title: Upgrading prostate cancer following proton beam therapy.
abstract: Pre- and post-radiation therapy (RT) effects on prostate histology have not been rigorously studied, but there appears to be a correlation between escalating radiation dosage and increasing post-RT histologic changes. Despite this dose-response relationship, radiation-induced changes may be heterogenous among different patients and even within a single tumor. When assessing residual tumor it is important to understand biopsy evaluation in the post-RT setting. We present the case of a poorly differentiated prostate adenocarcinoma following proton beam RT in a 45-year-old man with pre-RT Gleason 4 + 3 = 7 disease diagnosed in the setting of an elevated serum prostate-specific antigen level.
authors.affiliation: Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Jennifer K
authors.initials: JK
authors.lastname: Logan
authors.affiliation: Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Soroush
authors.initials: S
authors.lastname: Rais-Bahrami
authors.affiliation: Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Merino
authors.affiliation: Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA ; Center for Interventional Oncology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Pinto
keywords: Biopsy; prostate adenocarcinoma; proton beam; radiation-induced changes
references.citation: Hum Pathol. 1992 Apr;23 (4):344-51
references.pmid: 1563734
references.citation: Int J Radiat Oncol Biol Phys. 1993 Sep 1;27(1):31-7
references.pmid: 7690016
references.citation: Br J Cancer. 2013 Apr 2;108(6):1225-30
references.pmid: 23481182
references.citation: Cancer. 1993 Jun 1;71(11):3783-7
references.pmid: 8490929
references.citation: Am J Surg Pathol. 1982 Sep;6(6):541-51
references.pmid: 7149094
references.citation: Histol Histopathol. 2007 Jan;22(1):107-18
references.pmid: 17128417