This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Valicenti, R. Articles by Grignon, D. Search for Related Content PubMed PubMed Citation Articles by Valicenti, R. Articles by Grignon, D. Social Bookmarking                            What's this?

Survival Advantage From Higher-Dose Radiation Therapy for Clinically Localized Prostate Cancer Treated on the Radiation Therapy Oncology Group Trials

From the Kimmel Cancer Center, Thomas Jefferson University; Radiation Therapy Oncology Group Statistical Headquarters; and Department of Radiation Oncology, Albert Einstein Medical Center, Philadelphia PA; Department of Radiation Oncology, McAuley Health Center, Ann Arbor; and Wayne State University, Detroit, MI.

Address reprint requests to Richard Valicenti, MD, Bodine Center for Cancer Treatment, Thomas Jefferson University Hospital, 111 S 11th St, Philadelphia, PA 19107-5097; email richard.valicenti{at}mail.tju.edu

PURPOSE: We evaluated the effect of external-beam radiation therapy on disease-specific survival (death from causes related to prostate cancer) and overall survival in men with clinically localized prostate cancer.

METHODS: From 1975 to 1992, 1,465 men with clinically localized prostate cancer received radiation therapy on four Radiation Therapy Oncology Group phase III randomized trials and were pooled for this analysis. No one received androgen-deprivation therapy with his initial treatment. All original histology had central pathologic review for grading using the Gleason classification system. Total delivered radiation dose ranged from 60 to 78 Gy (median, 68.4 Gy). The median follow-up time was 8 years.

RESULTS: A Cox regression model revealed that Gleason score was an independent predictor of disease-specific survival and overall survival. The 10-year disease-specific survival rates by Gleason score were as follows: score of 2 through 5, 85%; score of 6, 79%; score of 7, 62%; and score of 8 through 10, 43%. Stratifying outcome by this important prognostic factor revealed that higher radiation dose was a significant predictor for improved disease-specific survival and overall survival only for those patients whose cancers had Gleason scores of 8 through 10 (P < .05). After adjusting for clinical T stage, nodal status, and age, treating with a higher radiation dose was associated with a 29% lower relative risk of death from prostate cancer and 27% reduced mortality rate (P < .05).

CONCLUSION: These data demonstrate that higher-dose radiation therapy can significantly reduce the risk of dying from prostate cancer in men with clinically localized disease. This survival benefit is restricted to men with poorly differentiated cancers.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				C. M.C. DEICHMUELLER, G. WEGENER, J. H. KARSTENS, and F. BRUNS Definitive Conformal Radiotherapy for Localized Prostate Cancer: A Long-term Follow-up Study Anticancer Res, July 1, 2009; 29(7): 2627 - 2634. [Abstract] [Full Text] [PDF]

				P. Pommier, S. Chabaud, J. L. Lagrange, P. Richaud, F. Lesaunier, E. Le Prise, J. P. Wagner, M. H. Hay, V. Beckendorf, J. P. Suchaud, et al. Is There a Role for Pelvic Irradiation in Localized Prostate Adenocarcinoma? Preliminary Results of GETUG-01 J. Clin. Oncol., December 1, 2007; 25(34): 5366 - 5373. [Abstract] [Full Text] [PDF]

				T. M. Pisansky External-beam radiotherapy for localized prostate cancer. N. Engl. J. Med., October 12, 2006; 355(15): 1583 - 1591. [Full Text] [PDF]

				K. Hashine, K. Numata, K. Azuma, Y. Sumiyoshi, and M. Kataoka Long-term Outcomes of 60 Gy Conventional Radiotherapy Combined with Androgen Deprivation for Localized or Locally Advanced Prostate Cancer Jpn. J. Clin. Oncol., November 1, 2005; 35(11): 655 - 659. [Abstract] [Full Text] [PDF]

				T. M. Pisansky External Beam Radiotherapy as Curative Treatment of Prostate Cancer Mayo Clin. Proc., July 1, 2005; 80(7): 883 - 898. [Abstract] [PDF]

				H. Elsaleh, D. Joseph, and S. Bydder Radiation Dose Escalation for Prostate Cancer J. Clin. Oncol., December 1, 2000; 18(23): 4003 - 4003. [Full Text] [PDF]