BACKGROUND: The therapeutic outcome and toxicity of 3-D conformal photon external beam therapy of prostate cancer is well documented in the literature. Progress is still in work for optimization of treatment strategies by risk-adapted dose escalation studies to improve local tumor control without increase of radiation side effects. PATIENTS AND METHODS: We present our experience of 291 patients treated between January 1994 and August 1997 with a 3-D planned four-field box technique and a central dose of 66 Gy. Biochemical response of patients with radiotherapy alone (group 1, n = 72 pts.) has been analyzed in detail. Acute radiation side effects are given for all patients (n = 291), late radiation side effects are given for patients treated between Jan 1994 and Jan 1996 with a median follow-up of 22 months (n = 115 pts.). RESULTS: We have observed a biochemical response (nadir PSA < 1 after 12 months, < 2 after 6 months) for patients treated with radiotherapy alone without hormone manipulation in 67%. Incidence of late rectal and bladder morbidity (grade 2 and 3) was 9.4% and 4%, respectively. CONCLUSION: Compared to other reports our results indicate a high rate of local tumor control (early biochemical response) and a low rate of late morbidity. Nevertheless, we will start a risk-adapted dose escalation study up to 74 Gy for unfavorable subgroups (G2-3, Gleason Score > 7, PSA > 10) to improve treatment outcome.
BACKGROUND: The therapeutic outcome and toxicity of 3-D conformal photon external beam therapy of prostate cancer is well documented in the literature. Progress is still in work for optimization of treatment strategies by risk-adapted dose escalation studies to improve local tumor control without increase of radiation side effects. PATIENTS AND METHODS: We present our experience of 291 patients treated between January 1994 and August 1997 with a 3-D planned four-field box technique and a central dose of 66 Gy. Biochemical response of patients with radiotherapy alone (group 1, n = 72 pts.) has been analyzed in detail. Acute radiation side effects are given for all patients (n = 291), late radiation side effects are given for patients treated between Jan 1994 and Jan 1996 with a median follow-up of 22 months (n = 115 pts.). RESULTS: We have observed a biochemical response (nadir PSA < 1 after 12 months, < 2 after 6 months) for patients treated with radiotherapy alone without hormone manipulation in 67%. Incidence of late rectal and bladder morbidity (grade 2 and 3) was 9.4% and 4%, respectively. CONCLUSION: Compared to other reports our results indicate a high rate of local tumor control (early biochemical response) and a low rate of late morbidity. Nevertheless, we will start a risk-adapted dose escalation study up to 74 Gy for unfavorable subgroups (G2-3, Gleason Score > 7, PSA > 10) to improve treatment outcome.
Authors: N Fukunaga-Johnson; H M Sandler; P W McLaughlin; M S Strawderman; K H Grijalva; K E Kish; A S Lichter Journal: Int J Radiat Oncol Biol Phys Date: 1997-05-01 Impact factor: 7.038
Authors: D M Tait; A E Nahum; L C Meyer; M Law; D P Dearnaley; A Horwich; W P Mayles; J R Yarnold Journal: Radiother Oncol Date: 1997-02 Impact factor: 6.280
Authors: T E Schultheiss; W R Lee; M A Hunt; A L Hanlon; R S Peter; G E Hanks Journal: Int J Radiat Oncol Biol Phys Date: 1997-01-01 Impact factor: 7.038
Authors: G E Hanks; W R Lee; A L Hanlon; M Hunt; E Kaplan; B E Epstein; B Movsas; T E Schultheiss Journal: Int J Radiat Oncol Biol Phys Date: 1996-07-15 Impact factor: 7.038
Authors: G E Hanks; T E Schultheiss; A L Hanlon; M Hunt; W R Lee; B E Epstein; L R Coia Journal: Int J Radiat Oncol Biol Phys Date: 1997-02-01 Impact factor: 7.038