PURPOSE: To identify prognostic factors and evaluate biochemical control rates for patients with localized prostate cancer treated with either high-dose intensity-modulated radiotherapy (IMRT) or conventional-dose three-dimensional conformal radiotherapy 3D-CRT. METHODS: Four hundred sixteen patients with a minimum follow-up of 3 years (median, 5 years) were included. Two hundred seventy-one patients received 3D-CRT with a median dose of 68.4 Gy (range, 66-71 Gy). The next 145 patients received IMRT with a median dose of 75.6 Gy (range, 70.2-77.4 Gy). Biochemical control rates were calculated according to both American Society for Therapeutic Radiology and Oncology (ASTRO) consensus definitions. Prognostic factors were identified using both univariate and multivariate analyses. RESULTS: The 5-year biochemical control rate was 60.4% for 3D-CRT and 74.1% for IMRT (p < 0.0001, first ASTRO Consensus definition). Using the ASTRO Phoenix definition, the 5-year biochemical control rate was 74.4% and 84.6% with 3D-RT and IMRT, respectively (p = 0.0326). Univariate analyses determined that PSA level, T stage, Gleason score, perineural invasion, and radiation dose were predictive of biochemical control. On multivariate analysis, dose, Gleason score, and perineural invasion remained significant. CONCLUSION: On the basis of both ASTRO definitions, dose, Gleason score, and perineural invasion were predictive of biochemical control. Intensity-modulated radiotherapy allowed delivery of higher doses of radiation with very low toxicity, resulting in improved biochemical control.
PURPOSE: To identify prognostic factors and evaluate biochemical control rates for patients with localized prostate cancer treated with either high-dose intensity-modulated radiotherapy (IMRT) or conventional-dose three-dimensional conformal radiotherapy 3D-CRT. METHODS: Four hundred sixteen patients with a minimum follow-up of 3 years (median, 5 years) were included. Two hundred seventy-one patients received 3D-CRT with a median dose of 68.4 Gy (range, 66-71 Gy). The next 145 patients received IMRT with a median dose of 75.6 Gy (range, 70.2-77.4 Gy). Biochemical control rates were calculated according to both American Society for Therapeutic Radiology and Oncology (ASTRO) consensus definitions. Prognostic factors were identified using both univariate and multivariate analyses. RESULTS: The 5-year biochemical control rate was 60.4% for 3D-CRT and 74.1% for IMRT (p < 0.0001, first ASTRO Consensus definition). Using the ASTRO Phoenix definition, the 5-year biochemical control rate was 74.4% and 84.6% with 3D-RT and IMRT, respectively (p = 0.0326). Univariate analyses determined that PSA level, T stage, Gleason score, perineural invasion, and radiation dose were predictive of biochemical control. On multivariate analysis, dose, Gleason score, and perineural invasion remained significant. CONCLUSION: On the basis of both ASTRO definitions, dose, Gleason score, and perineural invasion were predictive of biochemical control. Intensity-modulated radiotherapy allowed delivery of higher doses of radiation with very low toxicity, resulting in improved biochemical control.
Authors: Deborah W Bruner; Daniel Hunt; Jeff M Michalski; Walter R Bosch; James M Galvin; Mahul Amin; Canhua Xiao; Jean-Paul Bahary; Malti Patel; Susan Chafe; George Rodrigues; Harold Lau; Marie Duclos; Madhava Baikadi; Snehal Deshmukh; Howard M Sandler Journal: Cancer Date: 2015-04-02 Impact factor: 6.860
Authors: Piotr Zareba; Richard Flavin; Masis Isikbay; Jennifer R Rider; Travis A Gerke; Stephen Finn; Andreas Pettersson; Francesca Giunchi; Robert H Unger; Alex M Tinianow; Swen-Olof Andersson; Ove Andrén; Katja Fall; Michelangelo Fiorentino; Lorelei A Mucci Journal: Cancer Epidemiol Biomarkers Prev Date: 2017-01-06 Impact factor: 4.254
Authors: Jeff M Michalski; Yan Yan; Deborah Watkins-Bruner; Walter R Bosch; Kathryn Winter; James M Galvin; Jean-Paul Bahary; Gerard C Morton; Matthew B Parliament; Howard M Sandler Journal: Int J Radiat Oncol Biol Phys Date: 2013-10-08 Impact factor: 7.038
Authors: Martin Dolezel; Karel Odrazka; Milan Zouhar; Miloslava Vaculikova; Jana Sefrova; Jan Jansa; Petr Paluska; Tereza Kohlova; Jaroslav Vanasek; Josef Kovarik Journal: Strahlenther Onkol Date: 2015-01-15 Impact factor: 3.621
Authors: Bruce L Jacobs; Yun Zhang; Ted A Skolarus; John T Wei; James E Montie; Florian R Schroeck; Brent K Hollenbeck Journal: Urology Date: 2012-09-19 Impact factor: 2.649
Authors: Bruce L Jacobs; Yun Zhang; Ted A Skolarus; John T Wei; James E Montie; Florian R Schroeck; Brent K Hollenbeck Journal: Urology Date: 2012-12 Impact factor: 2.649