• Title/Summary/Keyword: Level 3 PSA

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Abiraterone for Treatment of Metastatic Castration-resistant Prostate Cancer: a Systematic Review and Meta-analysis

  • Zhou, Zhi-Rui;Liu, Shi-Xin;Zhang, Tian-Song;Xia, Jun;Li, Bo
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.3
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    • pp.1313-1320
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    • 2014
  • Introduction: Although most prostate cancers initially respond to castration with luteinizing hormonereleasing analogues or bilateral orchiectomy, progression eventually occurs. Based on the exciting results of several randomized controlled trials (RCTs), it seems that patients with metastatic castration-resistant prostate cancer (mCRPC) might benefit more from treatment withabiraterone. Therefore we conducted a systematic review to evaluate the efficacy and toxicity of abiraterone in the treatment of mCRPC. Methods: Literature was searched from Embase, PubMed, Web of Science, and Cochrane Library up to July, 2013. Quality of the study was evaluated according to the Cochrane's risk of bias of randomized controlled trial (RCT) tool, then the Grading of Recommendations Assessment, Development and Evaluation (GRADE) System was used to rate the level of evidence. Stata 12.0 was used for statistical analysis. Summary data from RCTs comparing abiraterone plus prednisone versus placebo plus prednisone for mCRPC were meta-analyzed. Pooled hazard ratios (HRs) for overall survival (OS), radiographic progression-free survival (RPFS) and time to PSA progression (TTPP); Pooled risk ratios (RR) for PSA response rate, objective response rate and adverse event were calculated. Results: Ten trials were included in the systematic review; Data of 2,283 patients (1,343 abiraterone; 940 placebo) from two phase 3 trials: COU-AA-301 and COU-AA-302 were meta-analyzed. Compared with placebo, abiraterone significantly prolonged OS (HR, 0.74; 95% confidence interval [CI], 0.66 to 0.84), RPFS (HR, 0.59; 95% CI, 0.48 to 0.74) and time to PSA progression (HR, 0.55; 95% CI, 0.43 to 0.70); it also significantly increased PSA response rate (RR, 3.63; 95% CI, 1.72 to 7.65) and objective response rate (RR, 3.05; 95% CI, 1.51 to 6.15). This meta-analysis suggested that the adverse events caused by abiraterone are acceptable and can be controlled. Conclutios: Abiraterone significantly prolonged OS, RPFS and time to progression patients with mCRPC, regardless of prior chemotherapy or whether chemotherapy-na$\ddot{i}$ve, and no unexpected toxicity was evident. Abiraterone can serve as a new standard therapy for mCRPC.

Prognostic significance of lymphovascular invasion in patients with prostate cancer treated with postoperative radiotherapy

  • Jeong, Jae-Uk;Nam, Taek-Keun;Song, Ju-Young;Yoon, Mee Sun;Ahn, Sung-Ja;Chung, Woong-Ki;Cho, Ick Joon;Kim, Yong-Hyub;Cho, Shin Haeng;Jung, Seung Il;Kwon, Dong Deuk
    • Radiation Oncology Journal
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    • v.37 no.3
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    • pp.215-223
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    • 2019
  • Purpose: To determine prognostic significance of lymphovascular invasion (LVI) in prostate cancer patients who underwent adjuvant or salvage postoperative radiotherapy (PORT) after radical prostatectomy (RP) Materials and Methods: A total of 168 patients with prostate cancer received PORT after RP, with a follow-up of ≥12 months. Biochemical failure after PORT was defined as prostate-specific antigen (PSA) ≥0.2 ng/mL after PORT or initiation of androgen deprivation therapy (ADT) for increasing PSA levels regardless of the value. We analyzed the clinical outcomes including survivals, failure patterns, and prognostic factors affecting the outcomes. Results: In total, 120 patients (71.4%) received salvage PORT after PSA levels were >0.2 ng/mL or owing to clinical failure. The 5-year biochemical failure-free survival (BCFFS), clinical failure-free survival (CFFS), distant metastasis-free survival (DMFS), overall survival, and cause-specific survival rates were 78.3%, 94.3%, 95.0%, 95.8%, and 97.3%, respectively, during a follow-up range of 12-157 months (median: 64 months) after PORT. On multivariate analysis, PSA level of ≤1.0 ng/mL at the time of receiving PORT predicted favorable BCFFS, CFFS, and DMFS. LVI predicted worse CFFS (p = 0.004) and DMFS (p = 0.015). Concurrent and/or adjuvant ADT resulted in favorable prognosis for BCFFS (p < 0.001) and CFFS (p = 0.017). Conclusion: For patients with adverse pathologic findings, PORT should be initiated as early as possible after continence recovery after RP. Even after administering PORT, LVI was an unfavorable predictive factor, and further intensive adjuvant therapy should be considered for these patients.

Overexpression of HER-2/neu in Patients with Prostatic Adenocarcinoma

  • Zahir, Shokouh Taghipour;Tafti, Hamid Fallah;Rahmani, Koorosh
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.15
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    • pp.6425-6428
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    • 2014
  • Background: Prostatic adenocarcinoma is one of the main causes of cancer death, and its timely diagnosis and preventing its progression dramatically helps improve life indexes. Given the high disease recurrence rate, today, research is more inclined toward exploring causes of recurrence and development, and innovation of modern treatment methods. Several studies have explored over-expression of human epidermal growth factor receptor 2 (HER-2/neu) in prostatic cancer so far, with different results. Thus, it was decided to investigate HER-2/neu overexpression in patients with prostatic adenocarcinoma in Iran. Materials and Methods: A sample size of 40 patients with prostate cancer entered the study, using a cross-sectional, non-randomized sampling method. Parameters studied included patient age at surgery, Gleason score, serum prostatic specific antigen (PSA) before surgery, and positive sample rate after immunohistochemical staining to investigate HER-2/neu overexpression. Results: In terms of HER-2/neu receptor staining rate, of 40 slides, 16 (40%) scored 0, 13 (32.5%) 1+, 7 (17.5%) 2+, and 4 (10%) 3+. In total 27.5% of slides showed HER-2/neu overexpression. In terms of age, an inverse correlation was found (-0.181), but without significance (p=0.263). In terms of serum PSA, the correlation coefficient was 0.449 (p=0.004). With respect to Gleason score, the coefficient was 0.190 (p=0.240). Conclusions: In this study, HER-2/neu overexpression occurred in 27.5% of prostate cancer cases, which is a relatively high figure, compared to similar studies elsewhere. While, we failed to reveal any relationship between HER-2/neu expression status with progression and prognosis of disease, it was demonstrated that the serum PSA level was significantly higher in cases with increased receptor expression.

Development of Web-based Off-site Consequence Analysis Program and its Application for ILRT Extension (격납건물종합누설률시험 주기연장을 위한 웹기반 소외결말분석 프로그램 개발 및 적용)

  • Na, Jang-Hwan;Hwang, Seok-Won;Oh, Ji-Yong
    • Journal of the Korean Society of Safety
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    • v.27 no.5
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    • pp.219-223
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    • 2012
  • For an off-site consequence analysis at nuclear power plant, MELCOR Accident Consequence Code System(MACCS) II code is widely used as a software tool. In this study, the algorithm of web-based off-site consequence analysis program(OSCAP) using the MACCS II code was developed for an Integrated Leak Rate Test (ILRT) interval extension and Level 3 probabilistic safety assessment(PSA), and verification and validation(V&V) of the program was performed. The main input data for the MACCS II code are meteorological, population distribution and source term information. However, it requires lots of time and efforts to generate the main input data for an off-site consequence analysis using the MACCS II code. For example, the meteorological data are collected from each nuclear power site in real time, but the formats of the raw data collected are different from each site. To reduce the efforts and time for risk assessments, the web-based OSCAP has an automatic processing module which converts the format of the raw data collected from each site to the input data format of the MACCS II code. The program also provides an automatic function of converting the latest population data from Statistics Korea, the National Statistical Office, to the population distribution input data format of the MACCS II code. For the source term data, the program includes the release fraction of each source term category resulting from modular accident analysis program(MAAP) code analysis and the core inventory data from ORIGEN. These analysis results of each plant in Korea are stored in a database module of the web-based OSCAP, so the user can select the defaulted source term data of each plant without handling source term input data.

A Comparative Review of Radiation-induced Cancer Risk Models

  • Lee, Seunghee;Kim, Juyoul;Han, Seokjung
    • Journal of Radiation Protection and Research
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    • v.42 no.2
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    • pp.130-140
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    • 2017
  • Background: With the need for a domestic level 3 probabilistic safety assessment (PSA), it is essential to develop a Korea-specific code. Health effect assessments study radiation-induced impacts; in particular, long-term health effects are evaluated in terms of cancer risk. The objective of this study was to analyze the latest cancer risk models developed by foreign organizations and to compare the methodology of how they were developed. This paper also provides suggestions regarding the development of Korean cancer risk models. Materials and Methods: A review of cancer risk models was carried out targeting the latest models: the NUREG model (1993), the BEIR VII model (2006), the UNSCEAR model (2006), the ICRP 103 model (2007), and the U.S. EPA model (2011). The methodology of how each model was developed is explained, and the cancer sites, dose and dose rate effectiveness factor (DDREF) and mathematical models are also described in the sections presenting differences among the models. Results and Discussion: The NUREG model was developed by assuming that the risk was proportional to the risk coefficient and dose, while the BEIR VII, UNSCEAR, ICRP, and U.S. EPA models were derived from epidemiological data, principally from Japanese atomic bomb survivors. The risk coefficient does not consider individual characteristics, as the values were calculated in terms of population-averaged cancer risk per unit dose. However, the models derived by epidemiological data are a function of sex, exposure age, and attained age of the exposed individual. Moreover, the methodologies can be used to apply the latest epidemiological data. Therefore, methodologies using epidemiological data should be considered first for developing a Korean cancer risk model, and the cancer sites and DDREF should also be determined based on Korea-specific studies.

Permanent Brachytherapy of Localized Prostate Cancer: Preliminary Results (국소 전립선암의 영구적 근접치료: 조기 결과)

  • Park, Hye-Li;Chang, Sei-Kyung;Kim, Ja-Young;Lee, Bo-Mi;Ko, Seong-Young;Kim, Sung-Joon;Shin, Hyun-Soo
    • Radiation Oncology Journal
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    • v.29 no.2
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    • pp.71-82
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    • 2011
  • Purpose: To evaluate the biochemical control rate and the rate of side effects after performing permanent brachytherapy of localized prostate cancer. Materials and Methods: 67 patients with localized prostate cancer were treated with brachytherapy between April 2007 and December 2008. Of these, 43 patients who were followed up and did not receive external radiotherapy were evaluated for the change in prostate specific antigen (PSA) level and the occurrence of side effects. In total, 18 patients were classified as low risk, 19 patients as intermediate risk, and 6 patients as high risk. The prescription dose was 145 Gy. Results: A PSA increase greater than 2 ng/mL occurred in 2 patients (4.7%). Radiation Therapy Oncology Group (RTOG) grade 1 and 2 acute urologic complications (UC) occurred in 40 and 3 patients, respectively. Further, 5 patients had RTOG grade 1 acute rectal complication (RC). The numbers of RTOG grade 1, 2, and 3 chronic UC were 1, 4, and 1, respectively. The numbers of RTOG grade 1, 2, and 4 chronic RC were 5, 10, and 3, respectively. The statistically significant risk factors (RF) of acute RC were the minimal dose in the most irradiated 0.1 cc volume ($D_{0.1cc}$, p=0.041) and absolute volume receiving 150% of the prescribed dose ($V_{150cc}$, p=0.038) in the entire rectum (ER). The percentage ($V_{100%}$, p=0.019) and absolute volume ($V_{100cc}$, p=0.047) in the involved rectum (IR) were also statistically significant. The RF of chronic RC were $V_{100%}$ (p=0.011) in the ER and the $D_{0.1cc}$ (p=0.049), $V_{100cc}$ (p=0.023) in the IR. The number of used seeds were related with acute UC (p=0.028). Conclusion: Permanent brachytherpy of localized prostate cancer showed a favorable short term biochemical control rate. As such, selective intermediate and high risk patients can be managed with permanent brachytherapy. The effort to reduce rectal complication is also necessary.

Analysis of Variation for Parallel Test between Reagent Lots in in-vitro Laboratory of Nuclear Medicine Department (핵의학 체외검사실에서 시약 lot간 parallel test 시 변이 분석)

  • Chae, Hong Joo;Cheon, Jun Hong;Lee, Sun Ho;Yoo, So Yeon;Yoo, Seon Hee;Park, Ji Hye;Lim, Soo Yeon
    • The Korean Journal of Nuclear Medicine Technology
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    • v.23 no.2
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    • pp.51-58
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    • 2019
  • Purpose In in-vitro laboratories of nuclear medicine department, when the reagent lot or reagent lot changes Comparability test or parallel test is performed to determine whether the results between lots are reliable. The most commonly used standard domestic laboratories is to obtain %difference from the difference in results between two lots of reagents, and then many laboratories are set the standard to less than 20% at low concentrations and less than 10% at medium and high concentrations. If the range is deviated from the standard, the test is considered failed and it is repeated until the result falls within the standard range. In this study, several tests are selected that are performed in nuclear medicine in-vitro laboratories to analyze parallel test results and to establish criteria for customized percent difference for each test. Materials and Methods From January to November 2018, the result of parallel test for reagent lot change is analyzed for 7 items including thyroid-stimulating hormone (TSH), free thyroxine (FT4), carcinoembryonic antigen (CEA), CA-125, prostate-specific antigen (PSA), HBs-Ab and Insulin. The RIA-MAT 280 system which adopted the principle of IRMA is used for TSH, FT4, CEA, CA-125 and PSA. TECAN automated dispensing equipment and GAMMA-10 is used to measure insulin test. For the test of HBs-Ab, HAMILTON automated dispensing equipment and Cobra Gamma ray measuring instrument are used. Separate reagent, customized calibrator and quality control materials are used in this experiment. Results 1. TSH [%diffrence Max / Mean / Median] (P-value by t-test > 0.05) C-1(low concentration) [14.8 / 4.4 / 3.7 / 0.0 ] C-2(middle concentration) [10.1 / 4.2 / 3.7 / 0.0] 2. FT4 [%diffrence Max / Mean / Median] (P-value by t-test > 0.05) C-1(low concentration) [10.0 / 4.2 / 3.9 / 0.0] C-2(high concentration) [9.6 / 3.3 / 3.1 / 0.0 ] 3. CA-125 [%diffrence Max / Mean / Median] (P-value by t-test > 0.05) C-1(middle concentration) [9.6 / 4.3 / 4.3 / 0.3] C-2(high concentration) [6.5 / 3.5 / 4.3 / 0.4] 4. CEA [%diffrence Max / Mean / median] (P-value by t-test > 0.05) C-1(low concentration) [9.8 / 4.2 / 3.0 / 0.0] C-2(middle concentration) [8.7 / 3.7 / 2.3 / 0.3] 5. PSA [%diffrence Max / Mean / Median] (P-value by t-test > 0.05) C-1(low concentration) [15.4 / 7.6 / 8.2 / 0.0] C-2(middle concentration) [8.8 / 4.5 / 4.8 / 0.9] 6. HBs-Ab [%diffrence Max / Mean / Median] (P-value by t-test > 0.05) C-1(middle concentration) [9.6 / 3.7 / 2.7 / 0.2] C-2(high concentration) [8.9 / 4.1 / 3.6 / 0.3] 7. Insulin [%diffrence Max / Mean / Median] (P-value by t-test > 0.05) C-1(middle concentration) [8.7 / 3.1 / 2.4 / 0.9] C-2(high concentration) [8.3 / 3.2 / 1.5 / 0.1] In some low concentration measurements, the percent difference is found above 10 to nearly 15 percent in result of target value calculated at a lower concentration. In addition, when the value is measured after Standard level 6, which is the highest value of reagents in the dispensing sequence, the result would have been affected by a hook effect. Overall, there was no significant difference in lot change of quality control material (p-value>0.05). Conclusion Variations between reagent lots are not large in immunoradiometric assays. It is likely that this is due to the selection of items that have relatively high detection rate in the immunoradiometric method and several remeasurements. In most test results, the difference was less than 10 percent, which was within the standard range. TSH control level 1 and PSA control level 1, which have low concentration target value, exceeded 10 percent more than twice, but it did not result in a value that was near 20 percent. As a result, it is required to perform a longer period of observation for more homogenized average results and to obtain laboratory-specific acceptance criteria for each item. Also, it is advised to study observations considering various variables.

Prostate Cancer Incidence in Turkey: An Epidemiological Study

  • Zorlu, Ferruh;Divrik, Rauf Taner;Eser, Sultan;Yorukoglu, Kutsal
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.21
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    • pp.9125-9130
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    • 2014
  • Background: This study aimed to determine the incidence of prostate cancer in Turkey in a population-based sample, and to determine clinical and pathological characteristics of the cases. Materials and Methods: All newly diagnosed prostate cancer patients were included in this national, multi-centered, prospective and non-interventional epidemiological registry study conducted in 12 cities representing the 12 regions of Turkey from July 2008 to June 2009. The population-based sample comprised 4,150 patients with a recent prostate cancer diagnosis. Results: Age-adjusted prostate cancer incidence rate was 35 cases per 100,000 in Turkey. At the time of diagnosis, median age was 68, median PSA level was 10.0 ng/mL. Digital rectal examination was abnormal in 36.2% of 3,218 tested cases. Most patients had urologic complaints. The main diagnostic method was transrectal ultrasound guided biopsy (87.8%). Gleason score was ${\leq}6$ in 49.1%, 7 in 27.8% and >7 in 20.6% of the cases. There was a statistically significant positive correlation between serum PSA level and Gleason score (p=0.000). The majority of patients (54.4%) had clinical stage T1c. Conclusions: This is the first population-based national data of incidence with the histopathological characteristics of prostate cancer in Turkey. Prostate cancer remains an important public health concern in Turkey with continual increase in the incidence and significant burden on healthcare resources.

Analysis of the bcl-2, Ki-67 and p53 Expression Level Based on the Gleason Score Group of Prostate Adenocarcinoma

  • Kim, Tai-Jeon;Kim, Sung-Chul
    • Biomedical Science Letters
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    • v.14 no.3
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    • pp.157-165
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    • 2008
  • Recently, the number of patients with prostate cancer has been increased gradually by both the change of living environment and the increase of aged population. In this study the serum prostate specific antigen (PSA) level was compared to the Gleason score known as a prognostic factor for the prostate cancer. In the Gleason score 6 and $9{\sim}10$, the average age was 69.68 years old and 69.52 years old, respectively and there was no statistically difference in both of age and Gleason score. the PSA serum consistency appeared <4 ng/mL as example 1, $4{\sim}20ng/mL$ as example 17 and ${\geq}20ng/mL$ as example 4 in the Gleason score 6, and In the Gleason score $9{\sim}10$, it appeared <4 ng/mL as example 1, $4{\sim}20ng/mL$ as example 6 and ${\geq}20ng/mL$ as example 15. PSA serum consistency in the Gleason score $9{\sim}10$ showed higher value than those of Gleason score 6 (P<0.05). Next, expression ratios of bcl-2, Ki-67 and p53 were examined in the Gleason score 6 and $9{\sim}10$. the p53 expression ratio, a tumor suppression gene, appeared the significance statistically by the classification of the Gleason score as example 7 (28%) in the Gleason score 6 and as example 16 (64%) in the Gleason score $9{\sim}10$ (P<0.05). but not different in the expression ratios of the Ki-67 and bcl-2. The expression ratio of p53 by the expression ratio of bcl-2 and the expression ratio of Ki-67 by the expression ratio of p53 had a positive relationship in all of the Gleason score 6 and the Gleason score $9{\sim}10$ (P<0.05). However, the expression ratio of Ki-67 by the expression ratio of bcl-2 did not show any significance in the Gleason score $9{\sim}10$ (P<0.05). Therefore, the results suggested that p53 expression could be used as an independent prognostic factor.

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Albizzia julibrissin Suppresses Testosterone-induced Benign Prostatic Hyperplasia by Regulating 5α-Reductase Type 2 - Androgen Receptor Pathway

  • Hong, Geum-Lan;Kim, Hyun-Tae;Park, Se-Ra;Lee, Na-Hyun;Ryu, Kyung-A;Kim, Tae-Won;Song, Gyu-Yong;Jung, Ju-Young
    • Natural Product Sciences
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    • v.25 no.3
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    • pp.200-207
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    • 2019
  • Albizzia julibrissin (AJ) is an herbal medicine that shows low toxicity, promotes promoting blood circulation and mitigates the inflammation and has mild side effects. Benign prostate hyperplasia (BPH) is one of the most common diseases that occurs in older males and often results in lower urinary tract symptoms. This study was conducted to evaluate the protective effect of AJ against BPH using LNCaP cells and Sprague Dawley rats treated with testosterone. Treatment with AJ extract reduced the expression of androgen receptor (AR) and prostate-specific antigen (PSA) in vitro. In vivo, rats were divided into 6 groups: 1 (Normal Control); 2 (Testosterone propionate (TP) alone); 3 (TP + finasteride); 4 (TP + AJ 10 mg/kg); 5 (TP + AJ 50 mg/kg); 6 (TP + AJ 300 mg/kg). The groups treated with AJ showed reduced the relative prostate weights and BPH-related proteins were altered, with decreased AR, PSA and proliferating cell nuclear antigen (PCNA) observed by western blot. Histopathological analysis revealed the therapeutic effect of AJ, with a decreased thickness of epithelial cells and reduced level of PCNA and $5{\alpha}$-reductase type 2. These results suggest that AJ extract could ameliorate testosterone-induced benign prostatic hyperplasia.