The aim of this study was to investigate whether it was necessary to increase the number of cores at initial prostate biopsy with patients of prostate-specific antigen （PSA） ≥ 20 ng/mL and to explore an appropriate...The aim of this study was to investigate whether it was necessary to increase the number of cores at initial prostate biopsy with patients of prostate-specific antigen （PSA） ≥ 20 ng/mL and to explore an appropriate individualized transrectal ultrasonograhpy （TRUS）-guided prostate biopsy for the detection of prostate cancer in men suspicious of prostate cancer. Methods： A total of 115 patients with PSA ≥ 20 ng/mL and suspicious of prostate cancer were prospectively randomized to perform TRUS-guided biopsy. Patients were randomized to a ＂6 ＋ X＂ cores or a ＂10 ＋ X＂ cores protocol. The primary end point was cancer detection rate. Secondary end points were cancer characteristics, rate of complications and the level of pain experienced by patients during TRUS-guided prostate biopsy. Results： Preoperative variables were similar in both groups. The overall prostate cancer detection rate was 73.9%. The ＂10 ＋ X＂ cores strategy increased cancer detection rate only 9.7% in patients with PSA ≥ 20 ng/mL but 〈 50 ng/mL, while there was no difference between the two strategies for cancer detection in patients with PSA ≥ 50.1 ng/mL. The number of extended biopsy cores and pain score of extended biopsy in prostate cancer patients increased significantly （P 〈 0.001）. Conclusion： Our findings suggest that there is no significant advantage in using extended biopsy protocol in all patients with PSA≥20 ng/mL.展开更多
Palliative radiotherapy(pRT) is primarily employed for palliation of bone pain in patients with castrate-resistant prostate cancer(CRPC). However, evidence that p RT influences prostate-specific antigen response in pa...Palliative radiotherapy(pRT) is primarily employed for palliation of bone pain in patients with castrate-resistant prostate cancer(CRPC). However, evidence that p RT influences prostate-specific antigen response in patients with CRPC on systemic therapy is lacking. We describe three cases of CRPC progressing after treatment with docetaxel(n=2) and abiraterone(n=1), who responded unusually after p RT for bone pain with the development of a significant biochemical response and restoration of response to systemic therapy. The possibility of p RT influencing metastatic disease in CRPC has not been previously reported, and raises the possibility of radiation-induced modulation of anti-tumor immune response mechanisms that may play a role in the restoration of response to systemic treatment.展开更多
基金Supported by Pudong New Area Medical Health System Outstanding Young Talent Training Plan(No.PWRq2013-17)Pudong New District Zhoupu Hospital of Shanghai(No.ZP-XM-2012B-22)
文摘The aim of this study was to investigate whether it was necessary to increase the number of cores at initial prostate biopsy with patients of prostate-specific antigen （PSA） ≥ 20 ng/mL and to explore an appropriate individualized transrectal ultrasonograhpy （TRUS）-guided prostate biopsy for the detection of prostate cancer in men suspicious of prostate cancer. Methods： A total of 115 patients with PSA ≥ 20 ng/mL and suspicious of prostate cancer were prospectively randomized to perform TRUS-guided biopsy. Patients were randomized to a ＂6 ＋ X＂ cores or a ＂10 ＋ X＂ cores protocol. The primary end point was cancer detection rate. Secondary end points were cancer characteristics, rate of complications and the level of pain experienced by patients during TRUS-guided prostate biopsy. Results： Preoperative variables were similar in both groups. The overall prostate cancer detection rate was 73.9%. The ＂10 ＋ X＂ cores strategy increased cancer detection rate only 9.7% in patients with PSA ≥ 20 ng/mL but 〈 50 ng/mL, while there was no difference between the two strategies for cancer detection in patients with PSA ≥ 50.1 ng/mL. The number of extended biopsy cores and pain score of extended biopsy in prostate cancer patients increased significantly （P 〈 0.001）. Conclusion： Our findings suggest that there is no significant advantage in using extended biopsy protocol in all patients with PSA≥20 ng/mL.
文摘Palliative radiotherapy(pRT) is primarily employed for palliation of bone pain in patients with castrate-resistant prostate cancer(CRPC). However, evidence that p RT influences prostate-specific antigen response in patients with CRPC on systemic therapy is lacking. We describe three cases of CRPC progressing after treatment with docetaxel(n=2) and abiraterone(n=1), who responded unusually after p RT for bone pain with the development of a significant biochemical response and restoration of response to systemic therapy. The possibility of p RT influencing metastatic disease in CRPC has not been previously reported, and raises the possibility of radiation-induced modulation of anti-tumor immune response mechanisms that may play a role in the restoration of response to systemic treatment.
