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Cited by 1,232Prostate Cancer Diagnosis and TreatmentAdvanced Radiotherapy TechniquesBreast Cancer Treatment Studies

Long-term results of the M.D. Anderson randomized dose-escalation trial for prostate cancer

Kuban, Deborah A., Tucker, Susan L., Dong, Lei, Starkschall, George, Huang, Eugene H., Cheung, M. Rex, Lee, Andrew K., Pollack, Alan·2008·International Journal of Radiation Oncology*Biology*Physics
DOI 10.1016/j.ijrobp.2007.06.054
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Abstract

Purpose To report the long-term results of a randomized radiotherapy dose escalation trial for prostate cancer.Methods and materials From 1993 to 1998, a total of 301 patients with stage T1b to T3 prostate cancer were accrued to a randomized external beam dose escalation trial using 70 Gy versus 78 Gy. The median follow-up is now 8.7 years. Kaplan-Meier analysis was used to compute rates of prostate-specific antigen (PSA) failure (nadir + 2), clinical failure, distant metastasis, disease-specific, and overall survival as well as complication rates at 8 years post-treatment.Results For all patients, freedom from biochemical or clinical failure (FFF) was superior for the 78-Gy arm, 78%, as compared with 59% for the 70-Gy arm (p = 0.004, and an even greater benefit was seen in patients with initial PSA >10 ng/ml (78% vs. 39%, p = 0.001). The clinical failure rate was significantly reduced in the 78-Gy arm as well (7% vs. 15%, p = 0.014). Twice as many patients either died of prostate cancer or are currently alive with cancer in the 70-Gy arm. Gastrointestinal toxicity of grade 2 or greater occurred twice as often in the high dose patients (26% vs. 13%), although genitourinary toxicity of grade 2 or greater was less (13% vs. 8%) and not statistically significantly different. Dose-volume histogram analysis showed that the complication rate could be significantly decreased by reducing the amount of treated rectum.Conclusions Modest escalation in radiotherapy dose improved freedom from biochemical and clinical progression with the largest benefit in prostate cancer patients with PSA >10 ng/ml.

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  • Advances in radiation oncology have improved outcomes in a number of different cancers.

    “This has resulted in improved outcomes in a number of different cancers (2, 342–350).”

    From Adrenocortical carcinoma (2014) · cites this paper as [346]

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Authors
Kuban, D. A., Tucker, S. L., Dong, L., Starkschall, G., Huang, E. H., Cheung, M. R., Lee, A. K., & Pollack, A.
Affiliations
  • The University of Texas MD Anderson Cancer Center (US)
  • Fox Chase Cancer Center (US)
Corresponding author
Kuban, Deborah A.
ORCID
Venue
International Journal of Radiation Oncology*Biology*Physics
Publisher
Elsevier BV
Published
2008-01
Volume
70
Issue
1
Pages
67-74
ISSN
0360-3016 (ISSN-L)
DOI
10.1016/j.ijrobp.2007.06.054
OpenAlex
W2054899405
Cited by
1,232
References
24
Citations by year
2026: 10 · 2025: 23 · 2024: 38 · 2023: 27 · 2022: 35 · 2021: 49 · 2020: 43 · 2019: 77 · 2018: 61 · 2017: 83 · 2016: 88 · 2015: 87 · 2014: 86 · 2013: 129 · 2012: 99
FWCI
60.77
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • International Journal of Radiation Oncology*Biology*Physics (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Prostate Cancer Diagnosis and Treatment
  • Physical Sciences › Physics and Astronomy › Radiation › Advanced Radiotherapy Techniques
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Breast Cancer Treatment Studies
Keywords
prostate cancer, radiation dose escalation, external beam radiotherapy, prostate-specific antigen failure, clinical failure, distant metastasis, disease-specific survival, overall survival, gastrointestinal toxicity, genitourinary toxicity
MeSH terms
Follow-Up Studies, Humans, Male, Neoplasm Staging, Prostatic Neoplasms, Radiotherapy, Radiotherapy Dosage, Survival Analysis, Treatment Failure, Prostate-Specific Antigen, Gastrointestinal Tract

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