Health-related quality of life in men with localized prostate cancer treated with radiotherapy: validation of an abbreviated version of the Expanded Prostate Cancer Index Composite for Clinical Practice in Spain.

BACKGROUND: Health-related quality of life (HRQoL) is greatly affected by prostate cancer (PCa) and associated treatments. This study aimed to measure the impact of radiotherapy on HRQoL and to further validate the Spanish version of the 16-item Expanded Prostate Cancer Index Composite (EPIC-16) in routine clinical practice. METHODS: An observational, non-interventional, multicenter study was conducted in Spain with localized PCa patients initiating treatment with external beam radiotherapy (EBRT) or brachytherapy (BQT). Changes from baseline in EPIC-16, University of California-Los Angeles Prostate Cancer Index (UCLA-PCI), and patient-perceived health status were longitudinally assessed at end of radiotherapy (V2) and 90 days thereafter (V3). Psychometric evaluations of the Spanish EPIC-16 were conducted. RESULTS: Of 516 patients enrolled, 495 were included in the analysis (EBRT, n = 361; BQT, n = 134). At baseline, mean (standard deviation [SD]) EPIC-16 global scores were 11.9 (7.5) and 10.3 (7.7) for EBRT and BQT patients, respectively; scores increased, i.e., HRQoL worsened, from baseline, by mean (SD) of 6.8 (7.6) at V2 and 2.4 (7.4) at V3 for EBRT and 4.2 (7.6) and 3.9 (8.2) for BQT patients. Changes in Spanish EPIC-16 domains correlated well with urinary, bowel, and sexual UCLA-PCI domains. EPIC-16 showed good internal consistency (Cronbach's alpha = .84), reliability, and construct validity. CONCLUSION: The Spanish EPIC-16 questionnaire demonstrated sensitivity, strong discriminative properties and reliability, and validity for use in clinical practice. EPIC-16 scores worsened after radiotherapy in different HRQoL domains; however, a strong tendency towards recovery was seen at the 3-month follow-up visit.

SIMBOSPROST: Prevalence of metabolic syndrome and osteoporosis in prostate cancer patients treated with radiotherapy and androgen deprivation therapy: A multicentre, cross-sectional study.

AIM: To assess the prevalence of metabolic syndrome (MetS) and osteoporosis in patients with prostate cancer (PCa) treated with radical radiotherapy (RT) with or without androgen deprivation therapy (ADT). BACKGROUND: Worldwide, the prevalence of MetS is estimated to range from 20% to 25% of the adult population. However, prevalence rates are much higher in PCa patients (pts) who undergo ADT. MATERIALS AND METHODS: Multicentre cross-sectional study of 270 pts in Spain with PCa. Patients were divided into 3 groups based on the duration of ADT (6, 12-18, ≥24 months) and compared to a control group without ADT. MetS was defined according to NCEP ATP III criteria. Osteoporosis was assessed by DEXA. RESULTS: A total of 270 pts, treated from November 2011 to October 2012, were included. Of these, 122 pts (47%) fulfilled the criteria for MetS. The median age of this group was significantly higher (71.3 vs. 69.38 years, p = 0.028). MetS prevalence was 50% in the control group. In pts who received ADT, prevalence was 44.8% after 6 months of ADT, 45.3% after 12-18 months, and 50% after ≥24 months (pns). Most pts (168/270; 62%) underwent DEXA. Of those tested, 78 (46.4%) had osteopenia and only 11 (6.5%) had osteoporosis. CONCLUSIONS: The prevalence of MetS in pts with PCa treated with radical RT was higher (47%) than in the general population. However, there were no significant differences in the duration of ADT administration. The prevalence of osteoporosis was low. These findings suggest that the prevalence of MetS in PCa patients may be higher than previously reported.

Radioterapia como tratamiento paliativo de la obstrucción biliar tumoral / Radiotherapy as palliative treatment of malignant biliary obstruction

OBJETIVOS: La ictericia obstructiva es un síntoma frecuente en los tumores irresecables de la vía biliar. Presentamos un caso clínico con diagnóstico de colangiocarcinoma recurrente con ictericia obstructiva tratada con radioterapia externa. Caso clínico: Paciente con diagnóstico de colangiocarcinoma recurrente metastásico que a pesar de la colocación de dos endoprótesis biliares continúa con ictericia y mal estado general. Se decide tratamiento con radioterapia externa paliativa sobre la lesión tumoral que comprime la vía biliar administrando una dosis total de 20Gy en 5 fracciones de 400 cGy. Tras la finalización del tratamiento las cifras de bilirrubina se estabilizan y comienzan a descender de forma progresiva hasta niveles normales, resolviéndose la ictericia y mejorando la calidad de vida del paciente. CONCLUSIONES: La radioterapia externa puede ser un tratamiento paliativo efectivo para descomprimir la vía biliar y mejorar la sintomatología en pacientes con tumores irresecables

OBJECTIVES: Obstructive jaundice is a frequent symptom in unresectable tumours of the bile duct. The case is reported of a patient diagnosed with recurrent cholangiocarcinoma with obstructive jaundice treated with external radiotherapy. Clinical case: A 47 year- old male diagnosed with recurrent and metastatic cholangiocarcinoma. Despite placing two biliary stents, the patient continued have high bilirubin levels, jaundice and a poor condition overall. With these findings, the proposed treatment was palliative external radiotherapy over the tumour lesion that compressed the bile duct, with a total dose of 20Gy in 5 fractions of 400 cGy. After completing the treatment, the bilirubin values began to descend gradually to normal levels, the jaundice disappeared and the quality of life of the patient improved. CONCLUSIONS: External radiotherapy can be an effective palliative treatment to decompress the bile duct and improve the symptoms in patients with unresectable tumours

Extrapulmonary small cell carcinoma in breast and prostate.

Extrapulmonary small cell carcinoma in breast and prostate are uncommon neoplasms. In the literature most of the data come from case reports and these show that these tumours are highly aggressive. Histologically, they bear striking similarities to small cell carcinomas of the lung and usually show evidence of additional histologies. Treatment, which may include surgery, radiotherapy and chemotherapy, is based on the clinical stage. We present the evolution of two cases.