To determine NANDA-I nursing diagnoses and NIC nursing interventions in patients who underwent radical prostatectomy.
A cross-sectional and descriptive study was conducted in a research and teaching hospital in western Turkey between June 2016 and June 2017.
Patients with metastatic prostate cancer are living longer than they used to, thanks to a wider range of therapeutic options. This means that an increasing number of men will receive long-term treatment with anti-hormonal therapy - androgen-deprivation therapy (ADT) - and the risk of side effects from this therapy is increasing.
Penile metastasis from prostate adenocarcinoma is rare and the disease is usually disseminated at presentation. We present a case of an 83-year-old man with solitary metastasis to the penis from prostate adenocarcinoma.
Patients with hematological cancers have improved outcomes after treatment with bispecific antibodies that bind to CD3 on T cells and that redirect T cells towards cancer cells. However, clinical benefit against solid tumors remains to be shown.
Previous costing and resource estimates for cancer have not been complete owing to lack of comprehensive data on cancer-related medication and radiation treatment. Our objective was to calculate the mean overall costs per patient of cancer-related medications and radiation, as well as by disease subtype and stage, in the first year after diagnosis for the 4 most prevalent cancers in Ontario.
Importance: Complete metastatic ablation of oligometastatic prostate cancer may provide an alternative to early initiation of androgen deprivation therapy (ADT).
Objective: To determine if stereotactic ablative radiotherapy (SABR) improves oncologic outcomes in men with oligometastatic prostate cancer.
Design, Setting, and Participants: The Observation vs Stereotactic Ablative Radiation for Oligometastatic Prostate Cancer (ORIOLE) phase 2 randomized study accrued participants from 3 US radiation treatment facilities affiliated with a university hospital from May 2016 to March 2018 with a data cutoff date of May 20, 2019, for analysis. Of 80 men screened, 54 men with recurrent hormone-sensitive prostate cancer and 1 to 3 metastases detectable by conventional imaging who had not received ADT within 6 months of enrollment or 3 or more years total were randomized.
Interventions: Patients were randomized in a 2:1 ratio to receive SABR or observation.
Main Outcomes and Measures: The primary outcome was progression at 6 months by prostate-specific antigen level increase, progression detected by conventional imaging, symptomatic progression, ADT initiation for any reason, or death. Predefined secondary outcomes were toxic effects of SABR, local control at 6 months with SABR, progression-free survival, Brief Pain Inventory (Short Form)–measured quality of life, and concordance between conventional imaging and prostate-specific membrane antigen (PSMA)–targeted positron emission tomography in the identification of metastatic disease.
Results: In the 54 men randomized, the median (range) age was 68 (61-70) years for patients allocated to SABR and 68 (64-76) years for those allocated to observation. Progression at 6 months occurred in 7 of 36 patients (19%) receiving SABR and 11 of 18 patients (61%) undergoing observation (P = .005). Treatment with SABR improved median progression-free survival (not reached vs 5.8 months; hazard ratio, 0.30; 95% CI, 0.11-0.81; P = .002). Total consolidation of PSMA radiotracer-avid disease decreased the risk of new lesions at 6 months (16% vs 63%; P = .006).No toxic effects of grade 3 or greater were observed. T-cell receptor sequencing identified significant increased clonotypic expansion following SABR and correlation between baseline clonality and progression with SABR only (0.082085 vs 0.026051; P = .03).
Conclusions and Relevance: Treatment with SABR for oligometastatic prostate cancer improved outcomes and was enhanced by total consolidation of disease identified by PSMA-targeted positron emission tomography. SABR induced a systemic immune response, and baseline immune phenotype and tumor mutation status may predict the benefit from SABR. These results underline the importance of prospective randomized investigation of the oligometastatic state with integrated imaging and biological correlates.
Trial Registration: ClinicalTrials.gov Identifier: NCT0268058
Ryan Phillips, MD, PhD1; William Yue Shi, BS2; Matthew Deek, MD1; Noura Radwan, MD1; Su Jin Lim, ScM3; Emmanuel S. Antonarakis, MD3; Steven P. Rowe, MD, PhD4,5; Ashley E. Ross, MD, PhD5; Michael A. Gorin, MD4,5; Curtiland Deville, MD1; Stephen C. Greco, MD1; Hailun Wang, PhD1; Samuel R. Denmeade, MD3; Channing J. Paller, MD3; Shirl Dipasquale, MS, RN1; Theodore L. DeWeese, MD1,3,5; Daniel Y. Song, MD1,3,5; Hao Wang, PhD3; Michael A. Carducci, MD3; Kenneth J. Pienta, MD3,5; Martin G. Pomper, MD, PhD4,5; Adam P. Dicker, MD, PhD6; Mario A. Eisenberger, MD3; Ash A. Alizadeh, MD, PhD7; Maximilian Diehn, MD, PhD2; Phuoc T. Tran, MD, PhD1,3,5
1Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, 2Stanford Cancer Institute, Department of Radiation Oncology, School of Medicine, Stanford University, Stanford, California, 3Department of Medical Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland, 4The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland, 5The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland, 6Sidney Kimmel Cancer Center, Department of Radiation Oncology, Thomas Jefferson University, Philadelphia, Pennsylvania, 7Stanford Cancer Institute, Division of Oncology, Department of Medicine, School of Medicine, Stanford University, Stanford, California
Source: Phillips R, Shi WY, Deek M, et al. Outcomes of Observation vs Stereotactic Ablative Radiation for Oligometastatic Prostate Cancer: The ORIOLE Phase 2 Randomized Clinical Trial. JAMA Oncol. Published online March 26, 2020. doi:10.1001/jamaoncol.2020.0147
Related content: https://www.urotoday.com/recent-abstracts/urologic-oncology/prostate-cancer/120241-intense-form-of-radiation-slows-disease-progression-in-some-men-with-prostate-cancer-that-has-spread.html
Previous studies suggest that androgen deprivation therapy (ADT) promotes antitumor immunity in prostate cancer. Whether a vaccine-based approach can augment this effect remains unknown.
Therefore, we conducted a neoadjuvant, randomized study to quantify the immunologic effects of a granulocyte-macrophage colony-stimulating factor (GM-CSF)-secreting allogeneic cellular vaccine in combination with low-dose cyclophosphamide (Cy/GVAX) followed by degarelix versus degarelix alone in patients with high-risk localized prostate adenocarcinoma who were planned for radical prostatectomy.
Prostate-specific membrane antigen (PSMA)-targeting radio-ligand therapy with beta-emitting 177Lutetium has already been investigated in several early phase dosimetry studies, demonstrated promising results in phase-2, and recently the first phase-3 trial finished recruitment.
To analyze contemporary multimodality treatment rates, defined as radical cystectomy plus chemotherapy and/or radiotherapy, for pT2-3 any N-stage M0 non-urothelial carcinoma of urinary bladder patients.
