812: Long-Term Survival in Men with High Grade Prostate Cancer: A Comparison Between Conservative Treatment, Radiation Therapy and Radical Prostatectomy: A Propensity Scoring Approach
Year: 2004
Type: conference-abstract
Abstract: median photon dose equivalent of 7800 cGy.A patient was considered to have biochemical failure if his PSA level post-nadir was measured at > 0.2 ng/ml.Complications were graded according to the RTOG toxicity scale.The median follow-up time was 49 months (range: 1-137 months.)RESULTS: Sixty four patients (38%) had evidence of biochemical failure.The 7 year overall survival was 84%.At 7 years, the actuarial biochemical relapse free survival (bRFS) was 44%.Of the 59 patients with a pre-radiation PSA < I ng/ml, the 5 year bRFS was 81 %.This compares with 45% for both the PSA 1-4 and > 4 ng/ml groups (p = 0.00008).The 3 year bRFS rates for patients whose PSA levels increased, decreased, and remained the same during radiation were 20%, 65%, and 76%, respectively (p=0.0005).Overall survival at 7 years in the decreased PSA group was 88% compared to 67% for those whose PSA level increased (p=0.43).Thirty three percent and 19% of the patients experienced grade 2 genitourinary (GU) and gastrointestinal (GI) complications, respectively.Six percent and 3% of the patients had grade 3 GU and GI complications, respectively.On univariate and multivariate analysis, the factors significantly associated with a favorable outcome were a declining PSA during RT and a pre-RT PSA < 1 ng/ml (p<0.001).CONCLUSIONS: Radiation therapy is an effective treatment modality for select patients with a biochemical recurrence following radical prostatectomy.Patients with a low pre-radiation PSA level ( < 1.0 ng/ml) had a significantly better outcome, which supports the early use of therapeutic radiation.The observation that patients with a rising PSA level during treatment do poorly supports the routine practice of monitoring these levels during radiotherapy.
Source: The Journal of Urology
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4205596617