Dose Escalation with External-Beam Radiotherapy for Prostate Cancer

2000 ◽  
pp. 158-164
Author(s):  
H.W. Sandler
Keyword(s):  
Prostate Cancer ◽  
Dose Escalation ◽  
External Beam Radiotherapy ◽  
External Beam

Determinants of biochemical failure and distant metastases-free survival in high-risk prostate cancer patients treated with external beam radiotherapy.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 371-371
Author(s):  
Avinash Pilar ◽  
Andrew Bayley ◽  
Danny Shehata ◽  
Zhihui (Amy) Liu ◽  
Alejandro Berlin ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
High Risk ◽  
Dose Escalation ◽  
External Beam Radiotherapy ◽  
Distant Metastases ◽  
Biochemical Failure ◽  
External Beam ◽  
Free Survival ◽  
High Risk Prostate Cancer ◽  
Risk Prostate Cancer

371 Background: Objectives were to1) identify predictors of biochemical failure(BCF) -free survival (FFS) & distant metastases free-survival (DMFS) in high-risk prostate cancer (HRPC) patients treated with external beam radiotherapy (EBRT) with or without androgen deprivation therapy (ADT); 2) assess the impact of nodal irradiation & escalation of dose to the nodal volumes in HRPC. Methods: Between Feb 2000 & May 2011, 462 patients with HRPC were treated with EBRT +/- ADT. This spanned an era of technical development; prior to 2002 conventional dose radiotherapy was routinely delivered, between 2002-2008, dose escalation to the prostate & pelvic lymph nodes was undertaken in a phase II trial & subsequently all patients were treated with a dose-escalated protocol. The disease characteristics included, a median PSA of 20ng/ml (range: 1-563), T3-T4 in 33% (n=158), & Gleason grade group (GGG) 3-5 in 72% (n=331). The majority (n=405, 88%) received ADT with EBRT & median duration of ADT was 36 months (range: 0-197). Dose escalated EBRT was utilized in 52% (n=241) & nodal irradiation in 69% (n=317); escalation of dose to nodal volumes was performed in 20% (n=93). Results: The median follow-up was 8.7yrs (range: 0.9-18.9). Median nadir PSA was < 0.05ng/ml (range: <0.05-5.78) with median time to nadir (TTN) of 11 months (range: 2-130). Cumulative incidence rates of BCF at 5 and 10-yrs were 23% & 45%; corresponding rates for DM were 6.6% & 14%, respectively. The 5 & 10-yr FFS rates were 75% & 51%; corresponding DMFS rates were 91.5% & 80%, respectively. On multivariate analysis, T stage (p<0.001), GGG (p<0.001), ADT (p=0.002), dose escalation to prostate (P=0.012) & median nadir PSA (p<0.001) were independent predictors of FFS. The GGG (p=0.007), median nadir PSA (p=<0.001) & Nodal RT (p=0.03) were independent predictors of DMFS. PSA of 20 & TTN predicted neither FFS nor DMFS. Conclusions: Nadir PSA level was an independent predictor of FFS & DMFS. Undetectable PSA level was associated with prolonged FFS & DMFS. Dose escalation to prostate resulted in an improved FFS & Nodal irradiation in an improved DMFS. Further studies are required to identify subgroups that may benefit the most from nodal irradiation.

scholarly journals Anatomical Patterns of Recurrence Following Biochemical Relapse in the Dose Escalation Era of External Beam Radiotherapy for Prostate Cancer

2015 ◽  
Vol 194 (6) ◽  
pp. 1624-1630 ◽  
Author(s):  
Zachary S. Zumsteg ◽  
Daniel E. Spratt ◽  
Paul B. Romesser ◽  
Xin Pei ◽  
Zhigang Zhang ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Dose Escalation ◽  
External Beam Radiotherapy ◽  
External Beam ◽  
Biochemical Relapse ◽  
Patterns Of Recurrence
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