Outcome and predictive factors for patients with Gleason score 7 prostate carcinoma treated with three‐dimensional conformal external beam radiation therapy

• Published in: Cancer 2000-12, Vol.89 (12), p.2565-2569
• Main Authors: Anderson, Penny R., Hanlon, Alexandra L., Horwitz, Eric, Pinover, Wayne, Hanks, Gerald E.
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - blood; Adenocarcinoma - pathology; Adenocarcinoma - radiotherapy; Analysis of Variance; Biological and medical sciences; conformal radiation therapy; Genital system. Mammary gland; Gleason score; Humans; Male; Medical sciences; Neoplasm Staging; Predictive Value of Tests; prostate carcinoma; prostate specific antigen; Prostate-Specific Antigen - blood; Prostatic Neoplasms - blood; Prostatic Neoplasms - pathology; Prostatic Neoplasms - radiotherapy; Radiotherapy Dosage; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Time Factors; Treatment Outcome
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/1097-0142(20001215)89:12<2565::AID-CNCR8>3.0.CO;2-I

BACKGROUND The purpose of this study was to determine the biochemical outcome and factors predictive of outcome in prostate carcinoma patients with Gleason score 7 tumors who were treated with three‐dimensional conformal radiation therapy (3DCRT). METHODS Between August 1990 and October 1997, 163 T1–T3NXM0 prostate carcinoma patients with Gleason score 7 were treated with definitive 3DCRT alone. The median follow‐up, International Commission on Radiological Units dose, and pretreatment prostate specific antigen (PSA) for the entire group were 50 months, 76 grays (Gy), and 11.4 ng/mL, respectively. Independent predictors based on multivariate results were used to stratify the patients into prognostic groups for which biochemical no evidence of disease (bNED) control was reported. Biochemical NED failure was defined according to the American Society for Therapeutic Radiology and Oncology Consensus Panel definition. RESULTS The 5‐year bNED control for all patients was 66%. Stratified by pretreatment PSA, 5‐year bNED control rates were 83%, 65%, and 21% for 0–9.9 ng/mL, 10–19.9 ng/mL, and ≥20 ng/mL, respectively. Dose to the central axis was found to be a significant treatment factor, with patients receiving ≥76 Gy experiencing 76% 5‐year bNED control versus 54% when treated with