Purpose: To determine the maximal tolerated dose of bortezomib with concurrent external beam radiation therapy in patients with incurable solid malignant tumors requiring palliative therapy.
Methods And Materials: An open label, dose escalation, phase I clinical trial evaluated the safety of three dose levels of bortezomib administered intravenously (1.0 mg/m(2), 1.3 mg/m(2), and 1.6 mg/m(2)/ dose) once weekly with concurrent radiation in patients with histologically confirmed solid tumors and a radiographically appreciable lesion suitable for palliative radiation therapy. All patients received 40 Gy in 16 fractions to the target lesion. Dose-limiting toxicity was the primary endpoint, defined as any grade 4 hematologic toxicity, any grade ≥3 nonhematologic toxicity, or any toxicity requiring treatment to be delayed for ≥2 weeks.
Results: A total of 12 patients were enrolled. Primary sites included prostate (3 patients), head and neck (3 patients), uterus (1 patient), abdomen (1 patient), breast (1 patient), kidney (1 patient), lung (1 patient), and colon (1 patient). The maximum tolerated dose was not realized with a maximum dose of 1.6 mg/m(2). One case of dose-limiting toxicity was appreciated (grade 3 urosepsis) and felt to be unrelated to bortezomib. The most common grade 3 toxicity was lymphopenia (10 patients). Common grade 1 to 2 events included nausea (7 patients), infection without neutropenia (6 patients), diarrhea (5 patients), and fatigue (5 patients).
Conclusions: The combination of palliative external beam radiation with concurrent weekly bortezomib therapy at a dose of 1.6 mg/m(2) is well tolerated in patients with metastatic solid tumors. The maximum tolerated dose of once weekly bortezomib delivered concurrently with radiation therapy is greater than 1.6 mg/m(2).
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http://dx.doi.org/10.1016/j.ijrobp.2009.07.1715 | DOI Listing |
Eur Urol Open Sci
January 2025
Department of Urology, Erasmus MC Cancer Institute, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands.
Background And Objective: In 2019 and 2021, Europa Uomo initiated the Europa Uomo Patient Reported Outcome Study (EUPROMS) and the EUPROMS 2.0 survey, with the goal of collecting data on patients' self-reported perspective on physical and mental well-being outside of a clinical trial setting, to be able to investigate the burden of prostate cancer (PCa) treatment from a patient-to-patient perspective. Acknowledging the importance of collecting quality of life (QoL) follow-up data, a 1-yr follow-up (1yrFU) study was conducted to assess the effect of additional PCa treatment on QoL.
View Article and Find Full Text PDFBMJ Open
January 2025
Institute of Health Economics and Clinical Epidemiology, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
Background: Magnetic resonance-guided transurethral ultrasound ablation (MR-TULSA) is a new focal therapy for treating localised prostate cancer that is associated with fewer adverse effects (AEs) compared with established treatments. To support large-scale clinical implementation, information about cost-effectiveness is required.
Objective: To evaluate the cost-utility of MR-TULSA compared with robot-assisted radical prostatectomy (RARP), external beam radiation therapy (EBRT) and active surveillance (AS) for patients with low- to favourable intermediate-risk localised prostate cancer.
J Med Imaging Radiat Oncol
January 2025
Department of Radiation Oncology, Townsville University Hospital, Townsville, Queensland, Australia.
Introduction: Prostate motion during external beam radiotherapy (EBRT) is common and typically managed using fiducial markers and cone beam CT (CBCT) scans for inter-fractional motion correction. However, real-time intra-fractional motion management is less commonly implemented. This study evaluated the extent of intra-fractional prostate motion using transperineal ultrasound (TPUS) and examined the impact of treatment time on prostate motion.
View Article and Find Full Text PDFInt J Radiat Oncol Biol Phys
January 2025
Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
Purpose: Randomized trials have demonstrated similar local tumor control in patients treated with accelerated partial-breast irradiation (APBI) compared with whole-breast irradiation. However, the optimal APBI dose for maximizing tumor control and minimizing toxicity is uncertain.
Methods And Materials: We enrolled patients ≥18 years of age with grade 1 or 2 ductal carcinoma in situ or stage I invasive breast cancer and resection margins ≥2 mm between 2003 and 2011 to a sequential dose-escalation trial using 3-dimensional conformal external beam APBI giving twice daily 4 Gy fractions with total doses of 32 Gy, 36 Gy, and 40 Gy.
Cancers (Basel)
January 2025
Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, 7621 Pécs, Hungary.
Glioblastoma, the most common and aggressive primary brain tumor in adults, presents a formidable challenge due to its rapid progression, treatment resistance, and poor survival outcomes. Standard care typically involves maximal safe surgical resection, followed by fractionated external beam radiation therapy and concurrent temozolomide chemotherapy. Despite these interventions, median survival remains approximately 12-15 months, with a five-year survival rate below 10%.
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