OBJECTIVETo evaluate the outcomes of T3a prostate cancer with unfavorable prognostic factors treated with permanent interstitial brachytherapy combined with external radiotherapy and hormone therapy.

METHODSFrom January 2003 to December 2008, 38 patients classified as T3a prostate cancer with unfavorable prognostic factors were treated with trimodality therapy (brachytherapy + external radiotherapy + hormone therapy). The prescription dose of brachytherapy and external radiotherapy were 110 Gy and 45 Gy, respectively. The duration of hormone therapy was 2-3 years. The endpoints of this study included biochemical failure-free survival (BFFS), distant metastasis-free survival (DMFS), cancer-specific survival (CSS), and overall survival (OS). Survival curves were calculated using the Kaplan-Meier method. The Log-rank test was used to identify the prognostic predictors for univariate analysis.

RESULTSThe median follow-up was 71 months. The serum pre-treatment prostate-specific antigen (PSA) level ranged from 10.0 to 99.8 ng/ml (mean 56.3 ng/ml), the Gleason score ranged from 5 to 9 (median 8), and the percentage of positive biopsy cores ranged from 10% to 100% (mean 65%). The 5-year BFFS, DMFS, CSS, and OS rates were 44%, 69%, 82%, and 76%, respectively. All biochemical failures occurred within 40 months. The percentage of positive biopsy cores was significantly correlated with BFFS, DMFS, and OS (all P=0.000), and the Gleason score with DMFS (P=0.000) and OS (P=0.001).

CONCLUSIONST3a prostate cancer with unfavorable prognostic factors presents not so optimistic outcome. Hormone therapy should be applied to prolong the biochemical progression-free or metastasis-free survival. The percentage of positive biopsy cores and the Gleason score are significant prognostic factors.

Androgen Antagonists ; therapeutic use ; Brachytherapy ; Combined Modality Therapy ; Gonadotropin-Releasing Hormone ; agonists ; Humans ; Male ; Neoplasm Grading ; Prognosis ; Prostatic Neoplasms ; mortality ; pathology ; therapy ; Treatment Outcome

Objective To evaluate the clinical characteristics and outcomes of patients with Gleason score 10 prostate cancer treated by external radiotherapy and hormone therapy.
Methods From January 2003 to March 2014, 1832 patients with prostate cancer were treated, among which 9 patients (represented 0.49%) were identified as Gleason score 10 disease on prostate core biopsy without distant metastases when first diagnosed. All 9 patients were treated by whole pelvic external radiotherapy (The whole pelvic dose was 50.0 Gy and the boost dose ranged from 76.2 to 78.0 Gy) and long-term hormone therapy. We assessed the clinical characteristics, treatment outcomes and treatment toxicities. Survival curves were calculated using the Kaplan-Meier method.
Results The median follow-up was 4.8 years. Six patients’ pre-treatment prostate-specific antigen (PSA) levels were lower than 20.0μg/L and three patients’ pre-treatment PSA levels were higher than 70.0μg/L. The median percentage of positive biopsy cores was 91%. Three, four and two cases were classified as T2c, T3a and T3b stage, respectively. Three cases were assessed as N1 stage. The 5-year biochemical failure-free survival, distant metastasis-free survival, cancer specific survival and overall survival rates were 28.6%, 57.1%, 66.7%and 57.1%, respectively. Five patients experienced grade 1-2 acute gastrointestinal toxicities and six patients complained of grade 1-2 acute genitourinary toxicities. No bone fracture or cardiovascular disease was detected.
Conclusions Gleason score 10 prostate cancer on core biopsy is usually combined with other high risk factors. The pre-treatment PSA levels lie in two extremes. Timely and active treatments are urgent needed because unfavourable oncological outcomes are often presented.

The establishment of in vitro model will provide optimal conditions for the study of human papillomavirus (HPV)-associated cervical cancer. In this study, E6 and E7 gens of HPV31 were cloned and expressed in E. coli. The recombinant proteins were purified and used as antigens to immunize mice for the production of polyclonal antibody. Mammalian expression plasmid pBudCE4. 1-HPV31-E6/E7 was also constructed and transfected into C33A cells. The transfected cells were then selected by Zeocin. The expressions of the E6 and E7 mRNAs and proteins were detected by RT-PCR and Western blot respectively. A stable cervical cancer cell line was established as an in vitro model for the study of human papillomavirus type 31(HPV31) associated cervical cancer.
Animals ; Cell Line ; virology ; Female ; Human papillomavirus 31 ; genetics ; metabolism ; Humans ; Mice ; Oncogene Proteins, Viral ; genetics ; metabolism ; Papillomavirus E7 Proteins ; genetics ; metabolism ; Papillomavirus Infections ; virology ; Recombinant Proteins ; genetics ; metabolism ; Transfection

Objective To evaluate the effectiveness of brachytherapy combined with external beam radia -tion therapy and hormonal therapy in treating localized high-risk prostate cancer patients .Methods We retro-spectively analyzed 132 prostate cancer patients treated with brachytherapy from December 2003 to December 2007 in Department of Urology , Peking Union Medical College Hospital , including 97 localized high-risk pa-tients, and 35 localized low-to intermediate-risk patients.Postoperative prostate specific antigen ( PSA) level was monitored regularly in follow-up visits.Biochemical relapse , progression to castration-resistant prostate canc-er (CRPC) or metastasis, and deaths were documented .Biochemical progression-free survival (bPFS), cause-specific survival (CSS), and overall survival (OS) of the patients were evaluated .Results The bPFS, CSS, and OS of the 132 patients were 83.3%, 91.7%, and 84.8%, respectively;those indexes of the 97 localized high-risk patients were 81.4%, 88.7%, and 81.4%, respectively;and those of the 35 localized low-to inter-mediate-risk patients were 88.6%, 100%, and 94.3%, respectively .No significant difference was observed in bPFS and OS between high-risk and low-to intermediate-risk patients ( P=0.433 , 0.098 ) , while CSS was sig-nificant higher in low-to intermediate-risk patients than in high-risk patients ( P=0.037 ) .After patients were grouped based on Gleason score, tumor-node-metastasis (TNM) clinical stage, or preoperative PSA levels, differences in bPFS among groups were not statistically significant ( P=0.084 , 0.537 , 0.850 ) .Conclusion Brachytherapy combined with external beam radiation therapy and hormonal therapy may effectively control PSA level and delay biochemical relapse in localized high-risk prostate cancer .

Objective To analyze the clinical characteristics of patients with Gleason score 10 prostate cancer on core biopsy and without distant metastases when first diagnosed , and to evaluate the effectiveness of ex-ternal radiotherapy combined with hormone therapy in these patients .Methods From January 2003 to March 2014 , 9 patients were identified as Gleason score 10 prostate cancer without distant metastases when first diag-nosed at Peking Union Medical College Hospital .All the patients were treated by whole pelvic external radiothera-py and long-term hormone therapy .The whole pelvic radiation dose was 50.0 Gy, the boost dose for the whole prostate, bilateral seminal vesicles , and regional positive lymph nodes ranged from 76.2 to 78.0 Gy.The hor-mone therapy used maximal androgen blockade , i.e.oral anti-androgen drugs plus monthly injection of luteini-zing hormone-releasing hormone analogs .We assessed the clinical characteristics of the patients and the treat-ment outcomes of the combination therapy .Survival curves were calculated using the Kaplan-Meier method. Results The median follow-up was 4.8 years ( 26 -75 months ) .The median pre-treatment serum prostate specific antigen ( PSA) level was 11.2 μg/L.The pre-treatment PSA levels were lower than 20 μg/L in 6 pa-tients, and higher than 70 μg/L in 3 patients.The median percentage of positive biopsy cores was 90.9 %. In TNM staging, 3, 4, and 2 cases were classified as T2c, T3a, and T3b, respectively;6 and 3 cases were clas-sified as N0 and N1 , respectively;and all the 9 cases were classified as M0 .Six patients developed biochemical failure, 5 of which progressed into distant metastasis .Four patients died during the follow-up period, 3 of which died of prostate cancer .The 5-year biochemical failure-free survival ( BFFS ) , distant metastasis-free survival ( DMFS ) , cancer-specific survival ( CSS ) , and overall survival ( OS ) were 28.6%, 57.1%, 66.7%, and 57.1%, respectively .Five patients experienced grade 1-2 acute gastrointestinal ( GI) toxicity and 6 patients developed grade 1-2 acute genitourinary (GU) toxicity due to radiotherapy.No late GI or GU toxicity was reported.No bone fracture, cardiovascular event, or other severe hormone therapy-related compli-cations was detected .Conclusions Gleason score 10 prostate cancer without distant metastases when first di-agnosed may be often combined with high risk factors such as high percentage of positive biopsy cores , and ad-vanced tumor stage .Timely and active comprehensive treatments including external radiotherapy and hormone therapy are usually necessary because these patients generally have unfavorable prognosis .

OBJECTIVETo evaluate the clinical characteristics and outcomes of patients with Gleason score 10 prostate cancer treated by external radiotherapy and hormone therapy.

METHODSFrom January 2003 to March 2014, 1832 patients with prostate cancer were treated, among which 9 patients (represented 0.49%) were identified as Gleason score 10 disease on prostate core biopsy without distant metastases when first diagnosed. All 9 patients were treated by whole pelvic external radiotherapy (The whole pelvic dose was 50.0 Gy and the boost dose ranged from 76.2 to 78.0 Gy) and long-term hormone therapy. We assessed the clinical characteristics, treatment outcomes and treatment toxicities. Survival curves were calculated using the Kaplan-Meier method.

RESULTSThe median follow-up was 4.8 years. Six patients' pre-treatment prostate-specific antigen (PSA) levels were lower than 20.0 μg/L and three patients' pre-treatment PSA levels were higher than 70.0 μg/L. The median percentage of positive biopsy cores was 91%. Three, four and two cases were classified as T2c, T3a and T3b stage, respectively. Three cases were assessed as N1 stage. The 5-year biochemical failure-free survival, distant metastasis-free survival, cancer specific survival and overall survival rates were 28.6%, 57.1%, 66.7% and 57.1%, respectively. Five patients experienced grade 1-2 acute gastrointestinal toxicities and six patients complained of grade 1-2 acute genitourinary toxicities. No bone fracture or cardiovascular disease was detected.

CONCLUSIONSGleason score 10 prostate cancer on core biopsy is usually combined with other high risk factors. The pre-treatment PSA levels lie in two extremes. Timely and active treatments are urgent needed because unfavourable oncological outcomes are often presented.

Aged ; Aged, 80 and over ; Biopsy ; Combined Modality Therapy ; Humans ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasm Staging ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; blood ; mortality ; pathology ; therapy