In a nutshell
The authors aimed to determine the use of pre-treatment bone scan index (BSI) as a prognostic (predictive) factor in hormone-naïve men with prostate cancer who have bone tumors.
The authors concluded that pre-treatment BSI and patients age were independent prognostic factors for men with hormone-naïve prostate cancer with bone tumors.
Some background
Hormone-naïve prostate cancer is cancer that has not been treated previously with hormone therapy. Hormone therapy targets the male sex hormones active in prostate cancer, such as testosterone, and is often used in men with advanced prostate cancer (cancer that has spread outside the prostate gland into surrounding organs). In some patients, advanced prostate cancer can spread to the bones. BSI can be used in patients as a biomarker (indicator that is used to determine a state or condition) to determine the amount of tumors present on the bone before treatment. A bone scan can be used to determine the extent of disease (EOD), which impacts a patient’s overall survival (patients who did not die following treatment). EOD can be classed as 1 (less than 6 bone tumors), 2 (6-20 bone tumors), 3 (more than 20 bone tumors) and 4 (bone tumors on more than 75% of the ribs, vertebrae and pelvic bones). This scan can be used to determine the BSI.
Methods & findings
The aim of this study was to determine the use of BSI as a way to predict outcome before treatment in men with hormone-naïve prostate cancer with bone tumors.
60 patients were included in this study. Patients were scanned prior to treatment. They then underwent hormonal therapy or surgical castration (removal of the testicles). 46.7% were treated with zoledronic acid (Zometa – used to treat high blood calcium levels that can occur with prostate cancer). 30% of patients received further treatment with docetaxel (Taxotere – chemotherapy drug). The average follow-up time was 21.4 months.
Overall 61.7% of patients experienced prostate specific antigen progression (PSA – protein elevated in the blood in the presence of prostate cancer). 26.7% of patients died. Of these, 25% died due to prostate cancer.
BSI and age were independent predictive factors for overall survival. The average overall survival was not reached in patients who had a lower BSI. The average overall survival was 34.8 months in patients with a higher BSI. Age over 72 was also associated with lower overall survival.
The bottom line
The authors concluded that pre-treatment BSI and age were independent predictive factors for men with hormone-naïve prostate cancer with bone tumors.
Published By :
BMC cancer
Date :
Feb 25, 2016
