Predictors of improved outcome for patients with localized prostate cancer treated with neoadjuvant androgen ablation therapy and three-dimensional conformal radiotherapy.

Zeléfsky, Michael J.; Lyass, Olga; Fuks, Zvi; Wolfe, Theresa; Burman, Chandra; Ling, C. Clifton; Leibel, Steven A.

doi:10.1200/jco.1998.16.10.3380

Cited by 75 publications

(47 citation statements)

References 15 publications

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“…While the pre-radiotherapy PSA correlates significantly with outcome in terms of freedom from PSA failure on univariate analysis (Table 2), it also correlates with presenting PSA, and is no longer statistically significant on multivariate analysis. The discrepancy between our findings and those of Zelefsky et al (1998) could reflect differences in the study populations, or the relative insensitivity of the PSA assay used in the early part of our series.…”

Section: Clinicalcontrasting

confidence: 93%

“…This is somewhat analagous to the clinical findings of Zelefsky et al (1998), who in their study of 213 men with clinically localised prostate cancer, found that a pre-radiation PSA of 50.5 ng ml 71 following neoadjuvant androgen deprivation was an independent favourable prognostic factor. We attempted to address this issue by testing the PSA measured immediately pre-radiotherapy as a possible predictive factor for biochemical control.…”

Section: Clinicalmentioning

confidence: 59%

“…These studies include a combined total of just over 400 men treated with NAD and radical radiotherapy. There are few other series of men treated in this way, the largest being a report on 213 patients from Memorial SloanKettering (Zelefsky et al, 1998).…”

mentioning

confidence: 99%

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Pre-treatment nomogram for biochemical control after neoadjuvant androgen deprivation and radical radiotherapy for clinically localised prostate cancer

et al. 2002

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Phase III studies have demonstrated the clinical benefit of adding neo-adjuvant androgen deprivation to radical radiotherapy for clinically localised prostate cancer. We have developed a nomogram to describe the probability of PSA control for patients treated in this way. Five hundred and seventeen men with clinically localised prostate cancer were treated with 3 -6 months of neo-adjuvant androgen deprivation and radical radiotherapy (64 Gy in 32#) between 1988 and 1998. Median presenting PSA was 20 ng ml 71 , and 56% of patients had T3/4 disease. Multivariate analysis of pre-treatment factors was performed, and a nomogram developed to describe PSA-failure-free survival probability. At a median follow-up of 44 months, 233 men had developed PSA failure. Presenting PSA, histological grade and clinical T stage were all highly predictive of PSA failure on multivariate analysis. The nomogram score for an individual patient is given by the summation of PSA (510=0, 10 -19=16, 20 -49=44, 550=100), grade (Gleason 2 -4=0, 5 -7=44, 8 -10=81) and T stage (T1/2=0, T3/4=35). For a nomogram score of 0, 50, 100 and 150 points the 2 year PSA control rate was 93, 87, 75 and 54%, and the 5 year PSA control rate was 82, 67, 44 and 18%. These results are comparable to those using surgery or higher doses of radical radiotherapy alone. The nomogram illustrates the results of multivariate analysis in a visually-striking way, and facilitates comparisons with other treatment methods.

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Section: Clinicalcontrasting

confidence: 93%

Section: Clinicalmentioning

confidence: 59%

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Pre-treatment nomogram for biochemical control after neoadjuvant androgen deprivation and radical radiotherapy for clinically localised prostate cancer

et al. 2002

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“…13 While this study was not designed to evaluate the effect of neoadjuvant hormonal therapy, 29% of patients had received this treatment to produce downsizing, with up to 81 Gy of radiation delivered to the bladder, rectum, seminal vesicles and prostate. This study demonstrated that 4 y survival depended on the number of favourable classical prognostic factors, including PSA, staging and Gleason score (Table 5), while the response was found to be better if 75.6 Gy or above was used.…”

Section: Review Of the Literature: Radiation With Or Without Neoadjuvmentioning

confidence: 99%

Is there a place for neoadjuvant hormonal therapy before radical prostatectomy or radiation therapy in the management of prostate cancer?

Teillac

1999

Prostate Cancer Prostatic Dis

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“…52 ,.1, 6 2 One refinement, for example, is the toticbiomarkers, changes in degree or new occurrence of concept that any changes in SEB must actually meet the PIN, cell/nuclear morphometry, chromosomal changes, requirement of "predicting" the likelihood of the actual and QOL parameters. Any modulations noted in SEB endpoint rather than merely "correlating with" it.…”

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confidence: 99%

Prevention of Post-Radiotherapy Failure in Prostate Cancer by Vitamin D

Vijayakumar¹

2003

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Public reporting burden for this collection of information is estimated to average I hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing this collection of information. Send comments regarding this burden estimate or any other aspect of this collection of Information, Including suggestions for reducing this burden to Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, A UTHOR(S)Srinivasan Vijayakumar, Ph.D. PERFORMING ORGANIZA TION NAME(S) AND ADDRESS(ES) 8. PERFORMING ORGANIZA TIONThe University of California REPORT NUMBER Davis, California 95616-8670vijay@ucdavis .edu SPONSORING / MONITORING 10. SPONSORING / MONITORING AGENCY NAME(S) AND ADDRESS(ES) AGENCY REPORT NUMBER U.S. Army Medical Research and Materiel CommandFort Detrick, Maryland 21702-5012 SUPPLEMENTARY NOTES 12a. DISTRIBUTION/A VAILABILITY STATEMENT 12b. DISTRIBUTION CODEApproved for Public Release; Distribution Unlimited ABSTRACT (Maximum 200 Words)Prostate cancer patients receive either surgery or radiation therapy as treatment for cancer. Among patients receiving radiation therapy, nearly 50% have an elevation of PSA within five years of treatment. These patients then receive hormone treatment. In this study, we wish to test the theory that chemopreventive agents, which show the ability to prevent or delay the growth of prostate cancer cells in the laboratory, may also prevent or delay the reappearance of prostate cancer in patients who have undergone radiation to treat their prostate cancer. We propose to have prostate cancer patients who have already undergone radiation treatment take a non-toxic chemopreventive agent [a synthetic form of vitamin D, I la-hydroxyvitamin D5] for two years and see if their reoccurrence rate can be decreased. Unlike regular vitamin D, D5 does not make calcium in the bloodstream reach levels that cause serious side effects. Forty patients will participate. They will be randomized to D5 or placebo arms. A biopsy will be done at the end of the study and the tissue will be analyzed for any benefit of D5 in decreasing the recurrence of prostate cancer and also for any differences between the groups in terms of expressed intermediate molecular biomarkers. INTRODUCTIONWe plan to conduct a phase I/I safety/chemoprevention study to determine whether taking a non-toxic Vitamin D analog, 1 a(OH)D5 (D5), can safely delay prostate cancer recurrence when administered after radiation therapy (RT). The newly synthesized analog 1 a(OH)D5 (1 aHydroxy-24-ethyl-cholecalciferol) has shown anti-tumor activity at non-hypercalcemic concentrations in animals. Based on our preliminary research, we believe D5 can be given in effective doses without causing harmful side effects. Forty randomized patients will receive either D5 or placebo, 12-60 months after completion of RT (20 ...

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Predictors of improved outcome for patients with localized prostate cancer treated with neoadjuvant androgen ablation therapy and three-dimensional conformal radiotherapy.

Cited by 75 publications

References 15 publications

Pre-treatment nomogram for biochemical control after neoadjuvant androgen deprivation and radical radiotherapy for clinically localised prostate cancer

Pre-treatment nomogram for biochemical control after neoadjuvant androgen deprivation and radical radiotherapy for clinically localised prostate cancer

Is there a place for neoadjuvant hormonal therapy before radical prostatectomy or radiation therapy in the management of prostate cancer?

Prevention of Post-Radiotherapy Failure in Prostate Cancer by Vitamin D

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