoprevention trials demonstrated significant reductions in overall prostate cancer incidence. However, a possible increase in high‐grade disease has raised concerns that the harms of the drugs, including mortality because of high‐grade disease, may outweigh the benefits. The authors attempted to estimate the effect of these drugs on prostate cancer mortality to be able to...
BACKGROUND.Androgen‐deprivation therapy (ADT) causes bone loss and fractures. Guidelines recommend bone density testing before and during ADT to characterize fracture risk. The authors of the current report assessed bone density testing among men who received ADT for ≥ 1 year.
METHODS.Surveillance, Epidemiology, and End Results/Medicare data were used to identify 28,960 men aged > 65 years with...
BACKGROUND:Randomized trials have demonstrated that escalated‐dose external‐beam radiotherapy (EDRT) is better than standard‐dose radiotherapy (SDRT) for patients with prostate cancer and that adding androgen‐deprivation therapy (ADT) to SDRT is better than SDRT alone; however, no trials have compared EDRT versus SDRT plus ADT or EDRT versus EDRT plus ADT. The authors designed a model to estimate...
BACKGROUND.The objective of this study was to report the rates of disease‐free survival (DFS), cause‐specific survival (CSS), and overall survival after low‐dose‐rate (LDR) prostate brachytherapy (PB).
METHODS.Data from 1006 consecutive patients with prostate cancer who received LDR‐PB and underwent implantation on or before October 23, 2003 were extracted from a prospective database on November...
BACKGROUND:Recent studies have suggested differing toxicity patterns for patients with prostate cancer who receive treatment with 3‐dimensional conformal radiotherapy (3DCRT), intensity‐modulated radiotherapy (IMRT), or proton beam therapy (PBT).
METHODS:The authors reviewed patient‐reported outcomes data collected prospectively using validated instruments that assessed bowel and urinary quality...
BACKGROUND:Randomized trials have demonstrated improved survival when hormonal therapy (HT) is added to radiation therapy (RT) for high‐risk prostate cancer. However, it is still unknown whether men who have a history of myocardial infarction (MI) or MI risk factors achieve a superior outcome from HT.
METHODS:A Markov decision analysis model was used to compare quality‐adjusted life expectancy (QALE)...
BACKGROUNDThe objective of this study was to assess the impact of a prostate‐specific antigen (PSA) complete response (PSA‐CR), measured at the end of external‐beam radiotherapy and short‐term hormone therapy, on treatment outcomes.
METHODSThe phase 3 Radiation Therapy Oncology Group 9413 trial, as part of its original protocol, used the assessment of PSA‐CR (ie, PSA ≤0.3 ng/mL) at the end of short‐term...
BACKGROUNDFollow‐through of a positive screening test is necessary to reap the potential benefits of cancer screening. Racial variation in follow‐through diagnostic care may underlie a proportion of the known disparity in prostate cancer mortality. The authors used data from the screening arm of the Prostate, Lung, Colorectal, and Ovarian (PLCO) cancer screening trial to determine whether race is...
BACKGROUNDAfrican Americans have a higher incidence of prostate cancer and experience poorer outcomes compared with Caucasian Americans. Racial differences in care are well documented; however, few studies have characterized patients based on their prostate cancer risk category, which is required to differentiate appropriate from inappropriate guideline application.
METHODSThe medical records of...
BACKGROUNDTimely delivery of care has been identified by the Institute of Medicine as an indicator for quality health care, and treatment delay is a potentially modifiable obstacle that can contribute to the disparities among African American (AA) and Caucasian patients in prostate cancer recurrence and mortality. Using the Surveillance, Epidemiologic and End Results (SEER)‐Medicare linked database,...
BACKGROUNDPreviously, the patient‐reported Total Illness Burden Index for Prostate Cancer (TIBI‐CaP) questionnaire and/or the physician‐reported Charlson Comorbidity Index (CCI) have provided assessments of competing comorbidity during treatment decisions for patients with prostate cancer. In the current study, the authors used these assessments to determine comorbidity and prognosis before prostate...
BACKGROUNDThe objective of this study was to examine the effect of tobacco use on disease control and late gastrointestinal and genitourinary toxicity in men undergoing external beam radiotherapy (EBRT) for prostate cancer.
METHODSIn total, 633 men with known tobacco history at consultation underwent definitive EBRT between 1988 and 2008. Tobacco use was defined as positive (current or prior) or...
BACKGROUNDThe Prostate Cancer Prevention Trial (PCPT) Risk Calculator is a widely used prediction tool for aiding decisions about biopsy for prostate cancer. This study hypothesized that recently reported differences between predictions from the model and findings from other cohorts were due to how prostate‐specific antigen (PSA) was entered into the statistical model, and to the inclusion of protocol...
BACKGROUNDPatients diagnosed with prostate cancer are often counseled about treatment options with the use of terms that are part of the “core vocabulary” of prostate cancer. It is hypothesized that predominantly lower literacy patients would demonstrate a severe lack of comprehension of prostate cancer terms, thus validating the findings of a previous single‐institution study.
METHODSA previously...
BACKGROUNDβ‐emitting bone‐seeking radiopharmaceuticals have historically been administered for pain palliation whereas docetaxel prolongs life in patients with metastatic castration‐resistant prostate cancer (mCRPC). In combination, these agents simultaneously target the bone stroma and cancer cell to optimize antitumor effects. The toxicity and efficacy when each agent is combined at full, recommended...
BACKGROUNDStudies suggest that low levels of vitamin D may be associated with prostate cancer, and darker skin reduces the body's ability to generate vitamin D from sunshine. The impact of sunshine on racial disparities in prostate cancer incidence and mortality is unknown.
METHODSUsing the Surveillance, Epidemiology, and End Results program database, the authors calculated age‐adjusted prostate...
BACKGROUNDOptimal management remains unknown following prostate‐specific antigen (PSA) failure when considering comorbidity and PSA kinetics at recurrence. In order to define randomized controlled trials (RCTs) that can address this issue, this study examined factors associated with the risk of death following PSA failure.
METHODSOf 206 men randomized to RT with or without 6 months of androgen suppression...
BACKGROUNDThe presence of Gleason pattern 5 (GP5) at radical prostatectomy (RP) has been associated with worse clinical outcome; however, this pathologic variable has not been assessed in patients receiving salvage radiation therapy (SRT) after a rising prostate‐specific antigen level.
METHODSA total of 575 patients who underwent primary RP for localized prostate cancer and subsequently received...
BACKGROUNDMen with high‐risk prostate cancer are often thought to have very poor outcomes in terms of disease control and survival even after definitive treatment. However, results after external beam radiotherapy have improved significantly through dose escalation and the use of androgen deprivation therapy (ADT). This report describes long‐term findings after low‐dose (< 75.6 Gy) or high‐dose...
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