title: Progress in 3D conformal radiation treatment of prostate cancer.
abstract: The development of 3D conformal radiation is reviewed and the proof given of three key hypotheses that result in improved patient results. The Fox Chase outcomes from 3D CRT show 7- and 8-year biochemical freedom of disease rates of 72% for all patients, 84% for PSA < 10 ng/ml, 73% for PSA 10-19.9 ng/ml and 37% for PSA > 20 ng/ml. Dose responses by pretreatment PSA level grouping show steep slopes for patients with PSA> 10 ng/ml. Dose response is also demonstrated for 'favorable' and 'unfavorable' prognostic subgroupings of the classic three pretreatment PSA groups. A matched pair analysis of high-dose 3D CRT versus low-dose 3D CRT shows on multivariate analysis a significant advantage in freedom from distant metastasis. A similar matched comparison of high-dose 3D CRT with low-dose 3D CRT patients and low-dose conventional technique patients shows a significant advantage in distant metastasis, cause-specific survival and overall survival for the high-dose group. Future studies including those using biochemical endpoints to direct differential dose distributions are discussed.
authors.affiliation: Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA 19111, USA. GE_Hanks@fccc.edu
authors.forename: G E
authors.initials: GE
authors.lastname: Hanks
mesh_terms: D004307:Dose-Response Relationship, Radiation; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D017430:Prostate-Specific Antigen / Q000032:analysis; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D011878:Radiotherapy / Q000295:instrumentation / Q000379:methods; D011879:Radiotherapy Dosage
chemical_list: D017430:Prostate-Specific Antigen