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Simultaneous irradiation for prostate cancer: intermediate results with modern techniques
F A Critz1, W H Williams, A K Levinson
1Radiotherapy Clinics of Georgia and Georgia Urology, Decatur, GA, USA.
The Journal of Urology
|August 23, 2000
Summary
This study shows that modern simultaneous radiation therapy for early prostate cancer yields an 88% 5-year disease-free survival rate. Pretreatment prostate-specific antigen (PSA) levels were the strongest predictor of treatment success.
Area of Science:
- Oncology
- Radiation Oncology
- Urology
Background:
- Early-stage prostate cancer requires effective treatment strategies.
- Simultaneous irradiation combines transperineal implantation and external beam radiation.
Purpose of the Study:
- To evaluate treatment outcomes in men with early prostate cancer using modern simultaneous irradiation.
- To determine disease-free survival rates based on prostate-specific antigen (PSA) nadir.
Main Methods:
- 689 men with clinical stage T1-T2, N0, Nx prostate cancer were treated between 1992 and 1996.
- Treatment involved ultrasound-guided transperineal 125iodine seed implantation followed by external beam radiation.
- Disease-free status was defined as maintaining a PSA nadir of ≤0.2 ng/ml, with a median follow-up of 4 years.
Main Results:
- The overall 5-year disease-free survival rate was 88%.
- Survival rates varied by pretreatment PSA: 94% for ≤4.0 ng/ml, 93% for 4.1-10.0 ng/ml, 75% for 10.1-20.0 ng/ml, and 69% for >20.0 ng/ml.
- Multivariate analysis identified pretreatment PSA as the strongest predictor of disease-free status, surpassing Gleason score and clinical stage.
Conclusions:
- Intermediate outcome analysis supports radiation dose intensification for intracapsular prostate cancer.
- The findings support treating potential microscopic capsular penetration with this method.
- Modern simultaneous irradiation demonstrates promising outcomes for early-stage prostate cancer.