Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0376358 (prostate cancer)
 59,338 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Although we could acquire a detailed 512 x 2048 matrix whole body scintigraphy, the 512 x 2048 matrix whole body scintigraphy was divided to the upper and lower half of the body, because a many of CRT system displayed only 1024 x 1024 matrix with non interlace mode. We made 12 dots of normal vertical image distance to 0 dot with laser imaging system (Li-10 Konica medical inc.), and we printed these divided whole body images in the four partition of the film. The lead bar phantom (interval from 6 mm to 3 mm) filled with 99mTcO4- was studied by both 512 x 2048 matrix whole body scanning mode and 256 x 1024 whole body scanning mode in the basic study. And the distance between the lead bar phantom and the gamma camera was changed from 10 mm to 100 mm. We studied 41 patients with metastatic bone tumor (14 breast cancer, 7 lung cancer, 7 prostate cancer, 5 others, 6 unknown origin) clinically. However the 512 x 2048 matrix whole body scan was better quality of images than 256 x 1024 matrix whole body scan at 100 mm distance in the basic study. The abnormal uptake of metastatic sites was shown equally in both 512 x 2048 and 256 x 1024 matrix whole body scintigraphy. The 512 x 2048 matrix whole body scan was better quality of images than 256 x 1024 matrix whole body scan in 26 out of 41 patients, equal in 10 out of 41 patients and worse in 3 out of 41 patients. The matrix size of 512 x 2048 matrix whole body scintigraphy (0.98 mm2) was smaller than that of 256 x 1024 matrix whole body scintigraphy (1.95 mm2).(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[512 x 2048 matrix whole body scintigraphy with laser imaging system]. 837 3

In the management of patients with localized prostate cancer, both radical prostatectomy and radiotherapy are shown in the U.S. to be equally effective to control a local disease but associate with different types of toxicity. Therefore, both treatments are recommended for patients to choose freely. Recently, mainly in western countries, radiotherapy has achieved technological innovation so as to increase target tumor doses and to decrease the volume and dose of peritumoral normal tissues, by which the treatment outcome is further improved. Major innovative techniques include three-dimensional conformal radiotherapy (3D CRT) and a high dose-rate (HDR) brachytherapy system. Three-D CRT focuses radiation on the tumor through multiple portals minutely tailored to the tumor volume determined by computed tomography, in conjunction with a sophisticated treatment planning system. A HDR brachytherapy system provides high-tech interstitial radiotherapy; a remote afterloading system precludes radiation exposure of hospital workers and a computer-controlled source-scanning system enables optimization of dose distribution. In order to provide a variety of effective treatment options for Japanese patients, radiation oncologists must master these techniques in practice, in cooperation with urologists.
 ...
PMID:[Radiotherapy: a significant treatment option in management of prostatic cancer]. 961 20

Three-dimensional conformal radiation therapy (3D-CRT) is a promising new treatment technique based on the principle that improved precision in both tumor definition and dose delivery will enhance outcomes by maximizing dose to the tumor area while minimizing dose to normal tissue. Using a cost-benefit analysis, in terms of outcomes, we first examined the overall risks and benefits of 3D-CRT. We then used the treatment of prostate cancer as a model to compare actual clinical outcomes reported between 3D-CRT and standard radiation therapy (SRT). Our analysis shows that application of 3D-CRT to the clinical setting remains difficult because of the continual difficulties of target definition, and that dose escalation cannot yet be justified on the basis of the lack of benefit found, and suggested increased late toxicity, in most of the dose escalation series compared with SRT.
 ...
PMID:Cost-benefit analysis of 3D conformal radiation therapy--treatment of prostate cancer as a model. 1042 49

We sought to assess potency preservation after three-dimensional conformal radiotherapy (3D-CRT) in prostate cancer patients eligible for radical prostatectomy, conventional radiotherapy, 3D-CRT, or transperineal prostate implantation. Patients with more advanced disease are commonly treated with hormonal therapy, which can cause impotence, and were consequently excluded from the analysis. Between December 1991 and June 1998, 198 prostate cancer patients were treated with 3D-CRT at the University of California, Davis Medical Center. Fifty-two of these patients had a pretreatment prostate-specific antigen (PSA) level of 10.0 ng/ml or less, a Gleason score of 6 or less, and a 1997 AJCC clinical stage T1bN0M0 to T2bN0M0. One patient was not evaluable. None of the 51 evaluable patients had diabetes mellitus. In 40 patients, the prostate gland only was irradiated to a total dose of 66 to 79.2 Gy by using daily 1.8-Gy fractions. In 11 patients, the prostate and seminal vesicles were treated to 44 to 55.8 Gy. Lymph nodes were not included in the clinical target volume. The median age was 68 years, and the median length of follow-up was 15 months. Potency in this study is defined as an erection sufficient for vaginal penetration. Kaplan-Meier analysis was used to describe potency as a function of time after 3D-CRT. Of the 51 evaluable patients, 35 (69%) were potent, 15 were impotent, and 1 was sexually inactive before 3D-CRT. Kaplan-Meier estimates of the potency preservation rates 1, 2, and 3 years after 3D-CRT are 100%, 83%, and 63%, respectively. On multivariate analysis, age, total radiation dose, and a history of transurethral resection of the prostate did not significantly affect potency preservation rates. Three (43%) of 7 patients who became impotent after 3D-CRT and used sildenafil were subsequently able to achieve erections sufficient for vaginal penetration. The preliminary results reported herein suggest that approximately two thirds of prostate cancer patients will retain their potency 3 years after 3D-CRT. Further follow-up is necessary to assess long-term potency after 3D-CRT. Sildenafil should be considered in patients who develop radiation-induced impotence.
 ...
PMID:Potency preservation after three-dimensional conformal radiotherapy for prostate cancer: preliminary results. 1095 56

The current study was undertaken to evaluate the Prostate Specific Antigen (PSA) relapse free survival and the prognostic factors in a total of 38 patients with stages of T2a-b, N0, M0 prostate carcinoma treated with three-dimensional conformal radiotherapy (3D-CRT). Mean 69.63 Gy was given with 3D-CRT, the mean follow up time was 13.89 months, and the mean prebiopsied PSA level was 25.12 ng/ml. The 2-year PSA relapse free survival was 47.37% for the entire group. The 2-year PSA relapse free survival rates were 100% and 44.74% for the patients with Gleason score < or = 7 and greater than 7 (p < or = 0.05). Patients with prebiopsied PSA level < or = 10 ng/ml and the stages of T2a or T2b did not show any significant differences (p > or = 0.05). Although the few case number and short term follow up, in this study 3D-CRT was a new effective technique to prostate cancer for our institutes and the Gleason score was important predictor of PSA relapse free survival.
 ...
PMID:Three dimensional conformal radiotherapy in patients with T2a-b, N0, M0 prostatic carcinoma. 1122 48

In prostatic cancer research three-dimensional conformal radiation therapy (3-D CRT), brachytherapy and new therapeutic modalities have been applied. Treatment planning and delivery of radiation therapy have substantially evolved in the past 20 years. The treatment of localized carcinoma of the prostate with 3-D CRT is described, preliminary clinical results are presented and compared with those with standard radiation therapy (SRT). The benefit of 3-D CRT hypothetically could be linked to improved local tumor control because of a better coverage of the target volume with a specific dose of irradiation, less acute and late toxicity, possibility of carrying out dose-escalation studies. Intensity modulated radiation therapy (IMRT) may be particularly useful in some cases. Further efforts are necessary with collaboration of urologists and radiation oncologists to continue to explore approaches to optimally select and manage patients with localized prostate cancer. A reliable assessment of the impact of 3-D CRT and IMRT on outcome should come from prospective randomized long-term studies. As for brachytherapy, standardized protocols should be developed to objectively evaluate brachytherapy in localized prostatic cancer. Recently a great deal of interest has been focused on new therapeutic modalities with chemotherapeutic agents, a new agent named prostate specific enhancer, a regulatory element of the PSA gene is being tested. Laboratory and animal studies of the viral construct have been reported. A phase I human clinical trial is being initiated in the U.S.A. in patients with postirradiation hormone refractory prostate cancer.
 ...
PMID:New trends in prostatic cancer research. Three-dimensional conformal radiation therapy (3-D CRT), brachytherapy, and new therapeutic modalities. 1136 99

Recently, minimally invasive therapy has been a key word in the medical field. Many new therapies have been developed in the field of urology. In this area, bacillus Calmette-Guerin (BCG) instillation therapy, transurethral resection of the bladder tumor and intra-arterial infusion with irradiation therapy are noted as minimally invasive therapies for bladder cancer. Laparoscopic prostatectomy, brachytherapy, three-dimensional conformal radiotherapy (3D-CRT) and high-intensity focused ultrasound (HIFU) have also been developed as minimally invasive therapies for prostate cancer. Though the establishment of the validity of each treatment will still take time, the best treatment for each patient should be chosen case by case, including considerations of postoperative quality of life and economic efficiency.
 ...
PMID:[Minimally invasive therapy for bladder and prostate cancer]. 1152 24

The incidence and predictors of acute toxicity were evaluated in patients treated with three-dimensional conformal radiotherapy (3D-CRT) for localized prostate cancer. Between December 1997 and November 1999, 116 patients with T1-T3 prostatic carcinoma were enrolled in the study. Ninety patients were treated with 70 Gy and 26 patients with T3 tumors received 74 Gy. Of the 116 patients 42 (36.2%) had a prior history of invasive urological procedure (IUP) (transurethral resection of the prostate or transvesical prostatectomy for benign prostatic hyperplasia). Acute gastrointestinal (GI) and genitourinary (GU) symptoms were graded according to the EORTC/RTOG scoring system. Toxicity duration after the completion of 3D-CRT was recorded. The majority of patients experienced only mild or no (Grade 1) acute toxicities. Medications for GI and GU symptoms (Grade 2) were required by 28.4% and 12.9% of patients, respectively. Only one case of Grade 3 GI toxicity (0.9%) was observed. Seven patients (6.1%) experienced severe GU toxicity (Grade 3 or 4). No correlation was found between acute toxicity and age, stage, dose (70 Gy vs. 74 Gy), IUP and pelvic lymphadenectomy. A significant relationship was observed between the duration of acute GU toxicity and prior IUP. Symptoms persisted for more than 4 weeks in 51.9% and 26.0% of patients with and without a prior history of IUP, respectively (p = 0.02). The incidence of acute complications, associated with 3D-CRT for prostate cancer, was acceptable in our cohort of patients. A prior history of IUP resulted in a significantly longer duration of acute GU toxicity.
 ...
PMID:Conformal radiotherapy for prostate cancer--longer duration of acute genitourinary toxicity in patients with prior history of invasive urological procedure. 1185 79

The aim of this study was to evaluate and compare the rates of grade 2 or worse late effects in patients treated for prostate cancer on Radiation Therapy Oncology Group (RTOG) 9406. The authors previously have reported the results of patients treated on the first 2 dose levels of this study with respect to grade 3 or greater late toxicity. This analysis examines the incidence of grade 2 toxicity in this study. From August 1994 to September 1999, 424 patients were entered on this dose escalation trial of 3-dimensional conformal radiation therapy (3D CRT) for localized adenocarcinoma of the prostate at doses of 68.4 Gy (level I) and 73.8 Gy (level II). All radiation prescriptions were a minimum dose to a planning target volume. Patients were stratified according to clinical stage and risk of seminal vesicle invasion based on Gleason score and presenting prostate-specific antigen. Average time at risk after completion of therapy ranged from 33.1 to 40.1 months for patients treated at dose level I and 15.6 to 34.2 months for patients at dose level II. The frequency of late effects > or = grade 2 was compared with a similar group of patients treated on RTOG studies 7506 and 7706 with adjustments made for the interval from completion of therapy. The RTOG toxicity scoring scales for late effects were used. The rate of grade 3 or greater late toxicity continues to be low compared with RTOG historical controls. No grade 4 or 5 late complications were reported in any of the 406 evaluable patients during the period of observation. Interestingly, the incidence of grade 2 late toxicity was increased relative to historical controls in all groups and dose levels. In group 1, level I and group 3, level II, the increase in grade 2 complications was statistically significant; 16 complications were observed in group 1, level I when 9.2 were expected (P =.026) and 22 were observed in group 3, level II when 7.6 were expected (P <.0001). When examining all late effects > or = grade 2, there were no significant differences in the rate of late effects in both groups and both dose levels with the exception of group 1, level II. This, in combination with the statistically significant decrease in late effects > or = grade 3, suggests that in most circumstances there has been a shift of grade 3 complications to grade 2. In group 1, dose level II there was a statistically significant reduction in > or = grade 2 late effects, suggesting there was no shift from grade 3 to grade 2 in these patients. In this circumstance there may have been a global reduction in all complications or a shift to late effects less severe than grade 2. In group 2, dose level II there is a trend (P =.085) toward this same result. It is important to continue to examine late effects closely in patients treated on RTOG 9406. The primary objective of dose escalation without an increase rate of > or = grade 3 complications has been achieved. However, the reduction in grade 3 complications may have resulted in a higher incidence of grade 2 late effects. Because grade 2 late effects may have a significant impact on a patient's quality of life, it is important to reduce these complications as much as possible. Improved conformal treatment delivery with intensity-modulated radiation therapy or the use of radioprotective agents could be considered. Clinical trials should use quality-of-life measures to determine that trade-offs between severity and rates of toxicity are acceptable to patients.
 ...
PMID:Trade-off to low-grade toxicity with conformal radiation therapy for prostate cancer on Radiation Therapy Oncology Group 9406. 1191 89

External radiotherapy is one of the modalities used to cure localized prostate carcinoma. Most of localized prostate carcinomas, specially those of the intermediate prognostic group, may benefit from escalated dose above 70 Gy at least as regard biochemical and clinical relapse free survival. 3D-CRT allows a reduction of the dose received by organs at risk and an increase of prostate dose over 70 Gy. It is on the way to become a standard. Intensity modulated radiation therapy increases dose homogeneity and reduces rectal dose. These methods necessitate rigorous procedures in reproducibility, delineation of volumes, dosimetry, daily treatment. They need also technological and human means. It is clear that localized prostate cancer is a good example for evaluation of these new radiotherapy modalities.
 ...
PMID:[Conformal radiotherapy in prostate cancer: for whom and how?]. 1211 39


1 2 3 4 5 6 Next >>