Early Prostate Cancer: The National Results of Radiation Treatment from the Patterns of Care and Radiation Therapy Oncology Group Studies With Prospects for Improvement with Conformal Radiation and Adjuvant Androgen Deprivation

No AccessJournal of Urology1 Nov 1994Early Prostate Cancer: The National Results of Radiation Treatment from the Patterns of Care and Radiation Therapy Oncology Group Studies With Prospects for Improvement with Conformal Radiation and Adjuvant Androgen Deprivation Gerald E. Hanks, Alexandra Hanlon, Timothy Schultheiss, Benjamin Corn, William U. Shipley, and W. Robert Lee Gerald E. HanksGerald E. Hanks More articles by this author , Alexandra HanlonAlexandra Hanlon More articles by this author , Timothy SchultheissTimothy Schultheiss More articles by this author , Benjamin CornBenjamin Corn More articles by this author , William U. ShipleyWilliam U. Shipley More articles by this author , and W. Robert LeeW. Robert Lee More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(17)32384-4AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Long-term outcome of the Patterns of Care Study and the Radiation Therapy Oncology Group are used to demonstrate the national average results of treating early prostate cancer in the United States. A group of patients with stage T1B2 disease and pathologically negative lymph nodes showed excellent 10-year survival rates and freedom from clinical evidence of disease, while prostate specific antigen (PSA) correlations in 10-year survivors indicate that 88% were clinically free of cancer and had a PSA level of less than 4.0 mg./nl., and 65% had a PSA level of less than 1.5 ng./ml. The latter group represented clinical and biochemical cures. The improvement noted in outcome of locally advanced prostate cancer treatment by Radiation Therapy Oncology Group prospective trials combining androgen deprivation and radiation therapy is presented. These trials will be extended to the poor prognosis group with stage Tl,2 disease. The advantages of conformal therapy in acute and late morbidity are illustrated with preliminary evidence of improved PSA response as a result of improved technique and higher dose associated with conformal 3-dimensional treatment. References 1. : Current status of prostate-specific antigen in the radiotherapeutic management of prostatic cancer. Sem. Oncol.1993; 3: 154. Google Scholar 2. : Prostate-specific antigen as a pre-therapy prognostic factor in patients treated with radiation therapy for clinically localized prostate cancer. J. Clin. Oncol.1993; 11: 2158. Google Scholar 3. : Detection of organ-confined prostate cancer is increased through prostate-specific antigen-based screening. J.A.M.A.1993; 270: 948. Google Scholar 4. : Screening and early detection of prostate cancer. Cancer1993; 71: 981. Google Scholar 5. : External beam radiation therapy for clinically localized prostate cancer: patterns of care studies in the United States. Natl. Cancer Inst. Monogr.1988; 7: 75. Google Scholar 6. : Conformal static field therapy for low volume low grade prostate cancer with rigid immobilization. Int. J. Rad. Oncol. Biol. Phys.1991; 20: 142. Google Scholar 7. : Conformal static field radiation therapy treatment of early prostate cancer versus non-conformal techniques: a reduction in acute morbidity. Int. J. Rad. Oncol. Biol. Phys.1992; 24: 485. Google Scholar 8. : Dose escalation for stage C (T3) prostate cancer: minimal rectal toxicity observed using conformal therapy. Radiother. Oncol.1992; 23: 53. Google Scholar 9. : Boost treatment of the prostate using shaped, fixed fields. Int. J. Rad. Oncol. Biol. Phys.1989; 16: 193. Google Scholar 10. : A phase III trial of androgen suppression before and during radiation therapy (RT) for locally advanced prostatic carcinoma: preliminary report of RTOG protocol 8610. March 12 Proc. Amer. Soc. Clin. Oncol.1993; : 229. March 12. Google Scholar 11. : The study of patterns of care in radiation therapy. Cancer1977; 39: 780. Google Scholar 12. : The patterns of care study: a na tionwide evaluation of the practice of radiation therapy in cancer management. Int. J. Rad. Oncol. Biol. Phys.1976; 1: 1231. Google Scholar 13. : Distinguishing among distribu tions using data from complex designs. J. Amer. Stat. Ass.1979; 74: 754. Google Scholar 14. : Elective pelvic irradiation in stage A2, B carcinoma of the prostate: analysis of RTOG 77-06. Int. J. Rad. Oncol. Biol. Phys.1988; 15: 1307. Google Scholar 15. : Prognostic factors in carcinoma of the prostate: analysis of RTOG 75-06. Int. J. Rad. Oncol. Biol. Phys.1987; 13: 339. Google Scholar 16. : Clinical experi ence with 3D radiotherapy treating prostate cancer. Proceedings of International Symposium on 3D Radiation Treatment of Prostate Cancer1993; . Google Scholar 17. Corn, B. W. and Hanks, G. E.: Superior PSA response achieved with conformal radiation therapy of prostate cancer. Int. J. Rad. Oncol. Biol. Phys., in press. Google Scholar 18. Hanks, G. E., Schultheiss, T. E., Hunt, M. A. and Epstein, B.: Factors influencing incidence of acute grade II morbidity in conformal and standard radiation treatment of prostate cancer. Int. J. Rad. Oncol. Biol. Phys., in press. Google Scholar 19. : The outcome of treatment of 313 patients with T-l (UICC) prostate cancer treated with external beam irradiation. Int. J. Rad. Oncol. Biol. Phys.1988; 14: 243. Google Scholar 20. : Outcome for lymph node dissection negative T-lb, T-2 (A-2,B) prostate cancer treated with external beam radiation therapy in RTOG 77-06. Int. J. Rad. Oncol. Biol. Phys.1991; 21: 1099. Google Scholar 21. : Patterns of care and RTOG studies in prostate cancer: long term survival, hazard rate observations, and possibilities of cure. Int. J. Rad. Oncol. Biol. Phys.1994; 28: 39. Google Scholar 22. Schultheiss, T. E. and Hanks, G. E.: Unpublished data. Google Scholar 23. : Long-term treatment sequelae following external beam irradiation for adenocarcinoma of theprostate: analysis of RTOG studies 7506 and 7706. Int. J. Rad. Oncol. Biol. Phys.1991; 21: 935. Google Scholar 24. : Patient survival and local recurrence rate following radical prostatectomy for prostatic carcinoma. J. Urol.1986; 136: 422. Link, Google Scholar 25. : Radical prosta tectomy for clinical stage T1-2N0M0 prostatic adenocarcinoma: long-term results. J. Urol.1990; 144: 1180. Abstract, Google Scholar 26. Hanks, G. E., Perez, C. A., Kozar, M., Asbell, S. O., Pilepich, Μ. V. and Pajak, T. F.: PSA confirmation of cure at 10 years of the TIB, T2, NO, M0 prostate cancer patients treated in RTOG protocol 7706 with external beam irradiation. Int. J. Rad. Oncol. Biol. Phys., in press. Google Scholar 27. : Serum PSA after anatomic radical prostatectomy. The Johns Hopkins experience after 10 years. Urol. Clin. N. Amer.1993; 29: 1. Google Scholar 28. : Radical radiation therapy in the management of loco-regionally confined prostate cancer: analysis of results using PSA as a tumor marker. abstract Int. Cong. Rad. Oncol.1993; : 348. abstract. Google Scholar © 1994 by The American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byStone N, Stock R and Unger P (2018) Indications for Seminal Vesicle Biopsy and Laparoscopic Pelvic Lymph Node Dissection in Men With Localized Carcinoma of ProstateJournal of Urology, VOL. 154, NO. 4, (1392-1396), Online publication date: 1-Oct-1995. Volume 152Issue 5 Part 2November 1994Page: 1775-1780 Advertisement Copyright & Permissions© 1994 by The American Urological Association Education and Research, Inc.Keywordsradiotherapyprostatic neoplasmsandrogensdelivery of health careMetricsAuthor Information Gerald E. Hanks More articles by this author Alexandra Hanlon More articles by this author Timothy Schultheiss More articles by this author Benjamin Corn More articles by this author William U. Shipley More articles by this author W. Robert Lee More articles by this author Expand All Advertisement PDF downloadLoading ...