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La curiethérapie prostatique se fait en implantant des grains radioactifs dans une zone tumorale. À cause des soucis temporaux, la planification considère ces grains comme des sources ponctuelles dans un monde uniforme d’eau. Ce mémoire présente une évaluation de l’impact de deux effets perturbant la dosimétrie, avec des méthodes Monte Carlo, en curiethérapie prostatique. L’orientation des sources, négligée actuellement, risque d’altérer la dosimétrie calculée. Cet impact est évalué sur une cohorte de patients (n=287). Aucun impact n’est calculé sur la prostate et l’urètre mais un impact de -2% est calculé sur la vessie et le rectum. La présence de calcifications dans la zone tumorale est négligée par la planification actuelle. Une cohorte de patients (n=43) possédant des calcifications permet d’évaluer cet impact. Il ressort du calcul MC une différence de -13% sur le D90 du CTV et de -16% sur le D10 de l’urètre, en comparaison avec l’algorithme de planification actuel. / Prostatic brachytherapy is performed by inserting radioactive seeds in a tumoral zone. Because of time constraint, clinical planning considers those seeds as point sources in a water medium. This thesis presents the quantification of the impact of two perturbing effects on the dosimetry, evaluated through a Monte Carlo algorithm, in prostatic brachytherapy. Seeds orientation, actually neglected, may alter the clinical dosimetry. The impact of this effect is evaluated on a cohort (n=287) of patients. No effect is calculated on the prostate or the urethra but a difference of -2%, when compared to the clinical algorithm, is calculated on the OARs. Calcifications are actually neglected in the clinical planning. A cohort of patients (n=43) with visible calcifications is used to measure the effect of this approximation. MC calculations yield a difference of -13% on the CTV D90 and -16% on the urethra D10, when compared to the clinical algorithm.

Tableau d’honneur de la Faculté des études supérieures et postdoctorales, 2010-2011 / Le cancer de la prostate (CaP) représente le cancer le plus fréquemment diagnostiqué chez les hommes de plus de 50 ans au Canada. Considérant l'hétérogénéité clinique du CaP, sa dépendance hormonale et une forte suspicion d'une contribution génétique à son étiologie, il apparaît crucial d'examiner si des polymorphismes au niveau des gènes reliés au métabolisme des androgènes et des oestrogènes seraient associés à une évolution clinique plus ou moins agressive du CaP. La glucuronidation est un processus majeur d'inactivation des hormones stéroïdiennes sexuelles. Cinq polymorphismes fonctionnels des enzymes UDP-glucuronosyltransférases (UGT) ont donc été étudiés. Une déficience en UGT2B17 et UGT2B28 a été associée à un risque accru de récidive biochimique post-prostatectomie chez les patients atteints d'un CaP cliniquement localisé. Ces résultats supportent l'hypothèse que des polymorphismes des UGT associés à une activité moindre conduisent potentiellement à des concentrations intracellulaires en androgènes actifs plus élevées, le tout se traduisant par une prolifération cellulaire accélérée et un pronostic moins favorable.

Chapter One provides a general introduction into the biology and chemistry of nitric oxide, with particular focus on the role of nitric oxide in cardiovascular disease, cancer and hypoxia. It also details the types of organic functional groups used as nitric oxide donors, with detailed discussion of nitrate esters, furoxans and sydnonimines. Chapter Two discusses prostate cancer. It provides an overview into the development of prostate cancer, prostate cancer staging, and treatment. The key molecular aspects of prostate cancer are detailed, and the types of treatment available outlined. Chapter Three details the synthesis and activity of NCX-1102, a nitric oxide-donating analogue of the non-steroidal anti-inflammatory drug sulindac, and the synthetic work in the preparation of analogues of NCX-1102, using nitrate esters, furoxans and sydnonimines as nitric oxide-donating functional groups. The compounds prepared were tested against a prostate cancer cell line (PC3) and the cytotoxicity results are presented. Chapter Four describes the synthesis of nitric-oxide donating analogues of abiraterone, a CYP17 inhibitor for the treatment of prostate cancer. The results of cytotoxicity assays against PC3 cells are detailed. Chapter Five discusses the application of nitric oxide-donating functional groups in tandem with biologically active motifs. The synthesis of nitric oxide-donating amino acids, and their application to the preparation of nitric oxide-donating RGD peptides and prostate-specific membrane antigen inhibitors is presented, along with representative biological evaluation. Chapter Six introduces possible future work for the continuation of the project, suggesting the synthesis of fluorinated sydnonimines, prostate-specific membrane antigen inhibitors combined with for prostate cancer imaging and a “tool-box” of nitric oxide-donating bioconjugation reagents.

An estimated 220,800 new prostate cancer cases and 27,540 deaths are expected to occur in US men by the end of 2015. Despite the increased treatment modes for prostate cancer, there is still no definite cure, and prognosis remains, at best, cautiously optimistic. The explicit amalgamation of two or more cancer therapeutic modalities such as surgery, radiation, and chemotherapy, has been one of the main interests of clinical investigation for several decades. Genistein (GN) and Beta-lapachone (BL) are two of the most promising anticancer phytochemical compounds. However, the anticancer activities of BL have been correlated with the enzyme activity of NQO1. The aim of this study was to investigate the enhancing effects of VLDR derived from a portable pyroelectric crystal generator on the chemopreventive and/or chemotherapeutic effects of GN and BL in NQO1+ PC3 and NQO1± (deficient) LNCaP prostate cancer cells (PCa) in vitro. The combination treat ment-induced cytotoxicity was investigated via MTT and Trypan blue exclusion assays. Dicoumarol (an NQO1 inhibitor) was co-administered to assess the effect of VLDR on NQO1 modulation. Nitro-blue tetrazolium assay was used to assess the intracellular ROS levels. Fluorescence microscopy was also used to assess the mode of cell death. In this study, a novel quantitative modeling approach was employed to comparably assess the cytotoxic effects of specific drugs used alone or in combinations with VLDR and to predict the potential synergistic therapeutic combinations. The data suggests that VLDR induced a rise in ROS levels, followed by upregulation in NQO1 levels. Pharmacodynamic indices were developed to quantify and characterize the combination treatment as synergistic, additive or antagonistic per dose or time-interval. Synergism was found to be dose and time-interval dependent. The major mode of cell death by this combination therapeutic regimen was found to be via apoptosis . In conclusion, our results confirm that VLDR enhanced cytotoxicity effects of both drugs dose- and time-dependently. / Includes bibliography. / Thesis (M.S.)--Florida Atlantic University, 2015. / FAU Electronic Theses and Dissertations Collection

Background: To compare the clinical value of the measurement of complex and total PSA in the discrimination between benign prostatic hyperplasia (BPH) and prostate cancer. Methods: In serum samples collected from 166 men with histopathologically proven clinically localized prostate cancer and of 97 men with BPH, total prostate-specific antigen (PSA), complexed PSA and the free to total PSA ratio were determined. The statistical analysis was done by the comparison of the receiver operator characteristic (ROC) curves. Results: The areas under the ROC curves were 0.776 for total PSA, 0.799 for complexed PSA (total PSA vs. cPSA: p < 0.0001) and 0.812 for the free to total PSA ratio. With a cut-off of 3.0 ng/ml for complexed PSA, the sensitivity was 90%, the specificity 58%, the positive and the negative predictive values 79 and 78%, respectively. With a cut-off of 4.0 ng/ml for total PSA, the sensitivity was 87%, the specificity 59%, the positive and the negative predictive values were 78 and 72%, respectively. Conclusions: There was a statistically significant advantage for complexed PSA compared to total PSA in the discrimination between BPH and prostate cancer. The difference was, however, small and its clinical relevance is questionable. / Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG-geförderten) Allianz- bzw. Nationallizenz frei zugänglich.