Radiation dose and late failures in prostate cancer
Purpose: To quantify the impact of radiation dose escalation on the timing of biochemical failure (BF) and distant metastasis (DM) for prostate cancer treated with radiotherapy (RT) alone. Methods: The data from 667 men with clinically localized intermediate- and high-risk prostate cancer treated wi...
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| Veröffentlicht in: | International journal of radiation oncology, biology, physics biology, physics, 2007-03, Vol.67 (4), p.1074-1081 |
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| creator | Morgan, Peter B., M.D Hanlon, Alexandra L., Ph.D Horwitz, Eric M., M.D Buyyounouski, Mark K., M.D Uzzo, Robert G., M.D Pollack, Alan, M.D., Ph.D |
| description | Purpose: To quantify the impact of radiation dose escalation on the timing of biochemical failure (BF) and distant metastasis (DM) for prostate cancer treated with radiotherapy (RT) alone. Methods: The data from 667 men with clinically localized intermediate- and high-risk prostate cancer treated with three-dimensional conformal RT alone were retrospectively analyzed. The interval hazard rates of DM and BF, using the American Society for Therapeutic Radiology and Oncology (ASTRO) and Phoenix (nadir + 2) definitions, were determined. The median follow-up was 77 months. Results: Multivariate analysis showed that increasing radiation dose was independently associated with decreased ASTRO BF ( p < 0.0001), nadir + 2 BF ( p = 0.001), and DM ( p = 0.006). The preponderance (85%) of ASTRO BF occurred at ≤4 years after RT, and nadir + 2 BF was more evenly spread throughout Years 1–10, with 55% of BF in ≤4 years. Radiation dose escalation caused a shift in the BF from earlier to later years. The interval hazard function for DM appeared to be biphasic (early and late peaks) overall and for the |
| doi_str_mv | 10.1016/j.ijrobp.2006.10.023 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_osti_</sourceid><recordid>TN_cdi_osti_scitechconnect_20944765</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S0360301606033608</els_id><sourcerecordid>70226741</sourcerecordid><originalsourceid>FETCH-LOGICAL-c489t-9662ab1ddfb1b82fafa5bd14347bf776a12e0590236108a52bd0172b41ad57c53</originalsourceid><addsrcrecordid>eNqFkVur1TAQhYMonu3RfyBSEHzrdiZJk_ZFkMPxAgcEL-BbyK2Y2p1uk1Y4_96EbhB88WnC8M2alTWEPEc4IqB4PR3DlBZzPlIAUVpHoOwBOWAvh5Z13feH5ABMQMsKfEWe5DwBAKLkj8kVShwkMjwQ9lm7oNewxMYt2Tc6umbWq29GHeYt-dyE2JzTktfatDpan56SR6Oes392qdfk27vbrzcf2rtP7z_evL1rLe-HtR2EoNqgc6NB09NRj7ozDjnj0oxSCo3UQzcU2wKh1x01DlBSw1G7TtqOXZOXu27ZHlS2YfX2h11i9HZVFAbOpajUq50qLn9tPq_qFLL186yjX7asJFAqJMcC8h205Ts5-VGdUzjpdK8QVI1UTWqPVNVIa7d4K2MvLvqbOXn3d-iSYQHe7IAvWfwOPlWrvgTlQqpO3RL-t-FfATuHGKyef_p7n6dlS7HkrFBlqkB9qWetV4VSyrNnfwBrTpxD</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>70226741</pqid></control><display><type>article</type><title>Radiation dose and late failures in prostate cancer</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals</source><creator>Morgan, Peter B., M.D ; Hanlon, Alexandra L., Ph.D ; Horwitz, Eric M., M.D ; Buyyounouski, Mark K., M.D ; Uzzo, Robert G., M.D ; Pollack, Alan, M.D., Ph.D</creator><creatorcontrib>Morgan, Peter B., M.D ; Hanlon, Alexandra L., Ph.D ; Horwitz, Eric M., M.D ; Buyyounouski, Mark K., M.D ; Uzzo, Robert G., M.D ; Pollack, Alan, M.D., Ph.D</creatorcontrib><description>Purpose: To quantify the impact of radiation dose escalation on the timing of biochemical failure (BF) and distant metastasis (DM) for prostate cancer treated with radiotherapy (RT) alone. Methods: The data from 667 men with clinically localized intermediate- and high-risk prostate cancer treated with three-dimensional conformal RT alone were retrospectively analyzed. The interval hazard rates of DM and BF, using the American Society for Therapeutic Radiology and Oncology (ASTRO) and Phoenix (nadir + 2) definitions, were determined. The median follow-up was 77 months. Results: Multivariate analysis showed that increasing radiation dose was independently associated with decreased ASTRO BF ( p < 0.0001), nadir + 2 BF ( p = 0.001), and DM ( p = 0.006). The preponderance (85%) of ASTRO BF occurred at ≤4 years after RT, and nadir + 2 BF was more evenly spread throughout Years 1–10, with 55% of BF in ≤4 years. Radiation dose escalation caused a shift in the BF from earlier to later years. The interval hazard function for DM appeared to be biphasic (early and late peaks) overall and for the <74-Gy group. In patients receiving ≥74 Gy, a reduction occurred in the risk of DM in the early and late waves, although the late wave appeared reduced to a greater degree. Conclusion: The ASTRO definition of BF systematically underestimated late BF because of backdating. Radiation dose escalation diminished and delayed BF; the delay suggested that local persistence may still be present in some patients. For DM, a greater radiation dose reduced the early and late waves, suggesting that persistence of local disease contributed to both.</description><identifier>ISSN: 0360-3016</identifier><identifier>EISSN: 1879-355X</identifier><identifier>DOI: 10.1016/j.ijrobp.2006.10.023</identifier><identifier>PMID: 17197131</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Aged, 80 and over ; Analysis of Variance ; Biochemical failure ; CARCINOMAS ; Distant metastasis ; FAILURES ; Hazard function ; HEALTH HAZARDS ; Hematology, Oncology and Palliative Medicine ; Humans ; Male ; METASTASES ; Middle Aged ; MULTIVARIATE ANALYSIS ; Neoplasm Metastasis ; PATIENTS ; PROSTATE ; Prostate cancer ; Prostate-Specific Antigen - blood ; Prostatic Neoplasms - blood ; Prostatic Neoplasms - pathology ; Prostatic Neoplasms - radiotherapy ; Radiation dose ; RADIATION DOSES ; Radiology ; RADIOLOGY AND NUCLEAR MEDICINE ; RADIOTHERAPY ; Radiotherapy Dosage ; Radiotherapy, Conformal ; Retrospective Studies ; Salvage Therapy ; Time Factors ; Treatment Failure</subject><ispartof>International journal of radiation oncology, biology, physics, 2007-03, Vol.67 (4), p.1074-1081</ispartof><rights>Elsevier Inc.</rights><rights>2007 Elsevier Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c489t-9662ab1ddfb1b82fafa5bd14347bf776a12e0590236108a52bd0172b41ad57c53</citedby><cites>FETCH-LOGICAL-c489t-9662ab1ddfb1b82fafa5bd14347bf776a12e0590236108a52bd0172b41ad57c53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0360301606033608$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17197131$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/20944765$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Morgan, Peter B., M.D</creatorcontrib><creatorcontrib>Hanlon, Alexandra L., Ph.D</creatorcontrib><creatorcontrib>Horwitz, Eric M., M.D</creatorcontrib><creatorcontrib>Buyyounouski, Mark K., M.D</creatorcontrib><creatorcontrib>Uzzo, Robert G., M.D</creatorcontrib><creatorcontrib>Pollack, Alan, M.D., Ph.D</creatorcontrib><title>Radiation dose and late failures in prostate cancer</title><title>International journal of radiation oncology, biology, physics</title><addtitle>Int J Radiat Oncol Biol Phys</addtitle><description>Purpose: To quantify the impact of radiation dose escalation on the timing of biochemical failure (BF) and distant metastasis (DM) for prostate cancer treated with radiotherapy (RT) alone. Methods: The data from 667 men with clinically localized intermediate- and high-risk prostate cancer treated with three-dimensional conformal RT alone were retrospectively analyzed. The interval hazard rates of DM and BF, using the American Society for Therapeutic Radiology and Oncology (ASTRO) and Phoenix (nadir + 2) definitions, were determined. The median follow-up was 77 months. Results: Multivariate analysis showed that increasing radiation dose was independently associated with decreased ASTRO BF ( p < 0.0001), nadir + 2 BF ( p = 0.001), and DM ( p = 0.006). The preponderance (85%) of ASTRO BF occurred at ≤4 years after RT, and nadir + 2 BF was more evenly spread throughout Years 1–10, with 55% of BF in ≤4 years. Radiation dose escalation caused a shift in the BF from earlier to later years. The interval hazard function for DM appeared to be biphasic (early and late peaks) overall and for the <74-Gy group. In patients receiving ≥74 Gy, a reduction occurred in the risk of DM in the early and late waves, although the late wave appeared reduced to a greater degree. Conclusion: The ASTRO definition of BF systematically underestimated late BF because of backdating. Radiation dose escalation diminished and delayed BF; the delay suggested that local persistence may still be present in some patients. For DM, a greater radiation dose reduced the early and late waves, suggesting that persistence of local disease contributed to both.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analysis of Variance</subject><subject>Biochemical failure</subject><subject>CARCINOMAS</subject><subject>Distant metastasis</subject><subject>FAILURES</subject><subject>Hazard function</subject><subject>HEALTH HAZARDS</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Humans</subject><subject>Male</subject><subject>METASTASES</subject><subject>Middle Aged</subject><subject>MULTIVARIATE ANALYSIS</subject><subject>Neoplasm Metastasis</subject><subject>PATIENTS</subject><subject>PROSTATE</subject><subject>Prostate cancer</subject><subject>Prostate-Specific Antigen - blood</subject><subject>Prostatic Neoplasms - blood</subject><subject>Prostatic Neoplasms - pathology</subject><subject>Prostatic Neoplasms - radiotherapy</subject><subject>Radiation dose</subject><subject>RADIATION DOSES</subject><subject>Radiology</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>RADIOTHERAPY</subject><subject>Radiotherapy Dosage</subject><subject>Radiotherapy, Conformal</subject><subject>Retrospective Studies</subject><subject>Salvage Therapy</subject><subject>Time Factors</subject><subject>Treatment Failure</subject><issn>0360-3016</issn><issn>1879-355X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkVur1TAQhYMonu3RfyBSEHzrdiZJk_ZFkMPxAgcEL-BbyK2Y2p1uk1Y4_96EbhB88WnC8M2alTWEPEc4IqB4PR3DlBZzPlIAUVpHoOwBOWAvh5Z13feH5ABMQMsKfEWe5DwBAKLkj8kVShwkMjwQ9lm7oNewxMYt2Tc6umbWq29GHeYt-dyE2JzTktfatDpan56SR6Oes392qdfk27vbrzcf2rtP7z_evL1rLe-HtR2EoNqgc6NB09NRj7ozDjnj0oxSCo3UQzcU2wKh1x01DlBSw1G7TtqOXZOXu27ZHlS2YfX2h11i9HZVFAbOpajUq50qLn9tPq_qFLL186yjX7asJFAqJMcC8h205Ts5-VGdUzjpdK8QVI1UTWqPVNVIa7d4K2MvLvqbOXn3d-iSYQHe7IAvWfwOPlWrvgTlQqpO3RL-t-FfATuHGKyef_p7n6dlS7HkrFBlqkB9qWetV4VSyrNnfwBrTpxD</recordid><startdate>20070315</startdate><enddate>20070315</enddate><creator>Morgan, Peter B., M.D</creator><creator>Hanlon, Alexandra L., Ph.D</creator><creator>Horwitz, Eric M., M.D</creator><creator>Buyyounouski, Mark K., M.D</creator><creator>Uzzo, Robert G., M.D</creator><creator>Pollack, Alan, M.D., Ph.D</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>OTOTI</scope></search><sort><creationdate>20070315</creationdate><title>Radiation dose and late failures in prostate cancer</title><author>Morgan, Peter B., M.D ; Hanlon, Alexandra L., Ph.D ; Horwitz, Eric M., M.D ; Buyyounouski, Mark K., M.D ; Uzzo, Robert G., M.D ; Pollack, Alan, M.D., Ph.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c489t-9662ab1ddfb1b82fafa5bd14347bf776a12e0590236108a52bd0172b41ad57c53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Analysis of Variance</topic><topic>Biochemical failure</topic><topic>CARCINOMAS</topic><topic>Distant metastasis</topic><topic>FAILURES</topic><topic>Hazard function</topic><topic>HEALTH HAZARDS</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Humans</topic><topic>Male</topic><topic>METASTASES</topic><topic>Middle Aged</topic><topic>MULTIVARIATE ANALYSIS</topic><topic>Neoplasm Metastasis</topic><topic>PATIENTS</topic><topic>PROSTATE</topic><topic>Prostate cancer</topic><topic>Prostate-Specific Antigen - blood</topic><topic>Prostatic Neoplasms - blood</topic><topic>Prostatic Neoplasms - pathology</topic><topic>Prostatic Neoplasms - radiotherapy</topic><topic>Radiation dose</topic><topic>RADIATION DOSES</topic><topic>Radiology</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>RADIOTHERAPY</topic><topic>Radiotherapy Dosage</topic><topic>Radiotherapy, Conformal</topic><topic>Retrospective Studies</topic><topic>Salvage Therapy</topic><topic>Time Factors</topic><topic>Treatment Failure</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Morgan, Peter B., M.D</creatorcontrib><creatorcontrib>Hanlon, Alexandra L., Ph.D</creatorcontrib><creatorcontrib>Horwitz, Eric M., M.D</creatorcontrib><creatorcontrib>Buyyounouski, Mark K., M.D</creatorcontrib><creatorcontrib>Uzzo, Robert G., M.D</creatorcontrib><creatorcontrib>Pollack, Alan, M.D., Ph.D</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>OSTI.GOV</collection><jtitle>International journal of radiation oncology, biology, physics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Morgan, Peter B., M.D</au><au>Hanlon, Alexandra L., Ph.D</au><au>Horwitz, Eric M., M.D</au><au>Buyyounouski, Mark K., M.D</au><au>Uzzo, Robert G., M.D</au><au>Pollack, Alan, M.D., Ph.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Radiation dose and late failures in prostate cancer</atitle><jtitle>International journal of radiation oncology, biology, physics</jtitle><addtitle>Int J Radiat Oncol Biol Phys</addtitle><date>2007-03-15</date><risdate>2007</risdate><volume>67</volume><issue>4</issue><spage>1074</spage><epage>1081</epage><pages>1074-1081</pages><issn>0360-3016</issn><eissn>1879-355X</eissn><abstract>Purpose: To quantify the impact of radiation dose escalation on the timing of biochemical failure (BF) and distant metastasis (DM) for prostate cancer treated with radiotherapy (RT) alone. Methods: The data from 667 men with clinically localized intermediate- and high-risk prostate cancer treated with three-dimensional conformal RT alone were retrospectively analyzed. The interval hazard rates of DM and BF, using the American Society for Therapeutic Radiology and Oncology (ASTRO) and Phoenix (nadir + 2) definitions, were determined. The median follow-up was 77 months. Results: Multivariate analysis showed that increasing radiation dose was independently associated with decreased ASTRO BF ( p < 0.0001), nadir + 2 BF ( p = 0.001), and DM ( p = 0.006). The preponderance (85%) of ASTRO BF occurred at ≤4 years after RT, and nadir + 2 BF was more evenly spread throughout Years 1–10, with 55% of BF in ≤4 years. Radiation dose escalation caused a shift in the BF from earlier to later years. The interval hazard function for DM appeared to be biphasic (early and late peaks) overall and for the <74-Gy group. In patients receiving ≥74 Gy, a reduction occurred in the risk of DM in the early and late waves, although the late wave appeared reduced to a greater degree. Conclusion: The ASTRO definition of BF systematically underestimated late BF because of backdating. Radiation dose escalation diminished and delayed BF; the delay suggested that local persistence may still be present in some patients. For DM, a greater radiation dose reduced the early and late waves, suggesting that persistence of local disease contributed to both.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>17197131</pmid><doi>10.1016/j.ijrobp.2006.10.023</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aged, 80 and over Analysis of Variance Biochemical failure CARCINOMAS Distant metastasis FAILURES Hazard function HEALTH HAZARDS Hematology, Oncology and Palliative Medicine Humans Male METASTASES Middle Aged MULTIVARIATE ANALYSIS Neoplasm Metastasis PATIENTS PROSTATE Prostate cancer Prostate-Specific Antigen - blood Prostatic Neoplasms - blood Prostatic Neoplasms - pathology Prostatic Neoplasms - radiotherapy Radiation dose RADIATION DOSES Radiology RADIOLOGY AND NUCLEAR MEDICINE RADIOTHERAPY Radiotherapy Dosage Radiotherapy, Conformal Retrospective Studies Salvage Therapy Time Factors Treatment Failure |
| title | Radiation dose and late failures in prostate cancer |
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