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Health-related Quality of Life of Patients Treated With Different Fractionation Schedules for Early Prostate Cancer Compared to the Age-standardized General Male Population

Peer reviewe

Acute Side-effects of Different Radiotherapy Treatment Schedules in Early Prostate Cancer

BACKGROUND: Optimal radiation therapy (RT) fractionation in early prostate cancer in elderly patients is controversial. We compared acute toxicities of fractionation schedules: 78/2 Gy, 60/3 Gy and 36.25/7.25 Gy, in this single-centre study. We also evaluated the effect of the rectal immobilization system Rectafix on quality of life (QoL). PATIENTS AND METHODS: Seventy-three patients with one or two intermediate prostate cancer risk factors according to National Comprehensive Cancer Network criteria were recruited. Twenty-one patients were treated with 78/2 Gy and 60/3 Gy, and 31 patients with 36.25/7.25 Gy. Their QoL data were assessed with regard to genitourinary, gastrointestinal and sexual wellbeing at the beginning and end of RT and at 3 months after treatment. Rectafix was used in the 78/2 Gy and 60/3 Gy groups. RESULTS: There were no statistically significant QoL differences in between the treatment groups 3 months after RT. The 78/2 Gy group had significantly increased bowel movements between baseline and 3 months after RT (p=0.036). At 3 months after RT, this group also had significantly more erectile dysfunction than the 60/3 Gy group (p=0.025). At the end of RT, the 78/2 Gy group had more symptoms than the 36.25/7.25 Gy group. Rectafix did not reduce acute toxicities in the 78/2 Gy or 60/3 Gy groups. CONCLUSION: Treatment with the 78/2 Gy schedule is no longer to be recommended due to its increased acute toxicity compared to treatments of 60/3 Gy and 36.25/7.25 Gy. The shortest schedule of 36.25 Gy in five fractions seems to be a convenient treatment option with tolerable acute toxicity.publishedVersionPeer reviewe

Pohjaveden puhdistaminen reaktiivisella seinämällä – Koekohteena Oriveden Asemanseudun pilaantunut pohjavesialue

Reaktiivisella seinämällä tarkoitetaan maaperään asennettua, reaktiivista materiaalia sisältävää seinämärakennetta tai –vyöhykettä, jonka läpi pilaantunut pohjavesi johdetaan muuttamatta pohjaveden luonnollisia virtausreittejä. Pohjavesi puhdistuu, kun seinämän läpi kulkevat haitta-aineet reagoivat reaktiivisen materiaalin kanssa ja muuntuvat samalla haitattomiksi tai alkuperäistä vähemmän haitallisiksi yhdisteiksi tai pidättyvät seinämään. Menetelmän toistaiseksi yleisin sovellus on ollut klooratuilla liuottimilla pilaantuneen pohjaveden puhdistaminen raemuotoisen metalliraudan avulla. Menetelmän toimivuutta Suomen olosuhteissa tutkittiin asentamalla koeseinämä Oriveden Asemanseudun pilaantuneelle pohjavesialueelle. Koeseinämässä käytettiin kotimaista rautamateriaalia. Oriveden koekohteen kokemukset seinämän asentamisesta Suomen hydrogeologisissa olosuhteisissa osoittivat, että seinämä saadaan sekä hydraulisesti että puhdistumisprosessin kannalta toimivaksi myös tyypillisissä vedenhankinnan kannalta tärkeissä pohjavesimuodostumissa

Dynamic Contrast-Enhanced Imaging as a Prognostic Tool in Early Diagnosis of Prostate Cancer : Correlation with PSA and Clinical Stage

Background and Purpose. Although several methods have been developed to predict the outcome of patients with prostate cancer, early diagnosis of individual patient remains challenging. The aim of the present study was to correlate tumor perfusion parameters derived from dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and clinical prognostic factors and further to explore the diagnostic value of DCE-MRI parameters in early stage prostate cancer. Patients and Methods. Sixty-two newly diagnosed patients with histologically proven prostate adenocarcinoma were enrolled in our prospective study. Transrectal ultrasound-guided biopsy (12 cores, 6 on each lobe) was performed in each patient. Pathology was reviewed and graded according to the Gleason system. DCE-MRI was performed and analyzed using a two-compartmental model; quantitative parameters including volume transfer constant (Ktrans), reflux constant (Kep), and initial area under curve (iAUC) were calculated from the tumors and correlated with prostate-specific antigen (PSA), Gleason score, and clinical stage. Results. Ktrans (0.11 ± 0.02 min−1 versus 0.16 ± 0.06 min−1; p<0.05), Kep (0.38 ± 0.08 min−1 versus 0.60 ± 0.23 min−1; p<0.01), and iAUC (14.33 ± 2.66 mmoL/L/min versus 17.40 ± 5.97 mmoL/L/min; p<0.05) were all lower in the clinical stage T1c tumors (tumor number, n=11) than that of tumors in clinical stage T2 (n=58). Serum PSA correlated with both tumor Ktrans (r=0.304, p<0.05) and iAUC (r=0.258, p<0.05). Conclusions. Our study has confirmed that DCE-MRI is a promising biomarker that reflects the microcirculation of prostate cancer. DCE-MRI in combination with clinical prognostic factors may provide an effective new tool for the basis of early diagnosis and treatment decisions

Radium-223 dichloride treatment in metastatic castration-resistant prostate cancer in Finland : A real-world evidence multicenter study

Background Radium-233 dichloride is an alpha emitter that specifically targets bone metastases in prostate cancer. Results of a previously reported phase III randomized trial showed survival benefit for radium-223 compared to best supportive care in castration-resistant prostate cancer (CRPC) with bone metastases. However, real-world data are also needed with wider inclusion criteria. Methods We report results of a retrospective multicenter study including all patients with metastatic CRPC treated with radium-223 in all five university hospitals in Finland since the introduction of the treatment. We identified 160 patients who had received radium-223 in Finland in 2014-2019. Results The median overall survival (OS) was 13.8 months (range 0.5-57 months), and the median real-world progression-free survival (rwPFS) was 4.9 months (range 0.5-29.8 months). Alkaline phosphatase (ALP) values within the normal range before and during the radium-223 treatment or the reduction of elevated ALP to normal range during treatment were associated with better OS when compared to elevated ALP values before and during treatment (p = 100 mu g/L) before radium-223 treatment was associated with poor OS compared to low PSA level (Peer reviewe

Health-related Quality of Life of Patients Treated With Different Fractionation Schedules for Early Prostate Cancer Compared to the Age-standardized General Male Population

Peer reviewe

Radium-223 dichloride treatment in metastatic castration-resistant prostate cancer in Finland : A real-world evidence multicenter study

Background Radium-233 dichloride is an alpha emitter that specifically targets bone metastases in prostate cancer. Results of a previously reported phase III randomized trial showed survival benefit for radium-223 compared to best supportive care in castration-resistant prostate cancer (CRPC) with bone metastases. However, real-world data are also needed with wider inclusion criteria. Methods We report results of a retrospective multicenter study including all patients with metastatic CRPC treated with radium-223 in all five university hospitals in Finland since the introduction of the treatment. We identified 160 patients who had received radium-223 in Finland in 2014-2019. Results The median overall survival (OS) was 13.8 months (range 0.5-57 months), and the median real-world progression-free survival (rwPFS) was 4.9 months (range 0.5-29.8 months). Alkaline phosphatase (ALP) values within the normal range before and during the radium-223 treatment or the reduction of elevated ALP to normal range during treatment were associated with better OS when compared to elevated ALP values before and during treatment (p = 100 mu g/L) before radium-223 treatment was associated with poor OS compared to low PSA level (Peer reviewe