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High dose 3DC radiation improves 5-yr cure rate for suitable prostate cancer candidates - Fox-ChaseMarch 1, 2000. Most prostate cancer patients who opt to receive external beam radiation will have a higher cure rate if they are treated with higher doses of radiation, a new study shows. The study was published today in the International Journal of Radiation Oncology, Biology and Physics.
The study, conducted at Fox Chase Cancer Center in Philadelphia, PA, of 618 patients found that five year cure rates were improved by 14 - 40 percent depending on the patients' disease extent when the patients were treated with higher doses. These high doses result in the cure of more than 80 percent of all patients with pre-treatment PSA levels of 20 or less.
Higher doses are possible because of three-dimensional conformal radiation therapy (3D-CRT), a technique that allows the radiation oncologist to "conform" the radiation to the tumor, thus avoiding some organs and tissues nearby, says Gerald E. Hanks, M.D., Chairman, Department of Radiation Oncology at Fox Chase Cancer Center. "Morbidity is very low if 3D-CRT is done," he says.
Yet, in 1998 (the latest year figures are available) only 40 percent of radiation oncology facilities were doing 3D-CRT. The American Society for Therapeutic Radiology and Oncology (ASTRO) is planning a series of educational programs designed to teach radiation oncologists nationwide how to appropriately utilize 3D-CRT. "We have the potential to cure more patients; it is essential that we take advantage of that potential," says Dr. Hanks.
Breakdown of Results Based on PSA Level
Favorable patients are those with T1 or T2a disease, Gleason score of 6 or less and no perineal invasion. Unfavorable patients are those with T2 or greater disease, Gleason score of 7 - 10 and/or perineal invasion. Patients with a PSA less than 10 Favorable patients treated at 73 Gy - 89 percent are cancer free at five years Favorable patients treated at 70 Gy - 77 percent are cancer free at five years Unfavorable patients treated at 78 Gy - 92 percent are cancer free at five years Unfavorable patients treated at 73 Gy - 70 percent are cancer free at five years Patients with a PSA between 10 - 20 Favorable patients treated with 77 Gy - 86 percent are cancer free at five years Favorable patients treated with 73 Gy - 72 percent are cancer free at five years Unfavorable patients treated with 77 Gy - 82 percent are cancer free at five years Unfavorable patients treated with 73 Gy - 51 percent are cancer free at five years.
The International Journal of Radiation Oncology, Biology and Physics is the official journal of the American Society for Therapeutic Radiology and Oncology (ASTRO), the largest radiation oncology society in the world, with more than 5,000 members. The society's goals are to advance the scientific base of radiation therapy and to extend the benefits of radiation therapy to those with cancer.
Fox Chase Cancer Center, one of the nation's first comprehensive cancer centers designated by the National Cancer Institute in 1974, conducts basic and clinical research; programs of prevention, detection and treatment of cancer; and community outreach. For more information about Fox Chase activities visit their website at http://www.fccc.edu.
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