Core Curriculum 2017 Flashcards
What are the three metals used for brachytherapy?
Iodine-125, Palladium-103 and Iridium-192
What are relative contraindications to radiation?
Prostate > 60 g, TURP, IPSS > 15
What 3 trials show benefit of adjuvant radiation to prostate bed after radical prostatectomy?
EORTC 22911
ARO 9602
SWOG 8794
What did SWOG 8794 show?
Adjuvant XRT improved OS compared to salvage. This was attributable to the number of patients with detectable PSA upon adjuvant treatment
What did EORTC 22911 and ARO 9602 show?
improvement in bRFS but not OS or DMFS
Which patients are likely to benefit from salvage XRT?
Gl < 7 pre-RT PSA < 2 neg SVI (+) margins PSA doubling time > 10 mo
One in __ men will be diagnosed with prostate cancer during their lifetime.
7
What percentage of men will die from prostate cancer?
2.8%
What ages does AUA recommend offering CaP screening?
55-69
What life expectancy should you stop offering screening?
10-15 year life expectancy
The European Randomized Study of Screening for Prostate cancer reported what?
A statistically significant relative reduction of 21% in prostate cancer mortality at 11 years.
What is very low risk prostate cancer per NCCN
PSA ≤ 10 ng/mL, Gleason score ≤ 6, clinical stage T1c, < 3 positive biopsy cores, ≤ 50% in each core, and PSA density < 0.15 ng/mL/g
Per NCCN, define low risk prostate cancer
PSA < 10 ng/mL, Gleason score ≤ 6, and clinical stageT1-T2a
Per NCCN, define intermediate risk prostate cancer
PSA 10 - 20, Gleason score ≤ 7, and clinical stage T2b-c
Per NCCN, define high risk prostate cancer
PSA > 20, Gl 8-10, cT3a
Per NCCN, define very high risk prostate cancer
cT3b - T4
Define AUA low risk prostate cancer
PSA ≤ 10 ng/mL, Gleason score ≤ 6, clinical stage T1c or cT2a
Define AUA intermediate risk prostate cancer
PSA > 10-20 ng/mL or Gleason score 7, or clinical stage T2b
Define AUA high risk prostate cancer
PSA > 20 or Gleason score 8-10, or clinical stage ≥T2c
What did the prostate cancer prevention trial show and in what patients?
in men with low risk of disease, PSA < 3, finasteride decreased overall relative risk of CaP by 25%
What did the REDUCE trial show and on which patients?
men with PSA 2.5 to 10 & prior neg biopsy on dutasteride had a relative risk reduction of 25% and absolute risk reduction of 5% of prostate cancer
Why did the FDA refuse to issue an indication for CaP chemoprevention with 5ARI?
risk of high grade cancer may be higher in those patients
What did the SELECT trial show?
selenium and vitamin E made no difference in the rate of prostate cancer
What did SPCG4 show? Scandinavian prostate cancer group study #4
improvement in overall and disease specific mortality in men undergoing radical prostatectomy
