TY - JOUR
T1 - Equivalent 5-year bned in select prostate cancer patients managed with surgery or radiation therapy despite exclusion of the seminal vesicles from the CTV
AU - D'Amico, Anthony V.
AU - Whittington, Richard
AU - Kaplan, Irving
AU - Beard, Clair
AU - Schultz, Delray
AU - Malkowicz, S. Bruce
AU - Tomaszewski, John E.
AU - Wein, Alan
AU - Coleman, C. Norman
PY - 1997
Y1 - 1997
N2 - Purpose: Prostate Specific Antigen (PSA) failure free survival was determined for select prostate cancer patients managed definitively with external beam radiation therapy to the prostate only or radical retropubic prostatectomy. Methods and Materials: A logistic regression multivariable analysis evaluating the variables of PSA, biopsy Gleason score, and clinical stage was used to evaluate the endpoint of pathologic seminal vesicle invasion (SVI) in 749 consecutive prostate cancer patients managed with a radical retropubic prostatectomy. In a subgroup of 332 surgically and 197 radiation managed patients who did not have the clinical predictors of SVI, PSA failure free survival (bNED) was determined. Comparisons were made using the log rank test between surgically and radiation managed patients in this subgroup. In this subgroup, radiation managed patients were treated to a median dose of 66 Gy (66-70 Gy) to the prostate only. Results: The pretreatment PSA (>10 ng/ml), biopsy Gleason score (≥7), and clinical stage (T2b, 2c, or 3) were found to be significant independent predictors (p<0.001) of SVI. Only 2% of patients without any of these factors had SVI and 17% had extracapsular extension (15% microscopic; 2% macroscopic). In this subgroup the 5-year bNED rates were equivalent [84 vs. 89% (p = 0.67)] for surgically and radiation managed patients, respectively. Conclusions: Conventional dose external beam radiation therapy directed at the prostate alone resulted in 5-year bNED rates equivalent to surgery on retrospective comparison in patients with clinical stage T1,2a, PSA ≤ 10 ng/ml, and biopsy Gleason ≤ 6 prostate cancer.
AB - Purpose: Prostate Specific Antigen (PSA) failure free survival was determined for select prostate cancer patients managed definitively with external beam radiation therapy to the prostate only or radical retropubic prostatectomy. Methods and Materials: A logistic regression multivariable analysis evaluating the variables of PSA, biopsy Gleason score, and clinical stage was used to evaluate the endpoint of pathologic seminal vesicle invasion (SVI) in 749 consecutive prostate cancer patients managed with a radical retropubic prostatectomy. In a subgroup of 332 surgically and 197 radiation managed patients who did not have the clinical predictors of SVI, PSA failure free survival (bNED) was determined. Comparisons were made using the log rank test between surgically and radiation managed patients in this subgroup. In this subgroup, radiation managed patients were treated to a median dose of 66 Gy (66-70 Gy) to the prostate only. Results: The pretreatment PSA (>10 ng/ml), biopsy Gleason score (≥7), and clinical stage (T2b, 2c, or 3) were found to be significant independent predictors (p<0.001) of SVI. Only 2% of patients without any of these factors had SVI and 17% had extracapsular extension (15% microscopic; 2% macroscopic). In this subgroup the 5-year bNED rates were equivalent [84 vs. 89% (p = 0.67)] for surgically and radiation managed patients, respectively. Conclusions: Conventional dose external beam radiation therapy directed at the prostate alone resulted in 5-year bNED rates equivalent to surgery on retrospective comparison in patients with clinical stage T1,2a, PSA ≤ 10 ng/ml, and biopsy Gleason ≤ 6 prostate cancer.
KW - Clinical target volume
KW - Gleason score
KW - Prostate cancer
KW - Prostate specific antigen
KW - Radiation therapy
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U2 - 10.1016/S0360-3016(97)00320-9
DO - 10.1016/S0360-3016(97)00320-9
M3 - Article
C2 - 9308936
AN - SCOPUS:0030769192
SN - 0360-3016
VL - 39
SP - 335
EP - 340
JO - International Journal of Radiation Oncology Biology Physics
JF - International Journal of Radiation Oncology Biology Physics
IS - 2 SUPPL.
ER -