The treatment of prostate cancer by conventional radiation therapy: An analysis of long-term outcome

Zietman, Anthony L.; Coen, John J.; Dallow, K.C.; Shipley, William U.

doi:10.1016/0360-3016(95)00123-g

Cited by 150 publications

(45 citation statements)

References 16 publications

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“…In a large study, Zietman et al [32] prescribed a tumor dose of 68.4 Gy, and found a biochemical control of < 40% after 5 years declining to < 20% after 10 years. Additional hormonal treatment was suggested for these cases (see [10] for a survey).…”

Section: Discussionmentioning

confidence: 99%

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Regional Hyperthermia in Conjunction with Definitive Radiotherapy against Recurrent or Locally Advanced Prostate Cancer T3 pN0 M0

et al. 2005

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Section: Discussionmentioning

confidence: 99%

“…On average, in 60% PSA progression occurs after 5 years and in 80% after 10 years [32]. Innovative strategies include dose escalation by intensity modulation, additive interstitial radiotherapy, and/or cytoreduction by hormonal manipulation, either neoadjuvant and/or adjuvant, for several years.…”

Section: Introductionmentioning

confidence: 99%

Regional Hyperthermia in Conjunction with Definitive Radiotherapy against Recurrent or Locally Advanced Prostate Cancer T3 pN0 M0

et al. 2005

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“…15 However, an increase of the radiation dose to the tumour implies an increase of the dose to the surrounding normal tissue, which results in elevated incidence of severe late GU and GI complications (such as radiocystitis, radiation colitis and, especially, proctitis). 4,5 In recent years, increasing attention has been paid to the use of combination therapy for advanced cancer. Currently, a few novel, minimally invasive techniques have been applied in the treatment of solid tumours, and the focus is on whether these minimally invasive therapies can replace or modify the traditional radiotherapy procedure to involve a safe, reduced radiation dose.…”

Section: Discussionmentioning

confidence: 99%

“…This off-target radiation often induces severe late gastrointestinal (GI) and genitourinary (GU) complications that affect the patient's quality of life. 4,5 Low-dose radiation therapy involves decreased radiationrelated toxicity, which also impairs its therapeutic effect. Utilizing new minimally invasive therapies to replace or modify the traditional radiotherapy procedure is a feasible approach to reduce the dose of radiation.…”

Section: Introductionmentioning

confidence: 99%

The feasibility and safety of high-intensity focused ultrasound combined with low-dose external beam radiotherapy as supplemental therapy for advanced prostate cancer following hormonal therapy

Wu¹,

Wang²,

Xu³

et al. 2011

Asian J Androl

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The aim of this study was to investigate the feasibility and safety of high-intensity focused ultrasound (HIFU) combined with (1) low-dose external beam radiotherapy (LRT) as supplemental therapy for advanced prostate cancer (PCa) following hormonal therapy (HT). Our definition of HIFU1LRT refers to treating primary tumour lesions with HIFU in place of reduced field boost irradiation to the prostate, while retaining four-field box irradiation to the pelvis in conventional-dose external beam radiotherapy (CRT). We performed a prospective, controlled and non-randomized study on 120 patients with advanced PCa after HT who received HIFU, CRT, HIFU1LRT and HT alone, respectively. CT/MR imaging showed the primary tumours and pelvic lymph node metastases visibly shrank or even disappeared after HIFU1LRT treatment. There were significant differences among four groups with regard to overall survival (OS) and disease-specific survival (DSS) curves (P50.018 and 0.015). Further comparison between each pair of groups suggested that the long-term DSS of the HIFU1LRT group was higher than those of the other three groups, but there was no significant difference between the HIFU1LRT group and the CRT group. Multivariable Cox's proportional hazard model showed that both HIFU1LRT and CRT were independently associated with DSS (P50.001 and 0.035) and had protective effects with regard to the risk of death. Compared with CRT, HIFU1LRT significantly decreased incidences of radiation-related late gastrointestinal (GI) and genitourinary (GU) toxicity grade oII. In conclusion, long-term survival of patients with advanced PCa benefited from strengthening local control of primary tumour and regional lymph node metastases after HT. As an alternative to CRT, HIFU1LRT showed good efficacy and better safety.

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“…However, disease recurrence after radical treatment is common. Long term follow up studies have shown actuarial PSA failure rates of 29% for T1 tumours, 46% for T2a, and as high as 80% for T2b/c, T3 or T4 cancers (Hancock et al, 1995;Zietman et al, 1995).…”

mentioning

confidence: 99%

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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The treatment of prostate cancer by conventional radiation therapy: An analysis of long-term outcome

Cited by 150 publications

References 16 publications

Regional Hyperthermia in Conjunction with Definitive Radiotherapy against Recurrent or Locally Advanced Prostate Cancer T3 pN0 M0

Regional Hyperthermia in Conjunction with Definitive Radiotherapy against Recurrent or Locally Advanced Prostate Cancer T3 pN0 M0

The feasibility and safety of high-intensity focused ultrasound combined with low-dose external beam radiotherapy as supplemental therapy for advanced prostate cancer following hormonal therapy

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

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