PURPOSE: The aim of this study was to investigate effect of increasing dose on risk groups for clinical failure (CF: local failure or distant failure or hormone ablation or PSA>or=25 ng/ml) in patients with T1-T2 prostate cancer treated with external beam radiotherapy. METHODS AND MATERIALS: Patients (n=4,537) were partitioned into nonoverlapping dose ranges, each narrow enough that dose was not a predictor of CF, and risk groups for CF were determined using recursive partitioning analysis (RPA). The same technique was applied to the highest of these dose ranges (70-76 Gy, 1,136 patients) to compare risk groups for CF in this dose range with the conventional risk-group classification. RESULTS: Cutpoints defining low-risk groups in each dose range shifted to higher initial PSA levels and Gleason scores with increasing dose. Risk groups for CF in the dose range 70-76 Gy were not consistent with conventional risk groups. CONCLUSIONS: The conventional classification of risk groups was derived in the early PSA era, when total doses<70 Gy were common, and it is inconsistent with risk groups for patients treated to doses>70 Gy. Risk-group classifications must be continuously re-examined whenever the trend is toward increasing total dose.
PURPOSE: The aim of this study was to investigate effect of increasing dose on risk groups for clinical failure (CF: local failure or distant failure or hormone ablation or PSA>or=25 ng/ml) in patients with T1-T2 prostate cancer treated with external beam radiotherapy. METHODS AND MATERIALS: Patients (n=4,537) were partitioned into nonoverlapping dose ranges, each narrow enough that dose was not a predictor of CF, and risk groups for CF were determined using recursive partitioning analysis (RPA). The same technique was applied to the highest of these dose ranges (70-76 Gy, 1,136 patients) to compare risk groups for CF in this dose range with the conventional risk-group classification. RESULTS: Cutpoints defining low-risk groups in each dose range shifted to higher initial PSA levels and Gleason scores with increasing dose. Risk groups for CF in the dose range 70-76 Gy were not consistent with conventional risk groups. CONCLUSIONS: The conventional classification of risk groups was derived in the early PSA era, when total doses<70 Gy were common, and it is inconsistent with risk groups for patients treated to doses>70 Gy. Risk-group classifications must be continuously re-examined whenever the trend is toward increasing total dose.
Authors: Matthew S Katz; Jason A Efstathiou; Anthony V D'Amico; Michael W Kattan; Martin G Sanda; Paul L Nguyen; Matthew R Smith; Peter R Carroll; Anthony L Zietman Journal: BJU Int Date: 2010-03-15 Impact factor: 5.588
Authors: Thomas N Eade; Alexandra L Hanlon; Eric M Horwitz; Mark K Buyyounouski; Gerald E Hanks; Alan Pollack Journal: Int J Radiat Oncol Biol Phys Date: 2007-03-29 Impact factor: 7.038
Authors: Cécile Proust-Lima; Jeremy M G Taylor; Scott G Williams; Donna P Ankerst; Ning Liu; Larry L Kestin; Kyounghwa Bae; Howard M Sandler Journal: Int J Radiat Oncol Biol Phys Date: 2008-11-01 Impact factor: 7.038
Authors: Yong Xu; Fang Fang; Daret K St Clair; Pradoldej Sompol; Sajni Josson; William H St Clair Journal: Mol Cancer Ther Date: 2008-08 Impact factor: 6.261