Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Proton therapy treatment preserves quality of life for men with prostate cancer

30.10.2012
Two MD Anderson-led studies conclude that patients' urinary, bowel function safe-guarded

Two studies led by The University of Texas MD Anderson Cancer Center have found that proton therapy preserves the quality of life, specifically urinary and bowel function, in men treated with this targeted radiation modality for prostate cancer.

Both studies, led by Andrew K. Lee, M.D., M.P.H., associate professor in MD Anderson's Department of Radiation Oncology, will be presented in a poster session at the 54th Annual Meeting of the American Society for Radiation Oncology (ASTRO).

"As oncologists, we obviously want good cancer control outcomes, but we also want to ensure that patients maintain a strong sense of continued quality of life after treatment, which can be very personal and subjective for each patient," said Lee.

"With this research, we looked at the well being of prostate cancer patients, post-treatment, and it was important that we obtain this information directly from men who actually underwent the therapy, rather than from their treatment providers," Lee continued. "In our own practice, we've observed that patients have done very well as measured by disease control and quality of life metrics. Our findings, both the wider-perspective multicenter study and the research conducted solely at MD Anderson, validate what we observe in our clinic."

The first, a multi-institutional study, and one of the largest quality of life studies of its kind ever conducted in such a patient population, involved more than 1,000 patients treated with proton therapy for various stages of prostate cancer. The men had all received proton therapy, with or without hormone therapy, at one of five proton therapy centers across the country. All participants were at least one year to more than 10 years post-treatment. The men completed the Expanded Prostate Cancer Index Composite (EPIC) survey, a comprehensive and validated tool designed to assess a patient's health-related quality of life, including function and bother after prostate cancer treatment. (The survey uses a scoring system of 1 to 100 in several quality of life areas; higher EPIC scores correlate with better function and quality of life.) The self-reporting was independently conducted by the patient, unaided by their respective treating institution.

This cohort of prostate cancer patients was compared to a cohort of 112 healthy men, all of whom did not have prostate cancer. The median age of those with prostate cancer and those without the disease was 65 and 64.8 years old, respectively.

In the post-treatment analysis, Lee and his colleagues found that men with prostate cancer treated with proton therapy reported excellent urinary and bowel summary scores, 89.8/100 and 92.7/100, respectively, similar to the healthy men, 89.5/100, and 92.4/100, respectively.

When comparing sexual function in both cohorts, the researchers found a statistically significant difference in the healthy men, compared to in those treated with proton therapy.

"However, when further analyzing these scores, it's important to note that decreased sexual function is more often associated with those proton patients who also received hormone therapy, had higher Gleason scores, were older at time of treatment, and/or greater years post treatment," Lee noted.

"In general, our patients are interested in learning how they will do compared to those treated with other modalities, but, more importantly, they want to know how they are going to do relative to their own normal state of health. With such a large data set, this study offers us a guide to have that discussion with patients considering proton therapy."

The second study focused only on patients treated at MD Anderson for prostate cancer with proton therapy; the findings complement those of the multi-center study. All of the men were treated for localized prostate cancer with proton therapy with or without hormone therapy between 2006 and 2009.

For this prospective study, Lee looked at the quality of life scores of 299 men receiving one of two proton doses: one cohort (100 men) received 75.6 Gray Equivalents (GyE) at 1.8 GyE/fraction; the second cohort (199 men) received 76 GyE at 2 GyE/fraction. The median age of both groups was 65 years old. Study participants completed the EPIC survey before receiving proton therapy, and at periodic intervals following their therapy.

Lee and his MD Anderson colleagues found a small but statistically significant difference in both groups in urinary and bowel function from their baseline scores to their scores at three years post-treatment; however, these changes were not clinically significant. No meaningful difference in quality of life changes between the dose groups was noted, except for sexual bother.

The researchers also assessed for toxicities in these patients. The three-year cumulative rates of Grade 2 urinary side effects, defined by Lee as those requiring some medical intervention (e.g. alpha blockers), were 24.1 percent and 17.6 percent for the 75.6 GyE and 76 GyE groups, respectively. The three-year cumulative rates of grade two rectal side effects were 10 percent and 13 percent for the first and second cohort, respectively. Only two men had Grade 3 toxicities, requiring additional medical or procedural intervention.

Three years post-treatment, both groups reported high satisfaction rates with their proton therapy, 91 percent and 93.5 percent.

Lee and his colleagues hope to compare the findings in the multi-center trial to patients who received other treatment modalities. He also plans to perform an analysis of a larger group of MD Anderson proton patients with longer follow up.

Besides Lee, other authors on the all-MD Anderson study include: Seungtaek Choi, M.D., Quynh Nguyen, M.D., TJ Pugh, M.D., Benson Mathai, Steven Frank, M.D., Karen Hoffman, M.D., Deborah Kuban, M.D., Sean McGuire, M.D., Ph.D. and Mark Munsell.

Other authors on the multi-institutional study include: Lawrence Levy, Seungtaek Choi, M.D., and Quynh Nguyen, M.D., all from MD Anderson; Carl Rossi, M.D., Scripps Proton Center; David Bush, M.D. and Jerry Slater, M.D., Loma Linda University Medical Center; Nancy Mendenhall, M.D., University of Florida Proton Therapy Institute; Sameer Keole, M.D., Radiation Medicine Associates; and Anthony Zietman, M.D., Massachusetts General Hospital.

For the multi-institutional study, the EPIC survey was distributed by ProtonBOB, a prostate cancer advocacy organization. None of the authors report financial declarations.

About MD Anderson:

The University of Texas MD Anderson Cancer Center in Houston ranks as one of the world's most respected centers focused on cancer patient care, research, education and prevention. MD Anderson is one of only 41 comprehensive cancer centers designated by the National Cancer Institute. For nine of the past 11 years, including 2012, MD Anderson has ranked No. 1 in cancer care in "America's Best Hospitals," a survey published annually in U.S. News & World Report.

Laura Sussman | EurekAlert!
Further information:
http://www.mdanderson.org

More articles from Health and Medicine:

nachricht Millions through license revenues
27.04.2017 | Rheinische Friedrich-Wilhelms-Universität Bonn

nachricht New High-Performance Center Translational Medical Engineering
26.04.2017 | Fraunhofer ITEM

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Making lightweight construction suitable for series production

More and more automobile companies are focusing on body parts made of carbon fiber reinforced plastics (CFRP). However, manufacturing and repair costs must be further reduced in order to make CFRP more economical in use. Together with the Volkswagen AG and five other partners in the project HolQueSt 3D, the Laser Zentrum Hannover e.V. (LZH) has developed laser processes for the automatic trimming, drilling and repair of three-dimensional components.

Automated manufacturing processes are the basis for ultimately establishing the series production of CFRP components. In the project HolQueSt 3D, the LZH has...

Im Focus: Wonder material? Novel nanotube structure strengthens thin films for flexible electronics

Reflecting the structure of composites found in nature and the ancient world, researchers at the University of Illinois at Urbana-Champaign have synthesized thin carbon nanotube (CNT) textiles that exhibit both high electrical conductivity and a level of toughness that is about fifty times higher than copper films, currently used in electronics.

"The structural robustness of thin metal films has significant importance for the reliable operation of smart skin and flexible electronics including...

Im Focus: Deep inside Galaxy M87

The nearby, giant radio galaxy M87 hosts a supermassive black hole (BH) and is well-known for its bright jet dominating the spectrum over ten orders of magnitude in frequency. Due to its proximity, jet prominence, and the large black hole mass, M87 is the best laboratory for investigating the formation, acceleration, and collimation of relativistic jets. A research team led by Silke Britzen from the Max Planck Institute for Radio Astronomy in Bonn, Germany, has found strong indication for turbulent processes connecting the accretion disk and the jet of that galaxy providing insights into the longstanding problem of the origin of astrophysical jets.

Supermassive black holes form some of the most enigmatic phenomena in astrophysics. Their enormous energy output is supposed to be generated by the...

Im Focus: A Quantum Low Pass for Photons

Physicists in Garching observe novel quantum effect that limits the number of emitted photons.

The probability to find a certain number of photons inside a laser pulse usually corresponds to a classical distribution of independent events, the so-called...

Im Focus: Microprocessors based on a layer of just three atoms

Microprocessors based on atomically thin materials hold the promise of the evolution of traditional processors as well as new applications in the field of flexible electronics. Now, a TU Wien research team led by Thomas Müller has made a breakthrough in this field as part of an ongoing research project.

Two-dimensional materials, or 2D materials for short, are extremely versatile, although – or often more precisely because – they are made up of just one or a...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Expert meeting “Health Business Connect” will connect international medical technology companies

20.04.2017 | Event News

Wenn der Computer das Gehirn austrickst

18.04.2017 | Event News

7th International Conference on Crystalline Silicon Photovoltaics in Freiburg on April 3-5, 2017

03.04.2017 | Event News

 
Latest News

Bare bones: Making bones transparent

27.04.2017 | Life Sciences

Study offers new theoretical approach to describing non-equilibrium phase transitions

27.04.2017 | Physics and Astronomy

From volcano's slope, NASA instrument looks sky high and to the future

27.04.2017 | Earth Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>