External beam irradiation of prostate cancer. Conformal treatment techniques and outcomes for the 1990

✍ Scribed by Gerald E. Hanks; Benjamin W. Corn; W. Robert Lee; Margie Hunt; Alexandra Hanlon; Timothy E. Schultheiss

• Publisher: John Wiley and Sons
• Year: 1995
• Tongue: English
• Weight: 472 KB
• Volume: 75
• Category: Article
• ISSN: 0008-543X
• DOI: 10.1002/1097-0142(19950401)75:7+<1972::aid-cncr2820751636>3.0.co;2-p

✦ Synopsis

Background. This paper presents the results of external beam treatment of prostate cancer. Long term results are represented by the US. national averages from the Patterns of Care study. The modern innovations of threedimensional-assisted conformal treatment are also shown to demonstrate the technologic progress in external beam treatment, the effect of pretreatment prostate specific antigen (PSA), the inaccuracy of clinical end points used for 30 years, and the new early outcome standards for the 1990s.

Methods. The Patterns of Care study has surveyed the national practice for processes of care and outcome of care in the United States. Ten-and '15-year outcomes are reported for patients treated in 1973 and 1978 by external beam irradiation.

The conformal radiation therapy program developed at Fox Chase Cancer Center since 1989 is used to illustrate the advantage of this technology, the importance of pretreatment PSA level on outcome, the inaccuracies in clinical end point evaluation, and the reduction in morbidity associated with conformal treatment. Three hundred seventy-three consecutive patients treated with conformal therapy were compared with 129 consecutive conventionally treated patients for survival end points. The outcome of 460 consecutive patients with pretreatment PSA are presented by pretreatment PSA level. Late morbidity is presented for 208 consecutive conformal treated patients who received 68-71 Gy to the center of the prostate. Cancer control is defined as biochemical control of