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Outcome and predictive factors for patients with Gleason score 7 prostate carcinoma treated with three‐dimensional conformal external beam radiation therapy
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...
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| Published in: | Cancer 2000-12, Vol.89 (12), p.2565-2569 |
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| container_title | Cancer |
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| creator | Anderson, Penny R. Hanlon, Alexandra L. Horwitz, Eric Pinover, Wayne Hanks, Gerald E. |
| description | 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 |
| doi_str_mv | 10.1002/1097-0142(20001215)89:12<2565::AID-CNCR8>3.0.CO;2-I |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_72484450</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>72484450</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3898-97ddc7d367e28e90c3049367ec7d54089ee404525191265364ba88fe37fa90c43</originalsourceid><addsrcrecordid>eNqVkd-KEzEUxgdR3O7qK0hAEPdiav52kq4Iy6hrYbHgH_AupJkzNDIz6Sapa-98BJ_Ah_NJzNhab7zxKjkf3_nOSX5FcUHwlGBMnxGsqhITTp9SjDGhRJxLNSf0ORUzMZ9fLl6W9dv6nXzBpnhaLy9oubhTTI5dd4tJbpOl4OzTSXEa4-dcVlSw-8UJIYQJSqpJ8WO5Tdb3gMzQoE2AxtnkvgBqjU0-RNT6gDYmORhSRLcurdFVByb6AUXrA6AqN_mYTAJkTbBu8L1BKUAWmr0_rQPAz2_fG9fDEJ0fTIesH3Jwn2_wNUEYpRWYHgXTuDwsp6c1BLPZPSjutaaL8PBwnhUfX7_6UL8pr5dXi_ryurRMKlmqqmls1bBZBVSCwpZhrsYqi4JjqQA45oIKogidCTbjKyNlC6xqTXZzdlY82efm19xsISbdu2ih68wAfht1RbnkXOBsfL832vzsGKDVm-B6E3aaYD1i0yMAPQLQf7BpqTTJZcamdcamf2PTTGNdLzXVi5z66DB-u-qh-Zt54JQNjw8GE63p2mAG6-LRp3ClhGDH37l1Hez-c7N_LbYX2C_xN8GL</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>72484450</pqid></control><display><type>article</type><title>Outcome and predictive factors for patients with Gleason score 7 prostate carcinoma treated with three‐dimensional conformal external beam radiation therapy</title><source>Wiley-Blackwell Read & Publish Collection</source><source>EZB Electronic Journals Library</source><creator>Anderson, Penny R. ; Hanlon, Alexandra L. ; Horwitz, Eric ; Pinover, Wayne ; Hanks, Gerald E.</creator><creatorcontrib>Anderson, Penny R. ; Hanlon, Alexandra L. ; Horwitz, Eric ; Pinover, Wayne ; Hanks, Gerald E.</creatorcontrib><description>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 <76 Gy to isocenter. Pretreatment PSA, dose, and palpation stage were significant independent predictors for bNED control upon multivariate analysis. Patients with a PSA <10 ng/mL who received a dose of ≥76 Gy had excellent 5‐year bNED control of 100% compared with 50% bNED if patients had PSA >10 ng/mL or received radiation therapy doses of <76 Gy.
CONCLUSIONS
Patients with Gleason score 7 adenocarcinoma who had a pretreatment PSA <10 ng/mL and received doses of ≥76 Gy had excellent 5‐year bNED control, emphasizing the importance of higher central axis doses in treating Gleason 7 tumors. Patients with intermediate PSA (10–19.9 ng/mL) also required doses ≥76 Gy. Pretreatment PSA ≥20 ng/mL portends a very poor bNED outcome for Gleason 7 patients treated with radiation therapy alone, and thus efforts should be directed toward multimodal or long term hormonal treatment strategies. Cancer 2000;89:2565–9. © 2000 American Cancer Society.
This is the first radiation therapy series to specifically and solely analyze outcome of prostate cancer patients with Gleason score 7. This report demonstrates the importance of higher central axis doses (≥ 76 Gy) in treating these patients with definitive three‐dimensional conformal radiation therapy.</description><identifier>ISSN: 0008-543X</identifier><identifier>EISSN: 1097-0142</identifier><identifier>DOI: 10.1002/1097-0142(20001215)89:12<2565::AID-CNCR8>3.0.CO;2-I</identifier><identifier>PMID: 11135217</identifier><identifier>CODEN: CANCAR</identifier><language>eng</language><publisher>New York: John Wiley & Sons, Inc</publisher><subject>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</subject><ispartof>Cancer, 2000-12, Vol.89 (12), p.2565-2569</ispartof><rights>Copyright © 2000 American Cancer Society</rights><rights>2001 INIST-CNRS</rights><rights>Copyright 2000 American Cancer Society.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c3898-97ddc7d367e28e90c3049367ec7d54089ee404525191265364ba88fe37fa90c43</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=907955$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11135217$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Anderson, Penny R.</creatorcontrib><creatorcontrib>Hanlon, Alexandra L.</creatorcontrib><creatorcontrib>Horwitz, Eric</creatorcontrib><creatorcontrib>Pinover, Wayne</creatorcontrib><creatorcontrib>Hanks, Gerald E.</creatorcontrib><title>Outcome and predictive factors for patients with Gleason score 7 prostate carcinoma treated with three‐dimensional conformal external beam radiation therapy</title><title>Cancer</title><addtitle>Cancer</addtitle><description>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 <76 Gy to isocenter. Pretreatment PSA, dose, and palpation stage were significant independent predictors for bNED control upon multivariate analysis. Patients with a PSA <10 ng/mL who received a dose of ≥76 Gy had excellent 5‐year bNED control of 100% compared with 50% bNED if patients had PSA >10 ng/mL or received radiation therapy doses of <76 Gy.
CONCLUSIONS
Patients with Gleason score 7 adenocarcinoma who had a pretreatment PSA <10 ng/mL and received doses of ≥76 Gy had excellent 5‐year bNED control, emphasizing the importance of higher central axis doses in treating Gleason 7 tumors. Patients with intermediate PSA (10–19.9 ng/mL) also required doses ≥76 Gy. Pretreatment PSA ≥20 ng/mL portends a very poor bNED outcome for Gleason 7 patients treated with radiation therapy alone, and thus efforts should be directed toward multimodal or long term hormonal treatment strategies. Cancer 2000;89:2565–9. © 2000 American Cancer Society.
This is the first radiation therapy series to specifically and solely analyze outcome of prostate cancer patients with Gleason score 7. This report demonstrates the importance of higher central axis doses (≥ 76 Gy) in treating these patients with definitive three‐dimensional conformal radiation therapy.</description><subject>Adenocarcinoma - blood</subject><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - radiotherapy</subject><subject>Analysis of Variance</subject><subject>Biological and medical sciences</subject><subject>conformal radiation therapy</subject><subject>Genital system. Mammary gland</subject><subject>Gleason score</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Neoplasm Staging</subject><subject>Predictive Value of Tests</subject><subject>prostate carcinoma</subject><subject>prostate specific antigen</subject><subject>Prostate-Specific Antigen - blood</subject><subject>Prostatic Neoplasms - blood</subject><subject>Prostatic Neoplasms - pathology</subject><subject>Prostatic Neoplasms - radiotherapy</subject><subject>Radiotherapy Dosage</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>0008-543X</issn><issn>1097-0142</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><recordid>eNqVkd-KEzEUxgdR3O7qK0hAEPdiav52kq4Iy6hrYbHgH_AupJkzNDIz6Sapa-98BJ_Ah_NJzNhab7zxKjkf3_nOSX5FcUHwlGBMnxGsqhITTp9SjDGhRJxLNSf0ORUzMZ9fLl6W9dv6nXzBpnhaLy9oubhTTI5dd4tJbpOl4OzTSXEa4-dcVlSw-8UJIYQJSqpJ8WO5Tdb3gMzQoE2AxtnkvgBqjU0-RNT6gDYmORhSRLcurdFVByb6AUXrA6AqN_mYTAJkTbBu8L1BKUAWmr0_rQPAz2_fG9fDEJ0fTIesH3Jwn2_wNUEYpRWYHgXTuDwsp6c1BLPZPSjutaaL8PBwnhUfX7_6UL8pr5dXi_ryurRMKlmqqmls1bBZBVSCwpZhrsYqi4JjqQA45oIKogidCTbjKyNlC6xqTXZzdlY82efm19xsISbdu2ih68wAfht1RbnkXOBsfL832vzsGKDVm-B6E3aaYD1i0yMAPQLQf7BpqTTJZcamdcamf2PTTGNdLzXVi5z66DB-u-qh-Zt54JQNjw8GE63p2mAG6-LRp3ClhGDH37l1Hez-c7N_LbYX2C_xN8GL</recordid><startdate>20001215</startdate><enddate>20001215</enddate><creator>Anderson, Penny R.</creator><creator>Hanlon, Alexandra L.</creator><creator>Horwitz, Eric</creator><creator>Pinover, Wayne</creator><creator>Hanks, Gerald E.</creator><general>John Wiley & Sons, Inc</general><general>Wiley-Liss</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20001215</creationdate><title>Outcome and predictive factors for patients with Gleason score 7 prostate carcinoma treated with three‐dimensional conformal external beam radiation therapy</title><author>Anderson, Penny R. ; Hanlon, Alexandra L. ; Horwitz, Eric ; Pinover, Wayne ; Hanks, Gerald E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3898-97ddc7d367e28e90c3049367ec7d54089ee404525191265364ba88fe37fa90c43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Adenocarcinoma - blood</topic><topic>Adenocarcinoma - pathology</topic><topic>Adenocarcinoma - radiotherapy</topic><topic>Analysis of Variance</topic><topic>Biological and medical sciences</topic><topic>conformal radiation therapy</topic><topic>Genital system. Mammary gland</topic><topic>Gleason score</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Neoplasm Staging</topic><topic>Predictive Value of Tests</topic><topic>prostate carcinoma</topic><topic>prostate specific antigen</topic><topic>Prostate-Specific Antigen - blood</topic><topic>Prostatic Neoplasms - blood</topic><topic>Prostatic Neoplasms - pathology</topic><topic>Prostatic Neoplasms - radiotherapy</topic><topic>Radiotherapy Dosage</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Anderson, Penny R.</creatorcontrib><creatorcontrib>Hanlon, Alexandra L.</creatorcontrib><creatorcontrib>Horwitz, Eric</creatorcontrib><creatorcontrib>Pinover, Wayne</creatorcontrib><creatorcontrib>Hanks, Gerald E.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Anderson, Penny R.</au><au>Hanlon, Alexandra L.</au><au>Horwitz, Eric</au><au>Pinover, Wayne</au><au>Hanks, Gerald E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outcome and predictive factors for patients with Gleason score 7 prostate carcinoma treated with three‐dimensional conformal external beam radiation therapy</atitle><jtitle>Cancer</jtitle><addtitle>Cancer</addtitle><date>2000-12-15</date><risdate>2000</risdate><volume>89</volume><issue>12</issue><spage>2565</spage><epage>2569</epage><pages>2565-2569</pages><issn>0008-543X</issn><eissn>1097-0142</eissn><coden>CANCAR</coden><abstract>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 <76 Gy to isocenter. Pretreatment PSA, dose, and palpation stage were significant independent predictors for bNED control upon multivariate analysis. Patients with a PSA <10 ng/mL who received a dose of ≥76 Gy had excellent 5‐year bNED control of 100% compared with 50% bNED if patients had PSA >10 ng/mL or received radiation therapy doses of <76 Gy.
CONCLUSIONS
Patients with Gleason score 7 adenocarcinoma who had a pretreatment PSA <10 ng/mL and received doses of ≥76 Gy had excellent 5‐year bNED control, emphasizing the importance of higher central axis doses in treating Gleason 7 tumors. Patients with intermediate PSA (10–19.9 ng/mL) also required doses ≥76 Gy. Pretreatment PSA ≥20 ng/mL portends a very poor bNED outcome for Gleason 7 patients treated with radiation therapy alone, and thus efforts should be directed toward multimodal or long term hormonal treatment strategies. Cancer 2000;89:2565–9. © 2000 American Cancer Society.
This is the first radiation therapy series to specifically and solely analyze outcome of prostate cancer patients with Gleason score 7. This report demonstrates the importance of higher central axis doses (≥ 76 Gy) in treating these patients with definitive three‐dimensional conformal radiation therapy.</abstract><cop>New York</cop><pub>John Wiley & Sons, Inc</pub><pmid>11135217</pmid><doi>10.1002/1097-0142(20001215)89:12<2565::AID-CNCR8>3.0.CO;2-I</doi><tpages>5</tpages></addata></record> |
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| 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 |
| title | Outcome and predictive factors for patients with Gleason score 7 prostate carcinoma treated with three‐dimensional conformal external beam radiation therapy |
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