Ten-year outcomes for pathologic node-positive patients treated in RTOG 75-06.
OBJECTIVE
This study was conducted to see what fraction of prostate cancer patients with biopsy-proven nodes are free of cancer 10 years after radiation treatment.


METHODS
RTOG protocol #75-06 included 90 patients with biopsy-proven pelvic nodal involvement treated with radiation. They have been continuously follow-up since treatment. When feasible, current prostate-specific antigen (PSA) levels have been solicited from patients clinically cancer-free (no evidence of disease, NED) at 10 years, to confirm cure.


RESULTS
The 10-year survival was 29%, the 10-year clinical NED survival 7%. PSA levels were obtained in 2 of 5 10-year clinical NED patients, they were both less than 0.8 ng/ml. The 2 proven cures were both clinical stage T-3, Gleason Score 6 and 8, and had 2 and 1 positive nodes, respectively. Multivariate analysis showed Gleason sum was significantly associated with clinical survival without disease.


CONCLUSIONS
A small fraction of node-positive patients are cured at 10-year follow-up by radiation therapy (2 of 90 with PSA +3 of 90 by clinical endpoints). Innovative treatment programs should be directed at node-positive patients in an effort to improve the fraction cured.
Hanks
G E
GE
Fox Chase Cancer Center, Philadelphia, PA 19111, USA.
Buzydlowski
J
J
Sause
W T
WT
Emami
B
B
Rubin
P
P
Parsons
J A
JA
Russell
A H
AH
Byhardt
R W
RW
Earle
J D
JD
Pilepich
M V
MV
D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy*; D013997:Time Factors; D016896:Treatment Outcome
D017430:Prostate-Specific Antigen