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Pain Research & Management 2023Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a complex male dysfunction, mostly seen in young and middle-aged men with a history of more than... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a complex male dysfunction, mostly seen in young and middle-aged men with a history of more than 3 months. As a traditional therapy of Traditional Chinese Medicine, acupuncture has been proven an effective method to treat CP/CPPS in recent years. Though some meta-analyses on acupuncture for chronic prostatitis were published in 2018 and 2019, most of the included studies were low in quality according to the JADAD score (JADAD < 4). The conclusions of acupuncture for CP/CPPS remain indefinite.
PURPOSE
This review aims to evaluate the efficacy of acupuncture for CP/CPPS by including high-quality literature only (JADAD ≥ 4) to provide a reliable basis for clinical applications and research.
METHOD
Nine electronic databases were searched from inception to March 1, 2022, and only randomized controlled trials (RCT) with high-quality (JADAD ≥ 4) were included. Data were analyzed using Review Manager 5.3. and was verified through trial sequential analysis (TSA). We carried out a sensitivity analysis for the heterogeneity ( ≥ 50%). Publication bias was explored using a funnel plot.
RESULT
Ten RCTs (11 trials) of high-quality methodology involving 798 patients were included. Meta-analysis showed that compared to sham acupuncture (SAT) and western medicine (WM), acupuncture (AT) played superior roles for CP/CPPS patients in pain score, NIH-CPSI score, quality of life score, urinary symptom, and efficacy rate. As for the adverse effects, 4 RCTs described mild hematoma and pain in AT and SAT groups, while specific symptoms including nausea, abdominal pain, dizziness, and low blood pressure were reported in WM groups.
CONCLUSION
This meta-analysis indicated that acupuncture has measurable benefits on CP/CPPS, and security has also been ensured. However, this meta-analysis only included 10 RCTs; thus, RCTs with a larger sample size and longer-term observation are required to verify the effectiveness of acupuncture further in the future.
Topics: Male; Middle Aged; Humans; Chronic Pain; Prostatitis; Chronic Disease; Acupuncture Therapy; Pelvic Pain
PubMed: 36960418
DOI: 10.1155/2023/7754876 -
Archivio Italiano Di Urologia,... Dec 2017The main outcome of this review was the association between a history of clinical chronic prostatitis (NIH category II or III) and a histologically confirmed diagnosis... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
The main outcome of this review was the association between a history of clinical chronic prostatitis (NIH category II or III) and a histologically confirmed diagnosis of prostate cancer.
MATERIALS AND METHODS
Crude odds ratios and 95% confidence intervals (CI) were calculated to analyze dichotomous data. For analysis of pooled data we adopted a random-effects model and the inverse variance weighing method. Heterogeneity was assessed by calculating the I2 value.
RESULTS
Out of 2794 screened records, we retrieved 16 full-text articles written in English, reporting the data of 15 case-control studies, involving 422.943 patients. Pooled analysis resulted in a significant crude odds ratio of 1.83 (95% CI: 1.43 to 2.35; P < 0.00001). The total set of data showed considerable heterogeneity (I2 = 91%). Both the Egger's test and the Begg's test for funnel plot asymmetry did not reach statistical significance. The 'trim and fill' method applied to the funnel plot imputed 3 missing studies and the resulting adjusted estimate of the odds ratio was 2.12 (95% CI: 1.38 to 3.22). According to GRADE criteria, the overall quality of the meta-analysis data is low, mainly due to the presence of bias, confounders and extreme effect size outliers. Five among the included studies reported data assessed in 8015 African-American subjects. Pooled analysis resulted in a non-significant crude odds ratio of 1.59 (95% CI: 0.71 to 3.57; P = 0.26), and considerable heterogeneity (I2 = 90%).
CONCLUSIONS
Meta-analysis of 15 case-control studies shows that a history of clinical chronic prostatitis can significantly increase the odds for prostate cancer in the general population, whereas such association in African-American individuals remains uncertain.
Topics: Black People; Chronic Disease; Humans; Male; Odds Ratio; Prostatic Neoplasms; Prostatitis; Risk Factors
PubMed: 29473374
DOI: 10.4081/aiua.2017.4.259 -
European Journal of Medicinal Chemistry Jan 2024Prostate specific membrane antigen (PSMA) has been the subject of several studies in recent decades as a promising molecular target for prostate cancer (PCa), in fact it... (Review)
Review
Prostate specific membrane antigen (PSMA) has been the subject of several studies in recent decades as a promising molecular target for prostate cancer (PCa), in fact it is considered an excellent molecular target for both PCa imaging (both for staging and follow-up), by means of PET/CT and for radioligand therapy. Its interesting molecular features have enabled the development of a new diagnostic and therapeutic approach for PCa, called "theranostics." Considering the abundance of PSMA-based probes that have appeared so far in the literature, the present work focuses the attention on radiopharmaceuticals with increasing clinical application, highlighting advantages and disadvantages in terms of different metabolization and excretion processes, pharmacokinetic, binding affinity and variable internalization rate, tumor-to-background ratio, residence times and toxicity profile.
Topics: Male; Humans; Positron Emission Tomography Computed Tomography; Prostatic Neoplasms; Radiopharmaceuticals; Precision Medicine; Gallium Radioisotopes
PubMed: 37992520
DOI: 10.1016/j.ejmech.2023.115966 -
Brachytherapy 2014To review and analyze the published data on high-dose-rate brachytherapy as monotherapy in the treatment of prostate cancer. (Review)
Review
PURPOSE
To review and analyze the published data on high-dose-rate brachytherapy as monotherapy in the treatment of prostate cancer.
METHODS
A literature search and a systematic review of the high-dose-rate (HDR) brachytherapy (monotherapy) prostate literature were performed on PubMed using "high-dose-rate, brachytherapy, prostate, monotherapy" as search terms. More than 80 articles and abstracts published between 1990 and 2013 were identified. Data tables were generated and summary descriptions created. Commentary and opinion was formulated through discussion and consensus based on the critical review of the literature and the author's combined personal experience and knowledge.
RESULTS
Thirteen articles reported clinical outcome and toxicity with followup ranging from 1.5 to 8.0 years. Results were available for all risk groups. A variety of dose and fractionation schedules were described. Prostate-specific antigen progression-free survival ranged from 79% to 100% and local control from 97% to 100%. The toxicity rates were low. Genitourinary toxicity, mainly frequency/urgency, was 0-16% (Grade 3). Gastrointestinal toxicity was 0-2% (Grade 3). Erectile function preservation was 67-89%. The radiobiological, clinical, and technical features of HDR brachytherapy were reviewed and discussed.
CONCLUSIONS
Consistently high local tumor control and low complications rates are reported with HDR monotherapy. It provides reproducible high-quality dosimetry, it has an advantage from a radiobiology perspective, and it has a good radiation safety profile. HDR brachytherapy is a safe and effective local treatment modality for prostate cancer.
Topics: Brachytherapy; Disease-Free Survival; Humans; Male; Prostate-Specific Antigen; Prostatic Neoplasms; Radiotherapy Dosage; Tomography, X-Ray Computed
PubMed: 25085454
DOI: 10.1016/j.brachy.2014.03.002 -
Scientific Reports Nov 2016Previous studies have reported controversial results on the association between tomato consumption and prostate cancer risk. Hence, we performed a meta-analysis to... (Meta-Analysis)
Meta-Analysis Review
Previous studies have reported controversial results on the association between tomato consumption and prostate cancer risk. Hence, we performed a meta-analysis to comprehensively evaluate this relationship. A total of 24 published studies with 15,099 cases were included. Relative risks (RR) and 95% confidence intervals (CI) were pooled with a random-effects model. Tomato intake was associated with a reduced risk of prostate cancer (RR 0.86, 95% CI 0.75-0.98, P = 0.019; P < 0.001 for heterogeneity, I = 72.7%). When stratified by study design, the RRs for case-control and cohort studies were 0.76 (95% CI 0.61-0.94, P = 0.010) and 0.96 (95% CI 0.84-1.10, P = 0.579), respectively. In the subgroup analysis by geographical region, significant protective effects were observed in Asian (RR 0.43, 95% CI 0.22-0.85, P = 0.015) and Oceania populations (RR 0.81, 95% CI 0.67-0.99, P = 0.035), but not in other geographical populations. Begg's test indicated a significant publication bias (P = 0.015). Overall, tomato intake may have a weak protective effect against prostate cancer. Because of the huge heterogeneity and null results in cohort studies, further prospective studies are needed to explore the potential relationship between tomato consumption and prostate cancer risk.
Topics: Food Preferences; Humans; Solanum lycopersicum; Male; Prostatic Neoplasms; Risk Factors; Vegetables
PubMed: 27841367
DOI: 10.1038/srep37091 -
Annals of Oncology : Official Journal... Oct 2015The increased use of the androgen receptor axis-targeted (ARAT) agents abiraterone and enzalutamide in first- and second-line treatment of metastatic... (Review)
Review
BACKGROUND
The increased use of the androgen receptor axis-targeted (ARAT) agents abiraterone and enzalutamide in first- and second-line treatment of metastatic castration-resistant prostate cancer (mCRPC) has improved patient outcomes, but resistance to these agents is inevitable. Early identification of patients with primary or secondary resistance to ARAT therapy is of increasing clinical concern.
DESIGN
PubMed and conference proceedings were searched for studies of agents used after progression on abiraterone or enzalutamide. The key search terms (or aliases) used a combination of mCRPC and abiraterone or enzalutamide, and results were limited to clinical trials and comparative or validation studies.
RESULTS AND CONCLUSION
This systematic review assembles current evidence and provides an approach to treatment using available clinical factors. Issues of patient selection, use of laboratory and clinical biomarkers to identify patients at risk of poor outcomes, and the timing and sequencing of available treatment options are addressed. Our findings reveal a lack of high-level evidence regarding predictive factors and treatment of patients with resistance to ARAT therapy, and a need for further research in this area. In the meantime, we suggest practical strategies to guide management of ARAT treatment-resistant patients based on available data.
Topics: Antineoplastic Agents; Drug Resistance, Neoplasm; Humans; Male; Molecular Targeted Therapy; Prognosis; Prostatic Neoplasms, Castration-Resistant; Receptors, Androgen
PubMed: 26101426
DOI: 10.1093/annonc/mdv267 -
Nutrients Feb 2023We conducted a systematic review and meta-analysis to investigate the role of alcohol consumption with the prognosis of prostate cancer (PCa). Published reports were... (Meta-Analysis)
Meta-Analysis Review
We conducted a systematic review and meta-analysis to investigate the role of alcohol consumption with the prognosis of prostate cancer (PCa). Published reports were gathered on 15 October 2022, from PUBMED/MEDLINE and EMBASE. We found 19 independent eligible studies on the association between consumption of alcoholic beverages and the risk of fatal PCa (n = 5), PCa mortality (n = 5) in healthy subjects, and PCa patients' survival (n = 7) or surrogates thereof (n = 2). We used random effects meta-analysis to obtain a summary risk estimate (SRE) and 95% confidence intervals (95%CI) for incidence of fatal PCa and PCa mortality. The meta-analysis revealed no association between alcohol consumption and fatal prostate cancer incidence risk in healthy subjects with an indication for publication bias, but omitting the study that mainly increased the between-study heterogeneity, the SRE becomes significant (SRE 1.33, 95%CI 1.12-1.58), and the heterogeneity disappeared ( = 0%) with no indication of publication bias. No association of alcohol consumption was found with mortality risk in PCa patients (SRE 0.97, 95%CI 0.92-1.03) and PCa mortality risk in healthy subjects (SRE 1.03, 95%CI 0.82-1.30). In conclusion, this study suggests that there is some evidence of an association between high alcohol consumption and an increased risk of incidence of fatal prostate cancer in healthy subjects. Given the inconsistencies this result warrants further confirmation.
Topics: Male; Humans; Alcohol Drinking; Prostatic Neoplasms; Prostate; Prognosis; Incidence
PubMed: 36839283
DOI: 10.3390/nu15040925 -
Asian Pacific Journal of Cancer... Jun 2018Background: Controversial results have been reported concerning the influence of calcium intake on prostate cancer risk. The aim of this study was to determine any... (Meta-Analysis)
Meta-Analysis Review
Background: Controversial results have been reported concerning the influence of calcium intake on prostate cancer risk. The aim of this study was to determine any association between total calcium (in the diet and in supplements) intake and prostate cancer. Materials and Methods: The present systematic review and meta-analysis study was carried out following a PRISMA guidelines. Two reviewers independently using MeSH keywords searched international databases including PubMed, Science Direct, Cochrane, EMBASE, Web of Science, CINAHL, EBSCO and search engines such as Google Scholar. The searches were performed without any time limit until May 2016. The results were pooled using a random effects model and homogeneity was confirmed using the Q test and I2 index. Subgroup analyses was performed according to continents and study designs. The data were analyzed using STATA software version 3.2, with p<0.05 considered significant. Result: Overall, 12 studies with a total sample size of 905,046 were entered into the final meta-analysis. The main age range of the participants was 50 to 70 years. The relative risks (RR) for total calcium with total prostate cancer, localized prostate cancer, and advance prostate cancer were estimated to be 1.15 (95% CI: 1.04-3.46), 1.05 (95% CI: 0.96-1.14), and 1.15 (95% CI: 0.89-1.50), respectively. Only the relationship between total calcium and total prostate cancer was significant (P<0.05). Conclusions: High calcium intake can be considered as a risk factor for total prostate cancer. Therefore, calcium intake might be a target for prevention.
Topics: Calcium; Dietary Supplements; Humans; Male; Prognosis; Prostatic Neoplasms
PubMed: 29936714
DOI: 10.22034/APJCP.2018.19.6.1449 -
Medicine Dec 2023Chronic prostatitis (CP) is a common condition that affects many individuals. Previous clinical trials have explored the use of moxibustion as a potential treatment for... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Chronic prostatitis (CP) is a common condition that affects many individuals. Previous clinical trials have explored the use of moxibustion as a potential treatment for CP. However, the evidence on the effectiveness of moxibustion for CP remains limited. Therefore, this study aimed to comprehensively assess the effects of moxibustion for CP.
METHODS
In order to gather relevant and up-to-date information, we conducted a systematic literature search of databases including Cochrane Library, PUBMED, EMBASE, CNKI, and Wangfang from inception until June 30, 2023. Only randomized clinical trials (RCTs) that investigated the use of moxibustion for CP were included in this study. The primary outcomes of interest were the National Institutes of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) scores and the overall response rate. To evaluate the quality of the included studies, we used the Cochrane risk-of-bias tool.
RESULTS
After analyzing the data from 8 RCTs involving a total of 664 patients, we found significant differences in NIH-CPSI scores between moxibustion and other treatment modalities. Specifically, when compared with herbal medicine, moxibustion was associated with a mean difference (MD) of -1.78 in NIH-CPSI scores (95% confidence interval [CI] [-2.78, -0.78], P < .001), and when compared with western medicine, moxibustion was associated with a MD of -5.24 in NIH-CPSI scores (95% CI [-7.80, -2.67], P < .08). In terms of the overall response rate, moxibustion was found to be superior to herbal medicine, with a MD of 2.36 (95% [19, 4.67], P = .01). Additionally, when moxibustion was combined with herbal medicine, it yielded a higher overall response rate with a MD of 4.07 (95% CI [1.54, 10.74], P = .005) compared to herbal medicine alone. Moxibustion also outperformed western medicine in terms of the overall response rate, with a MD of 4.56 (95% CI [2.24, 9.26], P < .001).
CONCLUSION
Based on the findings of this study, moxibustion appears to be a potentially efficacious treatment for CP. The results suggest that moxibustion can improve NIH-CPSI scores and overall response rate in patients with CP. However, further high-quality studies are needed to validate these results and establish the long-term effects of moxibustion as a treatment for CP.
Topics: Male; Humans; Moxibustion; Prostatitis; Chronic Disease; Acupuncture Therapy; Plant Extracts; Randomized Controlled Trials as Topic
PubMed: 38115243
DOI: 10.1097/MD.0000000000036742 -
Archivio Italiano Di Urologia,... Mar 2023A spectrum of psychological problems is commonly found in CP/CPPS patients, though it is not yet clear whether, a priori, psychological dysfunctions are the cause of...
INTRODUCTION/AIM
A spectrum of psychological problems is commonly found in CP/CPPS patients, though it is not yet clear whether, a priori, psychological dysfunctions are the cause of these pain syndromes, or whether these pain conditions are themselves causing psychological disturbances. In this article we present the current perspective on the impact of psychological problems in chronic prostatitis syndromes and we discuss the implications thereof from a clinical perspective.
MATERIALS AND METHODS
A database and a manual search were conducted in the MEDLINE database of the National Library of Medicine, EMBASE, and other libraries using the key words "prostatitis syndromes", "chronic bacterial prostatitis", "chronic pelvic pain", in various combinations with the terms "psychological issues", "depression" "anxiety", "stress", "unhappiness", "cognitive status" and "personality". Two independent reviewers performed data extraction. We included clinical studies with available information on chronic prostatitis and related psychological conditions. We considered full-text written papers. We excluded reviews and case reports. In order to reduce the risk of bias we analyzed only studies including patients with confirmed CBP or CP/CPPS. Bibliographic information in the selected publications was checked for relevant records not included in the initial search.
RESULTS
Database search allowed us to retrieve 638 studies to which we added to 16 additional studies retrieved by hand-searching. After screening, 34 relevant papers were identified for thorough review. Most studies included patients with chronic pelvic pain and prostatitis-like symptoms, whereas a smaller number of studies included patients with methodologically con- firmed CP/CPPS including studies with a microbiologically confirmed diagnosis of CBP. The psychosocial factors examined in the selected studies include pain, catastrophizing, stress, personality factors and social aspects. Comorbid psychiatric disorders evidenced in the studies included depression, anxiety and trauma-related disorders, somatization disorders, and substance abuse. Some studies investigated the association of pain with each individual psychological disturbance, while others examined the impact of pain in association with the overall quality of life. Sample size, study design and diagnostic measures varied among studies.
CONCLUSIONS
Despite limitations and variations in sample size, study design and diagnostic measures in all included studies, a relation between chronic prostatitis and psychological problems is a consistent finding. The existing evidence does not permit to definitely conclude whether psychological problems are a risk factor for CP/CPPS or whether they represent an array of symptoms that are associated with the exacerbation of this disease.
Topics: Male; Humans; Quality of Life; Prostatitis; Chronic Disease; Chronic Pain; Pelvic Pain
PubMed: 36943000
DOI: 10.4081/aiua.2023.11300