Biochemical response after 3-d conformal radiotherapy of localized prostate cancer to a total dose of 66 gy 4-year results
| Autor: | Natascha, Wachter-Gerstner, Stefan, Wachter, Gregor, Goldner, Elisabeth, Nechvile, Richard, Pötter |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Male
Antineoplastic Agents Hormonal Prostatic Neoplasms Androgen Antagonists Radiotherapy Dosage Adenocarcinoma Middle Aged Prostate-Specific Antigen Combined Modality Therapy Neoadjuvant Therapy Radiotherapy Computer-Assisted Imaging Three-Dimensional Biomarkers Tumor Humans Radiotherapy Conformal Aged Follow-Up Studies Neoplasm Staging |
| Zdroj: | Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]. 178(10) |
| ISSN: | 0179-7158 |
| Popis: | Since the introduction of 3-D conformal radiotherapy (CRT) doses of/= 70 Gy have been used in many European countries. In this analysis, the impact of a short-term neoadjuvant hormonal treatment in combination with CRT to a moderate dose level of 66 Gy was examined.From January 1994 to February 1999 397 patients were treated for carcinoma of the prostate. In 279 patients a definitive curative treatment (T1 = 38, T2 = 165, T3 = 50, Tx = 11) with or without androgen deprivation was performed. 164 patients with radiotherapy of the prostate +/- seminal vesicles to a total dose of 66 Gy (n = 109) alone or in combination with a short-term hormonal treatment (n = 55) were included in this analysis. Biochemical relapse was defined as three rising PSA values or reintroduction of hormonal treatment. A low-risk subgroup was defined for patients with maximum serum PSA level/= 10 and cT/=2 and G/=2, all other patients were summarized as high-risk patients.The median follow-up of alive patients was 40 months (12-72 months). There was a total of 29/164 deaths, two were cause-specific and 27 were considered unrelated to prostate cancer. The 4-year rates of no biochemical evidence of disease for all patients was 58%. For the high-risk group the 4-year rates could be improved with borderline significance from 35% to 66% (p = 0.057) by additional neoadjuvant hormonal treatment. In contrast for the low-risk group no significant improvement was observed: 73% and 82%, respectively (p = 0.5).Especially in high-risk patients doses/= 70 Gy for radiotherapy alone seem not to be sufficient for curative treatment. Additional hormonal treatment and doses/= 70 Gy should be considered. As a consequence of our earlier analysis a prospective multicenter treatment optimization protocol has been initiated in 1999. The protocol includes a risk-adapted dose increase from 70 Gy in low-risk patients to 74 Gy in high-risk patients including short-term androgen ablation. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink