Neoadjuvant radiohormonal therapy for oligo-metastatic prostate cancer: safety and efficacy outcomes from an open-label, dose-escalation, single-center, phase I/II clinical trial / 医学前沿

To evaluate the safety and efficacy of neoadjuvant radiohormonal therapy for oligometastatic prostate cancer (OMPC), we conducted a 3 + 3 dose escalation, prospective, phase I/II, single-arm clinical trial (CHiCTR1900025743), in which long-term neoadjuvant androgen deprivation was adopted 1 month before radiotherapy, comprising intensity modulated radiotherapy to the pelvis, and stereotactic body radiation therapy to all extra-pelvic bone metastases for 4-7 weeks, at 39.6, 45, 50.4, and 54 Gy. Robotic-assisted radical prostatectomy was performed after 5-14 weeks. The primary outcome was treatment-related toxicities and adverse events; secondary outcomes were radiological treatment response, positive surgical margin (pSM), postoperative prostate-specific antigen (PSA), pathological down-grading and tumor regression grade, and survival parameters. Twelve patients were recruited from March 2019 to February 2020, aging 66.2 years in average (range, 52-80). Median baseline PSA was 62.0 ng/mL. All underwent RARP successfully without open conversions. Ten patients recorded pathological tumor down-staging (83.3%), and 5 (41.7%) with cN1 recorded negative regional lymph nodes on final pathology. 66.7% (8/12) recorded tumor regression grading (TRG) -I and 25% (3/12) recorded TRG-II. Median follow-up was 16.5 months. Mean radiological progression-free survival (RPFS) was 21.3 months, with 2-year RPFS of 83.3%. In all, neoadjuvant radiohormonal therapy is well tolerated for oligometastatic prostate cancer.

Conhecimento, comportamento e práticas em saúde do homem em relação ao câncer de próstata / Knowledge, behaviour and health practices of men concerning the prostate cancer / Conocimiento, comportamiento y práctica en salud del hombre en relación con cáncer de próstata

Objetivo: Descrever o conhecimento, o comportamento e as práticas em relação ao câncer de próstata em adultos. Métodos: Estudo quantitativo, realizado com 130 homens. A coleta de dados ocorreu no primeiro semestre de 2015, por meio do Modelo de Crenças em Saúde. Resultados: Embora relatem conhecimento sobre o câncer, 30% realizam a dosagem do Antígeno Prostático Específico e 17,6% o exame de toque retal anualmente. A maioria percebe a susceptibilidade e a severidade do câncer e acredita que é capaz de fazer algo por si mesmo, beneficiando-se com esses cuidados. Quanto às barreiras, 16,9% apresentaram comportamento não preventivo. Conclusão: O medo da dor, a vergonha e a falta de coragem para realizar o exame constituem barreiras a esses indivíduos. A equipe de saúde deve oportunizar abordagens considerando esses aspectos, utilizando estratégias que ampliem o acesso dos homens ao serviço de saúde e estimulem a prática do autocuidado

Objective: The study's purpose has benn to describe the knowledge, behavior and health practices regarding the prostate cancer in adults. Methods: It is a cross-sectional and descriptive study with a quantitative approach, which had 130 participating men. Data collection took place from March to April 2015, using the Health Belief Model. Results: Although they report having knowledge about cancer, only 30% had done the prostate-specific antigen dosage and 17.6% the rectal examination annually. Most comprehend the susceptibility and severity of this cancer, and believe that they are capable of doing something for themselves and benefiting from such care. Regarding the barriers, 16.9% had non-preventive behavior. Conclusion: Fear of pain, shame, and lack of courage to take the exam are barriers to these individuals. The health team should opportunistically approach these aspects by using strategies that increase men's access to health care and encourage self-care practices

Objetivo: Describir el conocimiento, el comportamiento y las prácticas en relación al cáncer de próstata en adultos. Métodos: Estudio cuantitativo, realizado con 130 hombres. La recolección de datos ocurrió entre marzo a abril de 2015, a través del Modelo de Creencias en Salud. Resultados: Aunque reportan conocimiento sobre el cáncer, el 30% realiza la dosificación del Antígeno Prostático y el 17,6% el examen de tacto anual. La mayoría percibe la susceptibilidad y la severidad del cáncer y cree que es capaz de hacer algo por sí mismo y beneficiarse con esos cuidados. En cuanto a las barreras, el 16,9% presentó comportamiento no preventivo. Conclusión: El miedo al dolor, la vergüenza y la falta de coraje para realizar el examen constituyen barreras a esos individuos. El equipo de salud debe oportunizar enfoques considerando estos aspectos, utilizando estrategias que amplíen el acceso al servicio de salud y estimulen la práctica del autocuidado