The effect of overall treatment time on local control in patients with adenocarcinoma of the prostate treated with radiation therapy

Amdur, Robert J.; Parsons, James T.; Fitzgerald, Lawrence T.; Million, Rodney R.

doi:10.1016/0360-3016(90)90347-m

Cited by 70 publications

(15 citation statements)

References 17 publications

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“…However, the results from the University of Florida demonstrated that when the overall treatment time was >8 weeks, local failure increased (9). This group of patients, treated between 1964 and 1982, had received a dose range of 65-70 Gy, and 45% were diagnosed by transurethral resection of the prostate (TURP).…”

Section: Introductionmentioning

confidence: 99%

Does Treatment Duration Affect Outcome After Radiotherapy for Prostate Cancer?

D’Ambrosio

Horwitz

et al. 2008

International Journal of Radiation Oncology*Biology*Physics

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Purpose-The protraction of external beam radiotherapy (RT) time is detrimental in several disease sites. In prostate cancer, the overall treatment time can be considerable, as can the potential for treatment breaks. We evaluated the effect of elapsed treatment time on outcome after RT for prostate cancer.Methods and Materials-Between April 1989 and November 2004, 1,796 men with prostate cancer were treated with RT alone. The nontreatment day ratio (NTDR) was defined as the number of nontreatment days divided by the total elapsed days of RT. This ratio was used to account for the relationship between treatment duration and total RT dose. Men were stratified into low risk (n = 789), intermediate risk (n = 798), and high risk (n = 209) using a single-factor model. Results-The 10-year freedom from biochemical failure (FFBF) rate was 68% for a NTDR <33% vs. 58% for NTDR ≥33% (p = 0.02; BF was defined as a prostate-specific antigen nadir + 2 ng/mL). In the low-risk group, the 10-year FFBF rate was 82% for NTDR <33% vs. 57% for NTDR ≥33% (p = 0.0019). The NTDR was independently predictive for FFBF (p = 0.03), in addition to T stage (p = 0.005) and initial prostate-specific antigen level (p < 0.0001) on multivariate analysis, including Gleason score and radiation dose. The NTDR was not a significant predictor of FFBF when examined in the intermediate-risk group, high-risk group, or all risk groups combined.Conclusions-A proportionally longer treatment duration was identified as an adverse factor in low-risk patients. Treatment breaks resulting in a NTDR of ≥33% (e.g., four or more breaks during a 40-fraction treatment, 5 d/wk) should be avoided.

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Section: Introductionmentioning

confidence: 99%

Does Treatment Duration Affect Outcome After Radiotherapy for Prostate Cancer?

D’Ambrosio

Horwitz

et al. 2008

International Journal of Radiation Oncology*Biology*Physics

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“…Nevertheless, the conclusions drawn by the Consensus Conference of the National Institutes of Health (1988) remain valid [14]. These concluded that external radiotherapy offers identical results in terms of long-term survival rates to surgery, offering an at least equal quality of life and an obviously different range of secondary effects [15].…”

Section: Discussionmentioning

confidence: 98%

Radiotherapy in rectal cancer: development, adequacy and radiotherapy utilisation rate. A comparative analysis with the most frequent tumour sites

et al. 2011

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The "radiotherapy utilisation rate" for rectal cancer was equivalent to the estimated optimum rate as defined on the basis of reference groups. The therapy utilised developed chronologically in parallel with the available scientific evidence. The radiotherapy utilisation rates for breast and prostate cancer gradually increased, with a tendency to reach optimal rates. Radiotherapy as a treatment for lung cancer was underutilised. In global terms, the rate of utilisation of radiation therapy was low, although it displayed a tendency to increase.

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“…In a study (n~211) from the University of Florida, Amdur et al (1990) reached the conclusion that prolonged overall treatment time reduced the local control rate. The dose aim was 65 Gy for stage B1 patients and 65-70 Gy for patients with stage B2-C disease.…”

Section: Evidence For Repopulation In Prostate Tumoursmentioning

confidence: 97%

Dual radiobiological interpretations of retrospective clinical data: the time factor

D’Souza

Kuban

2003

International Journal of Radiation Biology

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Dual interpretations are different radiobiological mechanisms that explain theoretically the same observed results. Radiobiological interpretations of the time factor are most frequently based on changes in total dose that produce a given effect. If this dose is increased by different mechanisms (e.g. increasing overall time and decreasing dose per fraction) at the same time, proposals for altered fractionation schemes based on the choice of one or the other mechanism, in principle, can lead to erroneous predictions of outcome. This is especially the case when the analyses are based on retrospective clinical data, where the influence of patient selection is unknown. Examples of dual interpretations taken from the literature on head and neck, melanoma and prostate cancer are discussed.

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The effect of overall treatment time on local control in patients with adenocarcinoma of the prostate treated with radiation therapy

Cited by 70 publications

References 17 publications

Does Treatment Duration Affect Outcome After Radiotherapy for Prostate Cancer?

Does Treatment Duration Affect Outcome After Radiotherapy for Prostate Cancer?

Radiotherapy in rectal cancer: development, adequacy and radiotherapy utilisation rate. A comparative analysis with the most frequent tumour sites

Dual radiobiological interpretations of retrospective clinical data: the time factor

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