Radiation Therapy for Clinically Localized Prostate Cancer

摘要: ContextProstate-specific antigen (PSA) evaluation leads to the early detection of both prostate cancer and recurrences following primary treatment. Prostate-specific outcome information on patients 5 or more years following treatment is limited available mainly as single-institution reports.ObjectivesTo assess the likelihood durability tumor control using PSA after radical external beam radiation therapy to identify pretreatment prognostic factors in men with treated since 1988, era.Design SettingRetrospective, nonrandomized, multi-institutional pooled analysis patients alone between 1988 1995 at 6 US medical centers. Follow-up lasted up a maximum 9 years. Outcome data were analyzed Cox regression recursive partitioning techniques.PatientsA total 1765 stage T1b, T1c, T2 tumors treated external beam radiation. The majority (58%) were older than 70 24.2% had initial values 20 ng/mL higher. A minimum 2 of subsequent follow-up was required for participation.Main MeasureActuarial estimates freedom from biochemical failure.ResultsThe 5-year overall survival, disease-specific survival, from biochemical failure are 85.0% (95% confidence interval [CI], 82.5%-87.6%), 95.1% (95% CI, 94.0%-96.2%), 65.8% CI, 62.8%-68.0%), respectively. The PSA failure-free rates 7 patients presenting less 10 77.8% CI, 74.5%-81.3%), 72.9% 67.9%-78.2%). Recursive partitioning initial level, palpation stage, the Gleason score groupings yielded 4 separate groups: group 1, included level 9.2 ng/mL; 2, PSA level least but 19.7 3, at least Gleason 6; 4, level of 10. The estimated rates survival free 81% for group 1, 69% 47% 29% 4. Of the 302 followed beyond who of biochemical disease, 5.0% relapsed fifth eighth year.ConclusionsEstimated control in this analysis are similar those single institutions. These indicate the probability success subsets tumors several prognostic category groupings. results represent a multi-institutional benchmark evidence-based counseling prostate cancer about