Regarding radiotherapy for prostate cancer, what is the lowest recommended dose for salvage therapy?
54 Gy
64 Gy
74 Gy
84 Gy
Correct Answer :
B. 64 Gy
as per the American Society for Therapeutic Radiation Oncology (ASTRO) guidelines, 64 Gy is the lowest recommended dose for salvage radiotherapy.
Related Questions
Which PSA value interpretation is incorrect?
> 50% of men with PSA > 10 ng/mL have the disease beyond the prostate
pelvic lymph node involvement is found in PSA > 20 ng/mL
70% of men with a PSA between 4 and 10 ng/mL have organ-confined disease
80% of men with PSA < 4 ng/mL have organ-confined disease
What is false concerning antiandrogen class of prostate cancer medications?
commonly used in combination with a GnRH agonist
less effective than medical or surgical castration
not recommended for localized prostate cancer
inhibits various cytochrome P-450 enzymes
What is the major advantage of neoadjuvant androgen deprivation before radical prostatectomy on treating clinical stages (cT1-T2) prostate cancers?
reduces positive surgical margins
reduces local recurrence
has no proven advantage
reduces cardiac complications
What if false concerning the prostate cancer marker PCA3?
entails a genetic analysis of cells in the voided urine
urine sample is collected after a firm massage of the prostate
helps screen patients who are at intermediate risk of cancer
helps avoid the inconvenience of prostate biopsy
What is false concerning Gleason scoring system for prostate cancers?
ranges from 0 -10 based on a histologic evaluation of tumor specimens
based on the 2 most common histologic patterns
greatly relies on the skills and experience of the pathologist
a score of 7 indicates a moderate-grade or moderately differentiated tumor
Solid lesions in the seminal vesicles are most likely to be a result of:
imperfect prostate biopsies
immature teratoma
schistosomiasis
liposarcoma
What are the clinical parameters of tissue ablation achieved by cryotherapy for cancer cells destruction?
the number of freezing cycles
the lowest temperature achieved
the existence of regional heat sinks
all of the above
Prostate-specific membrane antigen has been detected in:
the prostate gland only
the central nervous system, intestine, and the prostate
malignant ovarian cysts, skeletal muscles, and the prostate
thyroid glands, adrenals, and the prostate
What is false concerning the interpretation of Gleason scoring system?
a low score means the cancer tissue is similar to normal prostate tissue
it indicates how likely the tumor will spread
the more cellular atypia observed the higher scoring will be
it relies only on the glandular architectural pattern
Regarding radiotherapy for prostate cancer, what is the lowest recommended dose for salvage therapy?
54 Gy
64 Gy
74 Gy
84 Gy
What fraction of men with a PSA value between 4 and 10 ng/mL has an organ-confined prostate cancer?
¼
½
BPH patients on finasteride longer than 6 months are expected to have:
decreased t-PSA but increased f-PSA
decreased t-PSA but unaltered f-PSA
decreased t-PSA and decreased f-PSA
any of the above
What are the possible complications of CO2 pneumoperitoneum during laparoscopic/robotic prostatectomy?
hypoxia and acidosis
tachycardia and tachypnea
bradycardia and hypotension
hypercarbia and oliguria
What is the proper pre-treatment risk stratification of prostate cancer for a patient with T2a, PSA < 11 ng/mL, and no Gleason score > 6?
low risk
intermediate risk
high risk
data not adequate
What is the likelihood that patients with positive surgical margins after radical prostatectomy will be cured for prostate cancer?
never
unlikely
likely
always
In which of the following cases PSA testing is NOT indicated:
72 yrs. man newly diagnosed BPH with normal DRE
2 weeks post TURP for obstructing cancerous prostate
screening for prostate cancer in 75 yrs. old Caucasian man
43 yrs. man with obstructive LUTS, who had a first-degree relative diagnosed with prostate cancer before age 65
Partin tables are probability tables for the determination of pathologic stages of prostatic cancers based on:
preoperative clinical stage, PSA level, and Gleason sum
seminal vesicle invasion, lymph node metastases, and Gleason sum
positive surgical margins, capsular penetration, and PSA level
PSA level, perineural invasion, vascular metastasis, and Gleason sum
What class of prostate cancer medications causes an initial increase in LH, FSH levels and consequently a rise in testosterone level for few weeks?
GnRH agonists
antiandrogens
antimicrotubular
bisphosphonates
Regarding chemotherapy for prostate cancers, nonsteroidal antiandrogens will result in:
elevated LH, elevated testosterone, elevated estrogen
elevated LH, elevated testosterone, declined estrogen
declined LH, declined testosterone, elevated estrogen
declined LH, elevated testosterone, declined estrogen
Regarding treating prostate cancer patients, watchful waiting is a reasonable option for:
patients who have a life expectancy ≤ 10 yrs. and/or well to moderately differentiated cancer
≥ 70 yrs. of age
PSA < 10 ng/mL, ratio < 0.22
patients with good performance status
Regarding radical prostatectomy, the commonest site of positive surgical margins is the:
apex
posterior
postero-lateral
anterior
During retropubic radical prostatectomy, what complication could be encountered on dividing the dorsal vein complex anteriorly?
incontinence
retrograde ejaculation
impotence
anejaculation
In which of the following situations prostate biopsy is most indicated?
normal DRE, abnormal PSA
abnormal DRE, abnormal PSA
abnormal DRE, normal PSA
hyperechoic areas on TRUS
Genetically, what are the changes associated with poor survival in prostate cancer patients?
loss of one or both copies of the tumor suppressor gene PTEN
TMPRSS2ERG chromosome fusion
P53 mutations and overexpression of MYC
all of the above
For prostate cancer patients, what do Partin tables predict?
survival rate
pathologic stage
extracapsular extension
lymph node involvement
In which of the following PSA readings prostate cancer is least suspected?
PSA velocity of 0.35 ng/mL/y, when the PSA is ≤ 2.5 ng/mL
PSA velocity of 0.75 ng/mL/y, when the PSA is 4 10 ng/mL
t-PSA is 2.8 ng/mL, f-PSA 0.94 ng/mL
t-PSA is 3.7 ng/mL, f-PSA 0.51 ng/mL
What is the first-line chemotherapeutic agent for metastatic castration-resistant prostate cancer?
bisphosphonate
docetaxel
sipuleucel-T
enzalutamide
What is the primary mechanism of prostate tissue ablation using high-intensity focused ultrasound?
disruption of protein synthesis
coagulative necrosis
cell wall destruction
DNA damage
What is true concerning TRUS prostatic biopsy?
hematospermia might persist for 4 6 weeks after taking biopsies
quinolone antibiotics prophylaxis eliminate possible infections
the right lateral decubitus position is commonly preferred
only hypoechoic lesions should be biopsied
What is against using TRUS-guided therapy for focal prostate cancer?
it overdiagnoses clinically insignificant cancers
it misses clinically significant cancers in the anterior or apical regions
it may underrepresent true cancer burden
all of the above