1
|
Tae BS, Ahn ST, Yoo JW, Song MS, Choi H, Bae JH, Park JY. Is There a Difference in the Incidence of Depression between Radiation and Surgical Treatments in Patients with Prostate Cancer? World J Mens Health 2024; 42:237-244. [PMID: 38171378 PMCID: PMC10782121 DOI: 10.5534/wjmh.230119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 08/24/2023] [Accepted: 09/01/2023] [Indexed: 01/05/2024] Open
Abstract
PURPOSE Patients with cancer have a high risk of depression. However, a few studies have assessed differences in the incidence of depression among patients with prostate cancer (PC) based on whether they received radiotherapy (RTx) or surgical treatment. MATERIALS AND METHODS We analyzed data from the National Health Insurance Sharing Service database regarding the entire Korean adult population with PC (n=210,924) between 2007 and 2017. The adjusted hazard ratios (HRs) of depression associated with treatment were estimated using propensity score-matched Cox proportional hazards models and Kaplan-Meier survival analyses. RESULTS Our final cohort comprised 9,456 patients with PC; of which, 8,050 men underwent surgery. During a mean follow-up duration of 7.1 years, 503 (5.3%) patients were newly diagnosed with depression. A significant difference in the incidence of depression was noted between the RTx and surgery groups (RTx vs. surgery: 5.55% vs. 5.28%; p=0.011) in the unmatched cohort. In the matched cohort, older age (≥70 years, HR: 1.596, p<0.001) and poor Charlson comorbidity index scores (HR: 1.232, p=0.039) were correlated with the risk of depression. In addition, the adjusted HR for depression in the surgery group was 0.843 (p=0.221) compared with that in the RTx group. Kaplan-Meier analyses revealed that no significant difference in the cumulative probability of persistent depression was detected between the RTx and surgery groups in matched cohort (p=0.3386). CONCLUSIONS In this nationwide population-based study, no significant differences in the risk of depression were observed between the surgical and RTx groups.
Collapse
Affiliation(s)
- Bum Sik Tae
- Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Sun Tae Ahn
- Department of Urology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Korea
| | - Jung Wan Yoo
- Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Min Sung Song
- Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Hoon Choi
- Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Jae Hyun Bae
- Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Jae Young Park
- Department of Urology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea.
| |
Collapse
|
2
|
Postoperative Effect Observation and Clinical Study of Dahuang Zhechong Pills from Jingui Yaolue in Treating Patients with Early-to-Mid Prostate Cancer Undergoing Radical Resection. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:2998825. [PMID: 35528360 PMCID: PMC9068324 DOI: 10.1155/2022/2998825] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 04/07/2022] [Accepted: 04/15/2022] [Indexed: 01/24/2023]
Abstract
Objective To explore the effect of applying Dahuang Zhechong pills (DHZCP) from Jingui Yaolue to patients with early-to-mid prostate cancer undergoing radical resection and carry out a theoretical clinical study of traditional Chinese medicine (TCM) to verify the effect of DHZCP formula under the guidance of TCM theory. Methods The clinical data of 98 patients with early-to-mid prostate cancer undergoing radical resection treated in our hospital (July 2014 to July 2016) were selected for the retrospective analysis, and the patients were divided into group A (n = 49, routine hormonal therapy) and group B (n = 49, routine hormonal therapy plus DHZCP) according to the double blind method, so as to compare the trauma symptoms, cancer recurrence rate, etc., after treatment between the two groups. Results Compared with group A, group B obtained significantly higher total effective rate of complication treatment at different time points (P < 0.05), significantly lower mean HAMA score after treatment (P < 0.05), and significantly lower total recurrence rate (P < 0.05). The "congestion" theory in Chapter VI On Pulse, Symptom Complex and Treatment of Arthralgia Due to Stagnation of Blood and Consumptive Diseases of Jingui Yaolue was the theoretical basis for postoperative effect observation of DHZCP in treating prostate cancer. Combining with the onset theory of congestion, personally, the author believed that cancer is caused by congestion disease formed by the extravasated blood in the human body, and with the passing of time, the intermingled deficiency, blood stasis, and toxicity lead to the qualitative change of endogenous cancer toxicity and develop into consumptive congestion disease, making it the core pathogenesis of cancer. And DHZCP had good preventive and treatment effect. Conclusion DHZCP is an effective drug for improving postoperative complications of early-to-mid prostate cancer, reducing the biological recurrence rate and clinical recurrence rate, and improving mental status. The formula treats both deficiency and excess, combines tonification with purgation, and dispels exogenous pathogen without damaging body resistance, which is a profound formula based on TCM theory to treat "congestion," "congestion disease," and "consumptive congestion disease." Using this theory to guide clinical syndrome differentiation and treatment and modifying the dosage and usage can play an important role in TCM preventive treatment of cancers, early, middle, and late treatment, and clinical prevention of other chronic diseases.
Collapse
|
3
|
Munoz F, Sanguineti G, Bresolin A, Cante D, Vavassori V, Waskiewicz JM, Girelli G, Avuzzi B, Garibaldi E, Faiella A, Villa E, Magli A, Noris Chiorda B, Gatti M, Rancati T, Valdagni R, Di Muzio NG, Fiorino C, Cozzarini C. Predictors of Patient-Reported Incontinence at Adjuvant/Salvage Radiotherapy after Prostatectomy: Impact of Time between Surgery and Radiotherapy. Cancers (Basel) 2021; 13:cancers13133243. [PMID: 34209562 PMCID: PMC8269132 DOI: 10.3390/cancers13133243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/16/2021] [Accepted: 06/24/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Baseline urinary incontinence (UI) strongly modulates UI recovery after adjuvant/salvage radiotherapy (ART/SRT), inducing clinicians to postpone it "as much as possible", maximizing UI recovery but possibly reducing efficacy. This series aims to analyze the trend of UI recovery and its predictors at radiotherapy start. METHODS A population of 408 patients treated with ART/SRT enrolled in a cohort study (ClinicalTrials.gov #NCT02803086) aimed at developing predictive models of radiation-induced toxicities. Self-reported UI and personality traits, evaluated by means of the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-SF) and Eysenck Personality Questionnaire - Revised (EPQ-R) questionnaires, were assessed at ART/SRT start. Several endpoints based on baseline ICIQ-SF were investigated: frequency and amount of urine loss (ICIQ3 and ICIQ4, respectively), "objective" UI (ICIQ3 + 4), "subjective" UI (ICIQ5), and "TOTAL" UI (ICIQ3 +4 + 5). The relationship between each endpoint and time from prostatectomy to radiotherapy (TTRT) was investigated. The association between clinical and personality variables and each endpoint was tested by uni- and multivariable logistic regression. RESULTS TTRT was the strongest predictor for all endpoints (p-values ≤ 0.001); all scores improved between 4 and 8 months after prostatectomy, without any additional long-term recovery. Neuroticism independently predicted subjective UI, TOTAL UI, and daily frequency. CONCLUSIONS Early UI recovery mostly depends on TTRT with no further improvement after 8 months from prostatectomy. Higher levels of neuroticism may overestimate UI.
Collapse
Affiliation(s)
- Fernando Munoz
- SC Radioterapia Oncologica, Ospedale Regionale Parini-AUSL Valle d’Aosta, 11100 Aosta, Italy;
| | - Giuseppe Sanguineti
- Deptartment of Radiotherapy, IRCCS Istituto Nazionale dei Tumori “Regina Elena”, 00144 Roma, Italy; (G.S.); (A.F.)
| | - Andrea Bresolin
- Deptartment of Medical Physics and Deptartment of Radiotherapy, IRCCS Istituto Scientifico Ospedale San Raffaele, 20132 Milano, Italy; (A.B.); (N.G.D.M.); (C.C.)
| | - Domenico Cante
- Deptartment of Radiotherapy, ASL TO4, Ospedale di Ivrea, 10015 Ivrea, Italy;
| | - Vittorio Vavassori
- Deptartment of Radiotherapy, Cliniche Gavazzeni-Humanitas, 24125 Bergamo, Italy; (V.V.); (E.V.)
| | | | - Giuseppe Girelli
- Deptartment of Radiotherapy, Ospedale degli Infermi, 22399 Biella, Italy;
| | - Barbara Avuzzi
- Deptartment of Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy; (B.A.); (B.N.C.); (T.R.); (R.V.)
| | - Elisabetta Garibaldi
- SC Radioterapia, AO SS Antonio e Biagio e Cesare Arrigo Alessandria, 15121 Alessandria, Italy;
| | - Adriana Faiella
- Deptartment of Radiotherapy, IRCCS Istituto Nazionale dei Tumori “Regina Elena”, 00144 Roma, Italy; (G.S.); (A.F.)
| | - Elisa Villa
- Deptartment of Radiotherapy, Cliniche Gavazzeni-Humanitas, 24125 Bergamo, Italy; (V.V.); (E.V.)
| | - Alessandro Magli
- Deptartment of Radiotherapy, Azienda Ospedaliero Universitaria S. Maria della Misericordia, 33100 Udine, Italy;
| | - Barbara Noris Chiorda
- Deptartment of Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy; (B.A.); (B.N.C.); (T.R.); (R.V.)
| | - Marco Gatti
- Istituto di Candiolo, Fondazione del Piemonte per l’Oncologia IRCCS, Candiolo, 10060 Torino, Italy;
| | - Tiziana Rancati
- Deptartment of Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy; (B.A.); (B.N.C.); (T.R.); (R.V.)
- Programma Prostata, Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | - Riccardo Valdagni
- Deptartment of Radiation Oncology 1, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy; (B.A.); (B.N.C.); (T.R.); (R.V.)
- Programma Prostata, Prostate Cancer Program, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
- Deptartment of Oncology and Hemato-Oncology, Università degli Studi di Milano, 20122 Milan, Italy
| | - Nadia G. Di Muzio
- Deptartment of Medical Physics and Deptartment of Radiotherapy, IRCCS Istituto Scientifico Ospedale San Raffaele, 20132 Milano, Italy; (A.B.); (N.G.D.M.); (C.C.)
| | - Claudio Fiorino
- Deptartment of Medical Physics and Deptartment of Radiotherapy, IRCCS Istituto Scientifico Ospedale San Raffaele, 20132 Milano, Italy; (A.B.); (N.G.D.M.); (C.C.)
- Correspondence:
| | - Cesare Cozzarini
- Deptartment of Medical Physics and Deptartment of Radiotherapy, IRCCS Istituto Scientifico Ospedale San Raffaele, 20132 Milano, Italy; (A.B.); (N.G.D.M.); (C.C.)
| |
Collapse
|
4
|
Pinkawa M, Gharib A, Schlenter M, Timm L, Eble MJ. Quality of life more than 10 years after radiotherapy for localized prostate cancer-impact of time after treatment and prescription dose. Qual Life Res 2020; 30:437-443. [PMID: 33034812 PMCID: PMC7886756 DOI: 10.1007/s11136-020-02639-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2020] [Indexed: 01/13/2023]
Abstract
Purpose Analysis of quality of life changes after radiotherapy with focus on the impact of time after treatment and prescription dose. Methods Consecutive patients were treated with doses from 70.2/1.8 Gy (n = 206) to 72/1.8–2.0 Gy (n = 176) in a single centre and surveyed using the Expanded Prostate Cancer Index Composite questionnaire. Results Urinary and bowel bother scores decreased 1 / 3 / 6 points and 7 / 7 / 9 points on average 1 / 5 / 10 years after RT in comparison to baseline scores. The rate of urinary (need of pads in 8% vs. 15% before vs. 10 years after RT; p = 0.01) and bowel (uncontrolled leakage of stool in 5% vs. 12% before vs. 10 years after RT; p < 0.01) incontinence, as well as rectal bleeding (4% vs. 8% before vs. 10 years after RT; p = 0.05) increased. Sexual function scores decreased (erections sufficient for intercourse in 36% vs. 12% before vs. 10 years after RT; p < 0.01). A higher dose had a statistically significant impact on urinary bother and stool incontinence, but also tended to decrease urinary continence. Age and comorbidities did not have an influence on score changes, but on baseline urinary function/bother and baseline sexual function. Conclusion Apart from an increasing rate of erectile dysfunction, urinary and bowel incontinence rates increased with increasing follow-up period. A higher dose was found to be associated with increased urinary problems and larger stool incontinence rates. Age and comorbidities were found to be relevant for baseline scores, but not for score changes.
Collapse
Affiliation(s)
- Michael Pinkawa
- Department of Radiation Oncology, RWTH Aachen University, Pauwelsstrasse 30, 52072, Aachen, Germany. .,Department of Radiation Oncology, MediClin Robert Janker Klinik, Villenstr. 8, 53129, Bonn, Germany.
| | - Amr Gharib
- Department of Radiation Oncology, RWTH Aachen University, Pauwelsstrasse 30, 52072, Aachen, Germany
| | - Marsha Schlenter
- Department of Radiation Oncology, RWTH Aachen University, Pauwelsstrasse 30, 52072, Aachen, Germany
| | - Ludmila Timm
- Department of Radiation Oncology, RWTH Aachen University, Pauwelsstrasse 30, 52072, Aachen, Germany.,Department of Radiation Oncology, MediClin Robert Janker Klinik, Villenstr. 8, 53129, Bonn, Germany
| | - Michael J Eble
- Department of Radiation Oncology, RWTH Aachen University, Pauwelsstrasse 30, 52072, Aachen, Germany
| |
Collapse
|
5
|
Braide K, Kindblom J, Lindencrona U, Månsson M, Hugosson J. A comparison of side-effects and quality-of-life in patients operated on for prostate cancer with and without salvage radiation therapy. Scand J Urol 2020; 54:393-400. [PMID: 32619133 DOI: 10.1080/21681805.2020.1782980] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE The extent of late side-effects in prostate cancer patients, after radical prostatectomy (RP = reference group) and salvage radiation therapy (SRT) in a self-reporting perspective (PROM) is still under-reported. We aimed to investigate the rate and severity of side-effects and quality-of-life (QoL) according to PROM. METHODS AND MATERIALS A PROM survey was administered to a cohort of SRT patients matched to a reference group with median follow-up 10 years after surgery. In total, 740 patients were analyzed. To investigate the association between SRT versus reference group regarding side-effects and QoL, a Poisson regression analysis was conducted and presented as relative risk estimates (RR) together with 95% confidence intervals regarding questions related to urinary, rectal, sexual symptoms and QoL. RESULTS RRs ranged from of 1.7-6.5 on rectal symptoms and 1.2-1.4 for urinary symptoms. In general health, QoL and sexual function all RRs were below 1.1. With increasing age, higher RRs were seen for urinary leakage and lowered sexual function whereas longer time following irradiation showed higher RRs for rectal symptoms and rectal leakage. Limitations of this study include the cross-sectional design and lack of baseline assessment. CONCLUSIONS Adding SRT to RP does not seem to result in other than acceptable side-effects in the majority of men receiving SRT when taking a long follow-up time (median 10 years after surgery) into account. However, a subset of men develop severe side-effects where rectal bleeding dominates.
Collapse
Affiliation(s)
- Karin Braide
- Department of Urology, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden.,Department of Urology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jon Kindblom
- Department of Oncology, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden.,Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ulrika Lindencrona
- Department of Radiation Physics, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Marianne Månsson
- Department of Urology, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Jonas Hugosson
- Department of Urology, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
6
|
Lu YC, Huang CY, Lu YC, Huang KH, Chow PM, Chang YK, Hung FC, Chen CH, Jaw FS, Hong JH. Association between low prostate-specific antigen levels and greater disease progression in high-grade locally-advanced prostate cancer. J Formos Med Assoc 2020; 120:483-491. [PMID: 32591157 DOI: 10.1016/j.jfma.2020.06.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 06/08/2020] [Accepted: 06/16/2020] [Indexed: 10/24/2022] Open
Abstract
PURPOSE In advanced or high-grade prostate cancer (PCa), prostate-specific antigen (PSA) is usually elevated, however, some patients may present with low initial PSA (iPSA) levels. The objective of this study was to evaluate whether different iPSA levels were associated with dissimilar clinical outcomes among men with high-grade PCa and advanced disease after robot-assisted laparoscopic radical prostatectomy (RaLRP). METHODS This study enrolled 69 PCa patients with initial Gleason score ≥8 and pathologic T-stage ≥3a from April 2012 to December 2018. Patients were stratified into 3 groups based on iPSA levels at diagnosis: <5.0, 5.0-9.9, and ≥10.0. The patients' related parameters were compared among these groups. RESULTS The median follow-up period was 33.1 months (IQR: 12.1-48.1). There was no difference in biochemical recurrence (BCR) between the 3 groups (Log-rank test, p = 0.484). We found a higher risk of biochemical recurrence in patients with positive surgical margins (HR: 5.04, 95% CI: 1.64-15.50, p = 0.005). In addition, patients with low iPSA levels (<5.0 ng/mL) had poor radiographic progression-free survival (Log-rank test, p = 0.001) and a higher risk of disease progression (HR: 12.2, 95% CI: 1.18-1260.99, p = 0.036) compared with patients with higher iPSA levels (≥10 ng/mL). CONCLUSION In patients with high-grade locally-advanced PCa, a low iPSA level was associated with a higher risk of disease progression, but not with biochemical recurrence. In this unique population, serum PSA may not be a reliable marker to detect disease progression. Monitoring of these patients may warrant other biomarkers or imaging.
Collapse
Affiliation(s)
- Yu-Cheng Lu
- Department of Urology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chao-Yuan Huang
- Department of Urology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yu-Chuan Lu
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan; Department of Urology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Kuo-How Huang
- Department of Urology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Po-Ming Chow
- Department of Urology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yi-Kai Chang
- Department of Urology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Fan-Ching Hung
- Department of Urology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chung-Hsin Chen
- Department of Urology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Fu-Shan Jaw
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan
| | - Jian-Hua Hong
- Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan; Department of Urology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
| |
Collapse
|