Отдаленные результаты консервативного лечения больных раком предстательной железы II—III стадии

The results of treatment of 170 patients with prostate cancer (T2—3N0—1M0—1) who received radiotherapy or radiotherapy plus antiandrogenic therapy from 1998 to 2003 were reviewed. The mean age was 69,5 year. The diagnosis was verified morphologically (Gl — 146 (85%), G2 — 10 (6%), G3 — 14 (8%) patients). The mean level of PSA was 24 ng/ml. Morphologic characteristics of tumors with defining of their differentiation grade according to Glisson scale were studied in 75 patients. Conformation radiotherapy with three dimensional planning was carried out by linear accelerator. Multipetal collimator was used for figured fields construction taking into account the spread of tumor.The total dose of radiation was 70—74 Gy. Only radiation therapy was carried out to 45 patients, whereas in 125 patients the radiotherapy was supplemented by administration of antiandrogenic therapy with Flucin or Zoladex. For initial assessment of tumor extent and evaluation of the treatment effect, we used transrectal ultrasound investigation (TRUSI) with ultrasonographic angiography. According to TRUSI, capsule invasion was found in 25 (16%) patients, which determines the risk of disease progression. Five year disease free survival in the absence of capsule invasion was 92%, whereas the capsule invasion diminishes it to 60%. With increasing levels of PSA long term results deteriorates: 5-year disease free survival was 80% at PSA level below 10 ng/ml, 72% at PSA level 10,1 — 20 ng/ml and 50% at PSA level higher than 20 ng/ml (p=0,36). Capsule invasion found on TRUSI and US angiography, high PSA level and Glisson sum are indications for administration of radiotherapy with antiandrogenic therapy. Unfavorable prognostic factors are found in one third patients over 70 years old, which demands employment of adequate antitumor treatment. Radiation therapy is an effective treatment for prostate cancer: 5-year observed survival was 86%, corrected survival — 91% and disease free survival — 78%

Long term results of conservative treatment for stage II—III prostate cancer

The results of treatment of 170 patients with prostate cancer (T2—3N0—1M0—1) who received radiotherapy or radiotherapy plus antiandrogenic therapy from 1998 to 2003 were reviewed. The mean age was 69,5 year. The diagnosis was verified morphologically (Gl — 146 (85%), G2 — 10 (6%), G3 — 14 (8%) patients). The mean level of PSA was 24 ng/ml. Morphologic characteristics of tumors with defining of their differentiation grade according to Glisson scale were studied in 75 patients. Conformation radiotherapy with three dimensional planning was carried out by linear accelerator. Multipetal collimator was used for figured fields construction taking into account the spread of tumor.The total dose of radiation was 70—74 Gy. Only radiation therapy was carried out to 45 patients, whereas in 125 patients the radiotherapy was supplemented by administration of antiandrogenic therapy with Flucin or Zoladex. For initial assessment of tumor extent and evaluation of the treatment effect, we used transrectal ultrasound investigation (TRUSI) with ultrasonographic angiography. According to TRUSI, capsule invasion was found in 25 (16%) patients, which determines the risk of disease progression. Five year disease free survival in the absence of capsule invasion was 92%, whereas the capsule invasion diminishes it to 60%. With increasing levels of PSA long term results deteriorates: 5-year disease free survival was 80% at PSA level below 10 ng/ml, 72% at PSA level 10,1 — 20 ng/ml and 50% at PSA level higher than 20 ng/ml (p=0,36). Capsule invasion found on TRUSI and US angiography, high PSA level and Glisson sum are indications for administration of radiotherapy with antiandrogenic therapy. Unfavorable prognostic factors are found in one third patients over 70 years old, which demands employment of adequate antitumor treatment. Radiation therapy is an effective treatment for prostate cancer: 5-year observed survival was 86%, corrected survival — 91% and disease free survival — 78

Health-related quality of life in multiple sclerosis: Effects of natalizumab

Objective: To report the relationship between disease activity and health-related quality of life (HRQoL) in relapsing multiple sclerosis, and the impact of natalizumab. Methods: HRQoL data were available from 2,113 multiple sclerosis patients in natalizumab clinical studies. In the Natalizumab Safety and Efficacy in Relapsing Remitting Multiple Sclerosis (AFFIRM) study, patients received natalizumab 300mg (n = 627) or placebo (n = 315); in the Safety and Efficacy of Natalizumab in Combination with Interferon Beta-1a in Patients with Relapsing Remitting Multiple Sclerosis (SENTINEL) study, patients received interferon beta-la (IFN-\u3b2-1a) plus natalizumab 300mg (n = 589), or IFN-\u3b2-1a plus placebo (n = 582). The Short Form-36 (SF-36) and a subject global assessment visual analog scale were administered at baseline and weeks 24, 52, and 104. Prespecified analyses included changes from baseline to week 104 in SF-36 and visual analog scale scores. Odds ratios for clinically meaningful improvement or worsening on the SF-36 Physical Component Summary (PCS) and Mental Component Summary were calculated. Results: Mean baseline SF-36 scores were significantly less than the general US population and correlated with Expanded Disability Status Scale scores, sustained disability progression, relapse number, and increased volume of brain magnetic resonance imaging lesions. Natalizumab significantly improved SF-36 PCS and Mental Component Summary scores at week 104 in AFFIRM. PCS changes were significantly improved by week 24 and at all subsequent time points. Natalizumab-treated patients in both studies were more likely to experience clinically important improvement and less likely to experience clinically important deterioration on the SF-36 PCS. The visual analog scale also showed significantly improved HRQoL with natalizumab. Interpretation: HRQoL was impaired in relapsing multiple sclerosis patients, correlated with severity of disease as measured by neurological ratings or magnetic resonance imaging, and improved significantly with natalizumab. \ua9 2007 American Neurological Association. Published by Wiley-Liss, Inc