Patterns of Care and RTOG studies in prostate cancer: long-term survival, hazard rate observations, and possibilities of cure.
OBJECTIVE
This study was undertaken to show the long-term survival and probability of cure of prostate cancer patients treated with external beam radiation in USA national surveys and in the prospective clinical trials of the RTOG.


METHODS
Two national patterns of care surveys of patients treated in 1973 and 1978 are reported along with two RTOG prospective trials (7506 and 7706). Hazard rates represent the risk of death and are compared to the rate expected for a normal population.


RESULTS
For patients with Stage A cancers, the survival is not different from the expected survival for any of the reported surveys. The hazard rate for death does not significantly exceed the expected hazard rate out to 15 years. For patients with Stage B cancer, there is a decrease in survival below expected and hazard rates show a continuing excess mortality as long as 15 years after treatment. For patients with Stage C cancers, there is a more rapid decrease in survival that then becomes parallel to the expected survival. Hazard rates indicate there has been a return to expected mortality at 15 years.


CONCLUSIONS
These data make a strong argument for the long-term cure of prostate cancer by external beam radiation, and support the continued use and study of radiation therapy as a curative modality in prostate cancer. No similar national data is available for any other method of management.
Hanks
G E
GE
Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111.
Krall
J M
JM
Hanlon
A L
AL
Asbell
S O
SO
Pilepich
M V
MV
Owen
J B
JB
D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010043:Outcome and Process Assessment, Health Care; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000532:radiotherapy*; D016019:Survival Analysis; D015996:Survival Rate; D013997:Time Factors