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- Clinical and metabolic implications of obesity in prostate cancer: is testosterone a missing link?Publication . Duarte, Fernanda; Luís, C.; Baylina, Pilar; Faria, Isabel; Fernandes, Rúben; La Fuente, J. M.Objectives: To assess sex hormones in men with obesity and prostate cancer (PCa) and to study association between androgens and the pathogenesis biology of PCa in vitro. Subjects and methods: One hundred and eighty-one men older than 45 years selected from of a population attending to Urology departments screening for PCa, (78 participants without PCa and 103 patients with PCa). All participants were assessed for body mass index (BMI), age, Gleason score, and PSA. Endocrine profile was determined for LH, total testosterone (TT), 17β-estradiol (E2), prolactin and leptin. Biochemical profile (HbA1c, triacylglycerols and lipoproteins) was also determined. In vitro experiments were also performed, involving the study of 5α-dihydrotestosterone (DHT) and E2 in the presence of adipocyte-conditioned medium (aCM). Results: All variables were continuous and described a Gaussian distribution unless mentioned. To determine the relation of aggressiveness, variable were transformed into categories. Thus, PCa aggressiveness is associated with the increase of age and BMI (p < .0001) but with is decreased with TT and E2 (p < .05). Moreover, adipocyte-secreted molecules increase aggressiveness of PCa cells in vitro. Lastly, DTH but not E2 enables invasiveness in vitro. Conclusions: It was observed a coexistence of hormone axis profile alteration with sex hormones and BMI in PCa patients, in accordance with the new perspective of PCa pathogenesis.
- The impact of a rectal spacer in VMAT Dosimetry in the treatment of Prostate CancerPublication . Oliveira, Susana; Fernandes, Ruben; Baylina, Pilar; Santos, João; Vieira, Guy; Faria, Isabel; Pereira, Norberto; Fernandes, Rúben; BAYLINA MACHADO, PILAR; Sousa Pinho Faria, Isabel MariaAlthough the dosimetric advantages of rectal spacers in prostate cancer radiotherapy have been demonstrated in selected clinical trials, real-world data from routine clinical practice remain limited—particularly within the Portuguese healthcare system. This study offers a detailed dosimetric comparison of Volumetric Modulated Arc Therapy (VMAT), with and without rectal spacer use, in a real-world patient cohort, aiming to assess the clinical relevance of spacer insertion under standard treatment protocols. A retrospective dosimetric evaluation was performed on 80 prostate cancer patients treated at a radiotherapy centre in southern Portugal. Patients were equally divided into two matched groups (n = 40): one receiving VMAT alone, the other receiving VMAT with hydrogel rectal spacer placement. Dose-volume histograms (DVHs) were analysed for the planning target volume (PTV) and key organs at risk (OARs). Standard dosimetric metrics, such as V50–V75 for the rectum and bladder, V50 for femoral heads, and mean dose for the penile bulb, were assessed. PTV coverage was evaluated using conformity and homogeneity indices. Spacer use significantly decreased rectal dose exposure across all evaluated parameters without compromising PTV coverage or increasing dose to other OARs. These findings support routine rectal spacer applications to enhance treatment safety and patient outcomes.
- The influence of miRNAs on radiotherapy treatment in prostate cancer – a systematic reviewPublication . Soares, Sílvia; Guerreiro, Susana S.; Cruz-Martins, Natália; Sousa Pinho Faria, Isabel Maria; Baylina, Pilar; Sales, Maria Goretti; Correa-Duarte, Miguel A.; Fernandes, RúbenIn the last years, extensive investigation on miRNomics have shown to have great advantages in cancer personalized medicine regarding diagnosis, treatment and even clinical outcomes. Prostate cancer (PCa) is the second most common male cancer and about 50% of all PCa patients received radiotherapy (RT), despite some of them develop radioresistance. Here, we aim to provide an overview on the mechanisms of miRNA biogenesis and to discuss the functional impact of miRNAs on PCa under radiation response. As main findings, 23 miRNAs were already identified as being involved in genetic regulation of PCa cell response to RT. The mechanisms of radioresistance are still poorly understood, despite it has been suggested that miRNAs play an important role in cell signaling pathways. Identification of miRNAs panel can be thus considered an upcoming and potentially useful strategy in PCa diagnosis, given that radioresistance biomarkers, in both prognosis and therapy still remains a challenge.