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ORIGINAL ARTICLE
Year : 2014  |  Volume : 10  |  Issue : 4  |  Page : 951-956

Radiation therapy for clinically localized prostate cancer: Long-term results of 469 patients from a single institution in the era of dose escalation


1 Department of Veterans Affairs, New York Harbor Healthcare System ; Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, NY, USA
2 Department of Veterans Affairs, New York Harbor Healthcare System, NY, USA
3 UF Orlando Health, Orlando, Florida, USA

Correspondence Address:
David Schwartz
800, Poly Place, Suite 114A, Brooklyn, NY 11209
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-1482.138096

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Aims: The aim of the following study is to analyze the long-term results of veterans treated with dose escalated radiation therapy for prostate cancer. Materials and Methods: This retrospective study analyzed 469 patients who were treated between 2003 and 2010 with dose escalated radiation therapy to a minimum dose of 7560 cGy for prostate cancer at the New York Harbor Department of Veterans Affairs. Biochemical failure-free survival (bFFS) and distant metastatic-free survival (DMFS) were compared using the Kaplan-Meier method. Univariate and multivariate Cox Regression were used to measure the impact of covariates on biochemical control. Results: The median follow-up was 61 months and 95.3% of patients were followed at least 2 years. The 5-year bFFS for National Cancer Care Network low, intermediate and high risk disease were 90.3%, 86.9% and 77.3% respectively (P = 0.001). Patients with high risk disease were more likely to develop metastatic disease. The 5-year DMFS was 99.1% for low risk, 98.8% for intermediate risk and 94.5% for high-risk (P < 0.001). There were 8 prostate cancer related deaths, of which 6 had high risk disease and 2 had intermediate risk disease. The 5-year prostate cancer specific survival was 98.4%. Toxicities were generally mild, however there were two genitourinary toxicity related deaths, though in both patients there were confounding medical issues that may have contributed to their deaths. Conclusions: Dose escalated radiation in the treatment of United States Veterans appears to be well-tolerated with results in line with prior reports. Further follow-up is necessary to identify any additional late toxicities as well as to assess the durability of their biochemical control beyond 5 years.

Abstract in Chinese

对临床局限性前列腺癌的放射治疗:在剂量递增的时代一个机构的469例患者治疗的长期结果 摘要 目的:以下研究的目的是分析治疗剂量升级的退伍军人前列腺癌放射治疗的长期结果。 材料和方法:回顾性分析在纽约港退伍军人事务部从2003年到2010年之间的469例前列腺癌患者,接受治疗剂量升级的放疗,最小剂量为7560 cGy。无生物化学失败生存率(BFFS)和无远处转移生存率(DMFS)是用Kaplan-Meier法比较。单变量和多变量Cox回归模型被用来测量的生物化学控制变量的影响。 结果:中位随访61个月,95.3%患者随访至少2年。以国家癌症关怀网低、中、高风险疾病为标准的5年无化学生物失败生存率分别为90.3%、86.9%和77.3%(P = 0.001)。伴随高风险疾病的患者更容易发生转移性疾病。5年无远处转移生存率,低、中、高风险组分别为99.1%、98.8%和94.5%(P<0.001)。有8例前列腺癌相关的死亡,其中6例高风险疾病,2例中度风险疾病。5年的前列腺癌特异性生存率为98.4%。不良反应一般轻微,但有两例泌尿生殖毒性相关的死亡,但均可能由医疗问题导致他们的死亡。 结论:剂量升级的辐射在美国退伍军人的治疗具有良好的耐受性,与先前报道的结果一致。进一步随访是必要的,且最好超过5年,以确定任何额外的晚期毒性以及评估他们的生物化学控制的耐受性。 关键词:剂量升级,前列腺癌,放疗



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