PURPOSE: This study was conducted to see what fraction of prostate cancer patients with biopsy-proven nodes are free of cancer 10 years after radiation treatment. METHODS AND MATERIALS: RTOG protocol #75-06 included 90 patients with biopsy-proven pelvic nodal involvement treated with radiation. They have been continuously follow-up since treatment. When feasible, current prostate-specific antigen (PSA) levels have been solicited from patients clinically cancer-free (no evidence of disease, NED) at 10 years, to confirm cure. RESULTS: The 10-year survival was 29%, the 10-year clinical NED survival 7%. PSA levels were obtained in 2 of 5 10-year clinical NED patients, they were both less than 0.8 ng/ml. The 2 proven cures were both clinical stage T-3, Gleason Score 6 and 8, and had 2 and 1 positive nodes, respectively. Multivariate analysis showed Gleason sum was significantly associated with clinical survival without disease. CONCLUSION: A small fraction of node-positive patients are cured at 10-year follow-up by radiation therapy (2 of 90 with PSA +3 of 90 by clinical endpoints). Innovative treatment programs should be directed at node-positive patients in an effort to improve the fraction cured.
PURPOSE: This study was conducted to see what fraction of prostate cancerpatients with biopsy-proven nodes are free of cancer 10 years after radiation treatment. METHODS AND MATERIALS: RTOG protocol #75-06 included 90 patients with biopsy-proven pelvic nodal involvement treated with radiation. They have been continuously follow-up since treatment. When feasible, current prostate-specific antigen (PSA) levels have been solicited from patients clinically cancer-free (no evidence of disease, NED) at 10 years, to confirm cure. RESULTS: The 10-year survival was 29%, the 10-year clinical NED survival 7%. PSA levels were obtained in 2 of 5 10-year clinical NED patients, they were both less than 0.8 ng/ml. The 2 proven cures were both clinical stage T-3, Gleason Score 6 and 8, and had 2 and 1 positive nodes, respectively. Multivariate analysis showed Gleason sum was significantly associated with clinical survival without disease. CONCLUSION: A small fraction of node-positive patients are cured at 10-year follow-up by radiation therapy (2 of 90 with PSA +3 of 90 by clinical endpoints). Innovative treatment programs should be directed at node-positive patients in an effort to improve the fraction cured.
Authors: Anja M Weidner; Emile N J Th van Lin; Dietmar J Dinter; Tom Rozema; Stefan O Schoenberg; Frederik Wenz; Jelle O Barentsz; Frank Lohr Journal: Strahlenther Onkol Date: 2011-02-21 Impact factor: 3.621
Authors: Gilles Créhange; Chien Peter Chen; Charles C Hsu; Norbert Kased; Fergus V Coakley; John Kurhanewicz; Mack Roach Journal: Cancer Treat Rev Date: 2012-06-15 Impact factor: 12.111
Authors: Malcolm D Mason; Wendy R Parulekar; Matthew R Sydes; Michael Brundage; Peter Kirkbride; Mary Gospodarowicz; Richard Cowan; Edmund C Kostashuk; John Anderson; Gregory Swanson; Mahesh K B Parmar; Charles Hayter; Gordana Jovic; Andrea Hiltz; John Hetherington; Jinka Sathya; James B P Barber; Michael McKenzie; Salah El-Sharkawi; Luis Souhami; P D John Hardman; Bingshu E Chen; Padraig Warde Journal: J Clin Oncol Date: 2015-02-17 Impact factor: 44.544