Effect of local tumor control on distant metastasis and survival in prostatic adenocarcinoma

Kuban, Deborah A.; El‐Mahdi, Anas M.; Schellhammer, Paul F.

doi:10.1016/0090-4295(87)90372-4

Cited by 104 publications

(28 citation statements)

References 18 publications

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“…Local failure after radiotherapy for prostate cancer predisposes to distant metastasis (1)(2)(3). Some have argued that local failure is a surrogate for tumor aggressiveness and that patients who fail locally would have failed distantly anyway (4).…”

Section: Introductionmentioning

confidence: 99%

Radiation dose and late failures in prostate cancer

Morgan

Hanlon

Horwitz

et al. 2007

International Journal of Radiation Oncology*Biology*Physics

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Purpose-To quantify the impact of radiotherapy (RT) dose escalation on the timing of biochemical failure (BF) and distant metastasis (DM) for prostate cancer treated with RT alone.Methods and Materials-A total of 667 men with clinically localized intermediate and high risk prostate cancer treated with 3D-conformal RT alone were retrospectively analyzed. The interval hazard rates of DM and biochemical failure (BF), using ASTRO and Phoenix (Nadir+2) definitions, were determined. Median follow-up was 77 months.Results-Multivariate analysis showed that increasing RT dose was independently associated with decreased ASTRO BF (P<.0001), Nadir+2 BF (P=.001), and DM (P=.006). The preponderance (85%) of ASTRO BF occurred at ≤4 years after RT, while Nadir+2 BF was more evenly spread over years 1-10, with 55% BF in ≤4 years. RT dose escalation caused a shift in the BF from earlier to later years. The interval hazard function for DM appeared to be biphasic (early and late peaks) overall and for the <74 Gy group. In patients receiving ≥74 Gy, there was a reduction in the risk of DM in both the early and late waves, although the late wave appears reduced to a greater degree.Conclusions-The ASTRO definition of BF systematically underestimates late BF due to backdating. RT dose escalation diminished and delayed BF; the delay suggests that there may still be local persistence in some patients. For DM, higher RT dose reduced both the early and late waves, suggesting that persistence of local disease contributes to both.

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Section: Introductionmentioning

confidence: 99%

Radiation dose and late failures in prostate cancer

Morgan

Hanlon

Horwitz

et al. 2007

International Journal of Radiation Oncology*Biology*Physics

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“…These results for iodine 125 implants are inferior to the local control rates of 60 to 80 percent reported for stage C patients treated with external-beam radiation therapy. 19,25,45 It should be noted, however, that Fuks et al 18 have demonstrated a clear relationship between an adequate implant dose and the probability of local control in a series of 679 relatively advanced stage B/N0 and C/N0 patients. In this series, patients who received a matched peripheral dose of 140 Gy or more achieved a 10-year local control rate of 60 percent, while those with a matched peripheral dose of less than 140 Gy had a local control rate of only 20 percent at 10 years.…”

Section: Iodine 125 Retropubic Methodsmentioning

confidence: 99%

“…19,21,[35][36][37][38] In those series that retrospectively compared iodine 125 with external-beam radiation therapy, overall survival results appeared equivalent at least to five years. 18,19,21,25,39,40 Longer follow-up is available in a few series with 10-year results of 50 percent 19 and 15-year actuarial survival of 37 percent. 41 In the Hilaris series, 41 a subgroup of patients judged to have been candidates for radical prostatectomy were identified based on pathologically negative pelvic lymph nodes and solitary prostate nodules of 1.5 cm or less.…”

Section: Iodine 125 Retropubic Methodsmentioning

confidence: 99%

“…Similar conclusions have been reached by other authors who reviewed their results with iodine 125 and retrospectively compared them to patients treated with external-beam radiation therapy at their own institutions. 19,25,45 Some series have attempted to evaluate the success of therapy by obtaining postimplant biopsies to determine histologic sterilization. The relevance of these histologic findings to the eventual clinical outcome is controversial as well.…”

Section: Iodine 125 Retropubic Methodsmentioning

confidence: 99%

“…Kuban et al 25 have demonstrated that in patients with stage B2 and C poorly differentiated tumors, external-beam radiation therapy may be superior to implants with iodine 125. It is unknown whether this result was due to a true dose-rate effect related to cell-cycling issues; advanced disease beyond the effective range of iodine 125 implants; or, simply, poor geometry from the retropubic technique used.…”

Section: Iodine 125mentioning

confidence: 99%

See 2 more Smart Citations

Brachytherapy for prostate cancer

Porter

Blasko

Grimm³

et al. 1995

CA: A Cancer Journal for Clinicians

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Interstitial iodine-125 radiation without adjuvant therapy in the treatment of clinically localized prostate carcinoma

Ragde

Blasko

Grimm

et al. 1997

Cancer

245

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William Cavanagh, B.S. 3 Posttherapy evaluation included clinical, biochemical (PSA), and pathologic (repeat needle biopsy) studies. No patient was surgically staged, and none received andro-1 Pacific Northwest Cancer Foundation/Northgen deprivation therapy. Morbidity was graded according to the Radiation Therapy west Hospital, Seattle, Washington.Oncology Group grading scale. Statistical appraisal was performed by the Kaplan-2 Department of Urology, University of WashMeier method. PSA failure was defined in two ways: (1) PSA progression, i.e., 2 ington, Seattle, Washington.consecutive increases from a nadir value; and (2) failure to attain an arbitrary serum PSA value of 1.0 or 0.5 ng/mL at last follow-up. 3 Department of Radiation Oncology, University RESULTS. The overall 7-year survival was 77%; there were no deaths from prostate of Washington, Seattle, Washington.carcinoma in this cohort. The 7-year actuarial PSA progression free outcome was 4 Northwest Tumor Institute, Seattle, Washing-89%, and the PSA°1.0 ng/mL outcome was 87%. When PSA°0.5 ng/mL was ton.selected as an outcome end point, and PSA values in this series of radiation-treated 5 Pathology Associates Inc., Spokane, Washingpatients were compared with PSA values proposed to indicate disease free survival ton.after radical prostatectomy (PSA°0.3-°0.6 ng/mL), the 7-year actuarial disease free survival was 79%. Morbidity was minimal except in patients who had preimplant or postimplant transurethral prostate resection. CONCLUSIONS.Outpatient-based iodine-125 prostate brachytherapy for prostate carcinoma classified as T1 or T2 resulted in biochemical outcomes comparable to end points resulting from radical prostatectomy and external beam radiation.

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Effect of local tumor control on distant metastasis and survival in prostatic adenocarcinoma

Cited by 104 publications

References 18 publications

Radiation dose and late failures in prostate cancer

Radiation dose and late failures in prostate cancer

Brachytherapy for prostate cancer

Interstitial iodine-125 radiation without adjuvant therapy in the treatment of clinically localized prostate carcinoma

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