Clinical Outcome of Patients Treated With 3D Conformal Radiation Therapy (3D-CRT) for Prostate Cancer on RTOG 9406

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• 作者：Jeff Michalski ; M.D.^&lowast ; ; ^§ ; § ; ; ^{michalski@wustl.edu} ; Kathryn Winter ; M.D.^&dagger ; ; Mack Roach ; M.D.^&Dagger ; ; Arnold Markoe ; M.D.^§ ; ; Howard M. Sandler ; M.D.^¶ ; ; ^鈥?/sup> ; Janice Ryu ; M.D.^&lowast ; &lowast ; ; ^&dagger ; &dagger ; ; Matthew Parliament ; M.D.^&Dagger ; &Dagger ; ; James A. Purdy ; Ph.D.^&lowast ; &lowast ; ; ^§ ; § ; ; Richard K. Valicenti ; M.D.^&lowast ; &lowast ; ; ^¶ ; ¶ ; ; James D. Cox ; M.D.^{鈥栤€?/sup>}
• 关键词：Prostate cancer ; 3D radiation ; PSA outcomes ; Dose escalation ; Conformal radiation
• 刊名：International Journal of Radiation Oncology*Biology*Physics
• 出版年：2012
• 期刊代码：136_03603016
• 类别：med
• 出版时间：1 July, 2012
• 卷：83
• 期：3
• 页码：e363-e370
• 文件大小：173 K

摘要

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Purpose

Report of clinical cancer control outcomes on Radiation Therapy Oncology Group (RTOG) 9406, a three-dimensional conformal radiation therapy (3D-CRT) dose escalation trial for localized adenocarcinoma of the prostate.

Methods and Materials

RTOG 9406 is a Phase I/II multi-institutional dose escalation study of 3D-CRT for men with localized prostate cancer. Patients were registered on five sequential dose levels: 68.4 Gy, 73.8 Gy, 79.2 Gy, 74 Gy, and 78 Gy with 1.8 Gy/day (levels I-III) or 2.0 Gy/day (levels IV and V). Neoadjuvant hormone therapy (NHT) from 2 to 6 months was allowed. Protocol-specific, American Society for Therapeutic Radiation Oncology (ASTRO), and Phoenix biochemical failure definitions are reported.

Results

Thirty-four institutions enrolled 1,084 patients and 1,051 patients are analyzable. Median follow-up for levels I, II, III, IV, and V was 11.7, 10.4, 11.8, 10.4, and 9.2 years, respectively. Thirty-six percent of patients received NHT. The 5-year overall survival was 90%, 87%, 88%, 89%, and 88%for dose levels I-V, respectively. The 5-year clinical disease-free survival (excluding protocol prostate-specific antigen definition) for levels I-V is 84%, 78%, 81%, 82%, and 82%, respectively. By ASTRO definition, the 5-year disease-free survivals were 57%, 59%, 52%, 64%and 75%(low risk); 46%, 52%, 54%, 56%, and 63%(intermediate risk); and 50%, 34%, 46%, 34%, and 61%(high risk) for levels I-V, respectively. By the Phoenix definition, the 5-year disease-free survivals were 68%, 73%, 67%, 84%, and 80%(low risk); 70%, 62%, 70%, 74%, and 69%(intermediate risk); and 42%, 62%, 68%, 54%, and 67%(high risk) for levels I-V, respectively.

Conclusion

Dose-escalated 3D-CRT yields favorable outcomes for localized prostate cancer. This multi-institutional experience allows comparison to other experiences with modern radiation therapy.