Localized prostate cancer
Ten-year experience with three-dimensional conformal radiotherapy
Keywords:
PROSTATIC NEOPLASMS, CONFORMAL RADIOTHERAPYAbstract
A sample of 560 patients with localized prostate cancer were analyzed from 1993 to 2001. All patients were treated with tridimensional conformal radiotherapy. Global survival after 9 years was 71%, while specific cause survival was 88%. Mortality due to prostate cancer was 4,8% compared to 8,3% observed in other causes mortality. Survival without biochemical fallen again according to risk-group was 83%, 68% and 41% after 9 years, respectively for groups at low, medium and high risk in 504 patients (p<0,05). Dosage >72 Gy improved biochemical control at 7 years in the whole population but was significant only in the group at high risk (p<0,006). Cox model showed that the group at risk, total dosage at continual variable and initial PSA as categorical variable were significant. When Cox model was employed in 188 patients at high risk, inductive or concomitant use of hormonetherapy and age became significant. Grade 3 and 4 severe complications after 10 years accounted for 1,2% and 1,4% (actuarial rates) respectively at urinary and digestive levels. tridimensional conformal radiotherapy at high dosage is an effective and of low morbidity treatment for localized prostate cancer.
References
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30) Kupelian PA, Elshaikh M, Reddy CA, Zippe C, Klein EA. Comparison of the efficacy of local therapies for localized prostate cancer in the prostate-specific antigen era: a large single-institution experience with radical prostatectomy and external-beam radiotherapy JCO 2002; 20: 3376-85.
2) Mettlin CJ, Murphy GP. Why is the prostate cancer death rate declining in the United States? Cancer 1998; 82: 249-25.
3) Catalona WJ. Surgical management of prostate cancer. Contemporary results with anatomic radical prostatectomy. Cancer 1995; 75: 1903-8.
4) Kupelian PA, Potters L, Khuntia D, Ciezki JP, Reddy C, Reuther A, et al. Radical prostatectomy, external beam radiotherapy <72 Gy, external beam radiotherapy =72 Gy, permanent seed implantation, or combined seeds/external beam radiotherapy for stage T1–T2 prostate cancer. Int J Rad Oncol Biol Phys 2004; 58: 25-33.
5) Chodak GW, Thisted RA, Gerber GS, Johansson JE, Adolfsson J, Jones GW. Results of conservative management of clinically localized prostate cancer. N Engl J Med 1994; 330: 242-8.
6) Carter CA, Donahue T, Sun L, Wu H, McLeod DG, Amling C. Temporarily deferred therapy (watchful waiting) for men younger than 70 Years and with low-risk localized prostate cancer in the prostate-specific antigen era. JCO 2003; 21: 4001-8.
7) Hanks GE. Three-dimensional conformal radiation therapy for prostate cancer. In: D’Amico AV, Hanks GE, eds. Radiotherapuetic management of prostate adenocarcinoma. Londres: Arnold, 1999: 21-50.
8) Armstrong J. Three-dimensional conformal radiation the-rapy: evidence-based treatment of prostate cancer. Radioth Oncol 2002; 64: 235-7.
9) American Joint Committee on Cancer. Cancer Staging Manual. 6ª ed. New York: Springer, 2002: 309-12.
10) Chism DB, Hanlon AL, Troncoso P, Al-Saleem T, Horwitz EM, Pollack A. The Gleason score shift: Score four and seven years ago. Int J Radiat Oncol Biol Phys 2003; 56(5): 1241-7.
11) Smith EB, Frierson HF, Jr, Mills SE, Boyd JC, Theodorescu D. Gleason scores of prostate biopsy and radical prostatectomy specimens over the past 10 years: Is there evidence for systematic upgrading? Cancer 2002; 94: 2282-7.
12) Bayley AJ, Catton CN, Haycocks T, Kelly V, Alasti H, Bristow R, et al. A randomized trial of supine vs. prone positioning in patients undergoing escalated dose conformal radiotherapy for prostate cancer. Radioth Oncol 2004; 70: 37-44.
13) Tinger A, Michalski JM, Cheng A, Low DA, Zhu R, Bosch WR, et al. A critical evaluation of the planning target volume for 3-D conformal radiotherapy of prostate cancer. Int J Radiat Oncol Biol Phys 1998; 42: 213-21.
14) International Commission on Radiation Units and Measurements (ICRU). Prescribing, recording, and reporting photon beam therapy. Washington: ICRU, 1993: 280 pp. (ICRU Report No. 50).
15) Hanks GE, Hanlon AL, Pinover WH, Horwitz EM, Price RA, Schultheiss T. Dose selection for prostate cancer patients based on dose comparison and dose response studies. Int J Radiat Oncol Biol Phys 2000; 46: 823-32.
16) Partin AW, Kattan MW, Subong EN, Walsh PC, Wojno KL, Oesterling JE, et al. Combination of prostate-specific antigen, clinical stage, and Gleason score to predict pathological stage of localized prostate cancer. A multi-institutional update. JAMA 1997; 277: 1445-51.
17) Cox DR. Regression models and life tables (with discussion), J R Stat Soc B 1972; 34: 187-200.
18) American Society for Therapeutic Radiology and Oncology Consensus Panel. Consensus statement: Guidelines for PSA following radiation therapy. Int J Radiat Oncol Biol Phys 1997; 37: 1035-41.
19) Thames H, Kuban D, Levy L, Horwitz EM, Kupelian P, Martínez AA. Comparison of alternative biochemical failure definitions based on clinical outcome in 4839 prostate cancer patients treated by external beam radiotherapy between 1986 and 1995. Int J Radiat Oncol Biol Phys 2003; 57: 929-43.
20) Kaplan EL, Meier P. Non parametric estimation from incomplete observations. J Am Statist Assoc 1958; 53: 457-81.
21) Mantel N. Evaluation of survival data and two new rank order statistics arising in its consideration. Cancer Chemother Rep 1966; 50: 163-70.
22) Storey MR, Pollack A, Zagars G, Smith L, Antolak J, Rosen I. Complications from radiotherapy dose escalation in prostate cancer: preliminary results of a randomized trial. Int J Radiat Oncol Biol Phys 2000; 48: 635-42.
23) Pilepich MV, Winter K, John MJ, Mesic JB, Sause W, Rubin P, et al. Phase III radiation therapy oncology group (RTOG) trial 86-10 of androgen deprivation adjuvant to definitive radiotherapy in locally advanced carcinoma of the prostate. Int J Rad Oncol Biol Phys 2001; 50: 1243-52.
24) Liu M, Pickles T, Arganovich A, Berthelet E, Duncan G, Keyes M, et al. Impact of neoadjuvant androgen ablation and other factors on late toxicity after external beam prostate radiotherapy. Int J Rad Oncol Biol Phys 2004; 58: 59-67.
25) Zelefsky M, Fuks Z, Chan H. Ten-year results of dose escalation with 3-dimensional conformal radiotherapy for patients with clinically localized prostate cancer. Int J Rad Oncol Biol Phys 2003: 57(2S): S149-S150.
26) Michalsky JM, Purdy JA, Winter K, Roach M 3rd, Vijayakumar S, Sandler HM, et al. Preliminary report of toxicity following 3D radiation therapy for prostate cancer on 3DOG/RTOG 9406. Int J Radiat Oncol Biol Phys 2000; 46: 391-402.
27) Sandler HM, Dunn RL, McLaughlin PW, Hayman JA, Sullivan MA, Taylor JM. Overall survival after prostate-specific-antigen-detected recurrence following conformal radiation therapy. Int J Radiat Oncol Biol Phys 2000; 48: 629-33.
28) Kupelian PA, Buchsbaum JC, Elshaikh MA, Reddy CA, Klein EA. Improvement in relapse-free survival throughout the PSA era in patients with localized prostate cancer treated with definitive radiotherapy: Year of treatment an independent predictor of outcome. Int J RadiatOncol Biol Phys 2002; 57: 629-34.
29) Kuban DA, Thames HD, Levy LB, Horwitz EM, Kupelian PA, Martinez AA, et al. Long-term multi-institutional analysis of stage T1–T2 prostate cancer treated with radiotherapy in the PSA era. Int J Radiat Oncol Biol Phys 2003; 57: 915-28.
30) Kupelian PA, Elshaikh M, Reddy CA, Zippe C, Klein EA. Comparison of the efficacy of local therapies for localized prostate cancer in the prostate-specific antigen era: a large single-institution experience with radical prostatectomy and external-beam radiotherapy JCO 2002; 20: 3376-85.
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Leborgne F, Leborgne JH, Zubizarreta E, Ortega B, Leborgne Deus J, Aguiar S, et al. Localized prostate cancer: Ten-year experience with three-dimensional conformal radiotherapy. Rev. Méd. Urug. [Internet]. 2004 Dec. 31 [cited 2024 Nov. 23];20(3):193-201. Available from: https://revista.rmu.org.uy/index.php/rmu/article/view/870
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