BACKGROUND: The ability to discriminate between therapeutic success and failure after radiotherapy (RT) for prostate cancer (PCa) remains a clinical challenge. Post-treatment biopsies would seem ideal for evaluating innovations such as dose escalation protocols or combination treatments involving brachytherapy or hormones. OBJECTIVE: Correlate post-treatment biopsy results with prostate-specific antigen (PSA) and clinical outcome in PCa patients treated with three-dimensional conformal radiotherapy (3DCRT) in a dose-escalation study. DESIGN, SETTING, AND PARTICIPANTS: This study included 160 patients with clinical stage T1c to T3b PCa treated between 1995 and 2005 in Hospital Universitario la Princesa with 3DCRT who consented to and underwent a transrectal ultrasound (TRUS)-guided prostate biopsy 24-36 mo after RT. The median follow-up was 78 mo (range 27-171 mo). INTERVENTION: The median radiation dose was 74 gray (Gy; range 66.0-84.1). Risk-adapted short-term androgen deprivation (STAD) and long-term androgen deprivation (LTAD) were associated in 25 and 106 patients, respectively. Right and left systematic biopsies were carried out by the same urologist and were examined by a genitourinary pathologist. MEASUREMENTS: Biochemical disease-free survival (bDFS) according to American Society for Therapeutic Radiology and Oncology (ASTRO) 1997 and Phoenix definition criteria as well as histologic control using post-treatment prostate biopsies. RESULTS: Twenty-one percent of patients (34 of 160) had post-treatment-positive biopsies (PB). The 5-yr bDFS according to the Phoenix definition was 87%, 65%, and 92% for the whole series (PB and negative biopsies [NB] patients, respectively [p<0.001]). Multivariate analysis showed that biopsy status at 24-36 mo was an independent predictor of bDFS (p<0.0005) and of clinical failure-free survival (p=0.043). CONCLUSION: The results of the present study show a strong correlation between a post-treatment PB and the 5-yr probability of bDFS, confirming that PSA control can be an adequate surrogate for local control, as assessed by post-treatment biopsies.
BACKGROUND: The ability to discriminate between therapeutic success and failure after radiotherapy (RT) for prostate cancer (PCa) remains a clinical challenge. Post-treatment biopsies would seem ideal for evaluating innovations such as dose escalation protocols or combination treatments involving brachytherapy or hormones. OBJECTIVE: Correlate post-treatment biopsy results with prostate-specific antigen (PSA) and clinical outcome in PCa patients treated with three-dimensional conformal radiotherapy (3DCRT) in a dose-escalation study. DESIGN, SETTING, AND PARTICIPANTS: This study included 160 patients with clinical stage T1c to T3b PCa treated between 1995 and 2005 in Hospital Universitario la Princesa with 3DCRT who consented to and underwent a transrectal ultrasound (TRUS)-guided prostate biopsy 24-36 mo after RT. The median follow-up was 78 mo (range 27-171 mo). INTERVENTION: The median radiation dose was 74 gray (Gy; range 66.0-84.1). Risk-adapted short-term androgen deprivation (STAD) and long-term androgen deprivation (LTAD) were associated in 25 and 106 patients, respectively. Right and left systematic biopsies were carried out by the same urologist and were examined by a genitourinary pathologist. MEASUREMENTS: Biochemical disease-free survival (bDFS) according to American Society for Therapeutic Radiology and Oncology (ASTRO) 1997 and Phoenix definition criteria as well as histologic control using post-treatment prostate biopsies. RESULTS: Twenty-one percent of patients (34 of 160) had post-treatment-positive biopsies (PB). The 5-yr bDFS according to the Phoenix definition was 87%, 65%, and 92% for the whole series (PB and negative biopsies [NB] patients, respectively [p<0.001]). Multivariate analysis showed that biopsy status at 24-36 mo was an independent predictor of bDFS (p<0.0005) and of clinical failure-free survival (p=0.043). CONCLUSION: The results of the present study show a strong correlation between a post-treatment PB and the 5-yr probability of bDFS, confirming that PSA control can be an adequate surrogate for local control, as assessed by post-treatment biopsies.
Authors: Niall M Corcoran; Guilherme Godoy; Rodney C Studd; Rowan G Casey; Antonio Hurtado-Coll; Scott Tyldesley; S Larry Goldenberg; Martin E Gleave Journal: Can Urol Assoc J Date: 2013 Mar-Apr Impact factor: 1.862
Authors: B Walter; T Weiss; F Hofstädter; A Gaumann; A Hartmann; S Rogenhofer; R Ganzer; S Wach; D Engehausen; W F Wieland; A Blana Journal: World J Urol Date: 2012-02-19 Impact factor: 4.226
Authors: Juanita Crook; Joseph P Rodgers; Thomas M Pisansky; Edouard J Trabulsi; Mahul B Amin; William Bice; Gerard Morton; Albert D Murtha; Eric Vigneault; Joelle Helou; Jeff M Michalski; Mack Roach; David Beyer; Ashesh B Jani; Eric M Horwitz; Adam Raben; Stephanie Pugh; Howard Sandler Journal: Int J Radiat Oncol Biol Phys Date: 2021-11-03 Impact factor: 7.038
Authors: A Zapatero; M Adrados; L Torres; M S Talaya; A Cruz Conde; C Martin de Vidales; L Vega Piris; C Olivier; M T Murillo Journal: Rep Pract Oncol Radiother Date: 2019-12-09