Survival advantage from higher-dose radiation therapy for clinically localized prostate cancer treated on the radiation therapy oncology group trials

Richard K Valicenti, Jiandong Lu, Miljenko Pilepich, Sucha Asbell, David Grignon

Research output: Contribution to journalArticle

140 Citations (Scopus)

Abstract

Purpose: We evaluated the effect of external-beam radiation therapy on disease-specific survival (death from causes related to prostate cancer) and overall survival in men with clinically localized prostate cancer. Methods: From 1975 and 1992, 1,465 men with clinically localized prostate cancer received radiation therapy on four Radiation Therapy Oncology Group phase III randomized trials and were pooled for this analysis. No one received androgen-deprivation therapy with his initial treatment. All original histology had central pathologic review for grading using the Gleason classification system. Total delivered radiation dose ranged from 60 to 78 Gy (median, 68.4 Gy). The median follow-up time was 8 years. Results: a Cox regression model revealed that Gleason score was an independent predictor of disease-specific survival and overall survival. The 10-year disease-specific survival rates by Gleason score were as follows: score of 2 through 5, 85%; score of 6, 79%; score of 7, 62%; and score of 8 through 10, 43%. Stratifying outcome by this important prognostic factor revealed that higher radiation dose was a significant predictor for improved disease-specific survival and overall survival only for those patients whose cancers had Gleason scores of 8 through 10 (P < .05). After adjusting for clinical T state, nodal status, and age, treating with a higher radiation dose was associated with a 29% lower relative risk of death from prostate cancer and 27% reduced mortality rate (P < .05). Conclusion: These data demonstrate that higher-dose radiation therapy can significantly reduce the risk of dying from prostate cancer in men with clinically localized disease. This survival benefit is restricted to men with poorly differentiated cancers. (C) 2000 by American Society of Clinical Oncology.

Original languageEnglish (US)
Pages (from-to)2740-2746
Number of pages7
JournalJournal of Clinical Oncology
Volume18
Issue number14
StatePublished - Jul 2000
Externally publishedYes

Fingerprint

Radiation Oncology
Prostatic Neoplasms
Radiotherapy
Neoplasm Grading
Survival
Radiation
Proportional Hazards Models
Androgens
Cause of Death
Neoplasms
Histology
Survival Rate
Mortality
Therapeutics

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Survival advantage from higher-dose radiation therapy for clinically localized prostate cancer treated on the radiation therapy oncology group trials. / Valicenti, Richard K; Lu, Jiandong; Pilepich, Miljenko; Asbell, Sucha; Grignon, David.

In: Journal of Clinical Oncology, Vol. 18, No. 14, 07.2000, p. 2740-2746.

Research output: Contribution to journalArticle

@article{ce87479a58a640b88143e9b9df0ba5ea,
title = "Survival advantage from higher-dose radiation therapy for clinically localized prostate cancer treated on the radiation therapy oncology group trials",
abstract = "Purpose: We evaluated the effect of external-beam radiation therapy on disease-specific survival (death from causes related to prostate cancer) and overall survival in men with clinically localized prostate cancer. Methods: From 1975 and 1992, 1,465 men with clinically localized prostate cancer received radiation therapy on four Radiation Therapy Oncology Group phase III randomized trials and were pooled for this analysis. No one received androgen-deprivation therapy with his initial treatment. All original histology had central pathologic review for grading using the Gleason classification system. Total delivered radiation dose ranged from 60 to 78 Gy (median, 68.4 Gy). The median follow-up time was 8 years. Results: a Cox regression model revealed that Gleason score was an independent predictor of disease-specific survival and overall survival. The 10-year disease-specific survival rates by Gleason score were as follows: score of 2 through 5, 85{\%}; score of 6, 79{\%}; score of 7, 62{\%}; and score of 8 through 10, 43{\%}. Stratifying outcome by this important prognostic factor revealed that higher radiation dose was a significant predictor for improved disease-specific survival and overall survival only for those patients whose cancers had Gleason scores of 8 through 10 (P < .05). After adjusting for clinical T state, nodal status, and age, treating with a higher radiation dose was associated with a 29{\%} lower relative risk of death from prostate cancer and 27{\%} reduced mortality rate (P < .05). Conclusion: These data demonstrate that higher-dose radiation therapy can significantly reduce the risk of dying from prostate cancer in men with clinically localized disease. This survival benefit is restricted to men with poorly differentiated cancers. (C) 2000 by American Society of Clinical Oncology.",
author = "Valicenti, {Richard K} and Jiandong Lu and Miljenko Pilepich and Sucha Asbell and David Grignon",
year = "2000",
month = "7",
language = "English (US)",
volume = "18",
pages = "2740--2746",
journal = "Journal of Clinical Oncology",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
number = "14",

}

TY - JOUR

T1 - Survival advantage from higher-dose radiation therapy for clinically localized prostate cancer treated on the radiation therapy oncology group trials

AU - Valicenti, Richard K

AU - Lu, Jiandong

AU - Pilepich, Miljenko

AU - Asbell, Sucha

AU - Grignon, David

PY - 2000/7

Y1 - 2000/7

N2 - Purpose: We evaluated the effect of external-beam radiation therapy on disease-specific survival (death from causes related to prostate cancer) and overall survival in men with clinically localized prostate cancer. Methods: From 1975 and 1992, 1,465 men with clinically localized prostate cancer received radiation therapy on four Radiation Therapy Oncology Group phase III randomized trials and were pooled for this analysis. No one received androgen-deprivation therapy with his initial treatment. All original histology had central pathologic review for grading using the Gleason classification system. Total delivered radiation dose ranged from 60 to 78 Gy (median, 68.4 Gy). The median follow-up time was 8 years. Results: a Cox regression model revealed that Gleason score was an independent predictor of disease-specific survival and overall survival. The 10-year disease-specific survival rates by Gleason score were as follows: score of 2 through 5, 85%; score of 6, 79%; score of 7, 62%; and score of 8 through 10, 43%. Stratifying outcome by this important prognostic factor revealed that higher radiation dose was a significant predictor for improved disease-specific survival and overall survival only for those patients whose cancers had Gleason scores of 8 through 10 (P < .05). After adjusting for clinical T state, nodal status, and age, treating with a higher radiation dose was associated with a 29% lower relative risk of death from prostate cancer and 27% reduced mortality rate (P < .05). Conclusion: These data demonstrate that higher-dose radiation therapy can significantly reduce the risk of dying from prostate cancer in men with clinically localized disease. This survival benefit is restricted to men with poorly differentiated cancers. (C) 2000 by American Society of Clinical Oncology.

AB - Purpose: We evaluated the effect of external-beam radiation therapy on disease-specific survival (death from causes related to prostate cancer) and overall survival in men with clinically localized prostate cancer. Methods: From 1975 and 1992, 1,465 men with clinically localized prostate cancer received radiation therapy on four Radiation Therapy Oncology Group phase III randomized trials and were pooled for this analysis. No one received androgen-deprivation therapy with his initial treatment. All original histology had central pathologic review for grading using the Gleason classification system. Total delivered radiation dose ranged from 60 to 78 Gy (median, 68.4 Gy). The median follow-up time was 8 years. Results: a Cox regression model revealed that Gleason score was an independent predictor of disease-specific survival and overall survival. The 10-year disease-specific survival rates by Gleason score were as follows: score of 2 through 5, 85%; score of 6, 79%; score of 7, 62%; and score of 8 through 10, 43%. Stratifying outcome by this important prognostic factor revealed that higher radiation dose was a significant predictor for improved disease-specific survival and overall survival only for those patients whose cancers had Gleason scores of 8 through 10 (P < .05). After adjusting for clinical T state, nodal status, and age, treating with a higher radiation dose was associated with a 29% lower relative risk of death from prostate cancer and 27% reduced mortality rate (P < .05). Conclusion: These data demonstrate that higher-dose radiation therapy can significantly reduce the risk of dying from prostate cancer in men with clinically localized disease. This survival benefit is restricted to men with poorly differentiated cancers. (C) 2000 by American Society of Clinical Oncology.

UR - http://www.scopus.com/inward/record.url?scp=0033911948&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033911948&partnerID=8YFLogxK

M3 - Article

C2 - 10894874

AN - SCOPUS:0033911948

VL - 18

SP - 2740

EP - 2746

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 14

ER -