Is there a subset of patients with PSA ? 20 ng/ml who do well after conformal beam radiotherapy?

Autor: Özer Algan, Tahseen Al-Saleem, Gerald E. Hanks, H D O Wayne Pinover, Alexandra L. Hanlon
Rok vydání: 1999
Předmět:
Zdroj: Radiation Oncology Investigations. 7:106-110
ISSN: 1520-6823
1065-7541
DOI: 10.1002/(sici)1520-6823(1999)7:2<106::aid-roi6>3.0.co;2-j
Popis: To determine if there is a subgroup of patients with pretreatment PSA > or = 20 ng/ml with a favorable outcome after external beam radiation therapy. We analyzed retrospectively treatment outcomes of 129 patients with pretreatment PSA > or = 20 ng/ml treated in our department from 2/88-8/94. Median patient age was 70 years (range 51-89 years). Tumor stage was T1/T2ab in 68, T2c/T3 in 61 patients. Initial Gleason grade was or = 7 in 47 patients. Median PSA was 35 ng/ml (mean 45 ng/ml, range 20-191 ng/ml). Ninety-seven patients received four-field conformal external beam radiation therapy. No patient received surgery or hormonal therapy prior to treatment. Median central axis dose was 73 Gy (range 68-79 Gy). Covariates considered in univariate and multivariate analyses included central axis dose, pretreatment PSA, presence of perineural invasion, Gleason score, palpable tumor stage and patient age. bNED failure was defined as a PSA > or = 1.5 and rising on two consecutive determinations. Median follow up was 50 months (range 3-100 months). Overall bNED control for the entire patient population was 22% at five years. Of the covariates analyzed, dose (P 73 Gy to the central axis. Patients in Group II had at least one of the above poor prognostic features or were treated to central axis doses or = 20 ng/ml where treating to doses over 73 Gy to the central axis is warranted (four-year bNED rate of 58%). However, because of the small patient numbers, these results will need to be validated with longer follow up.
Databáze: OpenAIRE
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