title: The influence of percentage of preradiation needle biopsies with adenocarcinoma and total radiation dose on the pathologic response of unfavorable prostate adenocarcinoma.
abstract: We studied relationships among clinicopathologic factors in 78 patients with unfavorable prostate adenocarcinoma treated in a dose-escalation radiation therapy (RT) study using pre- and 18-month protocol post-RT biopsy specimens. Pre-RT factors analyzed were serum prostate-specific antigen (PSA) level, Gleason score, and percentage of needle cores with adenocarcinoma; post-RT factors were percentage of needle cores with adenocarcinoma and amount of radiation effect on the adenocarcinoma. Of 78 patients, 42 (54%) had residual adenocarcinoma in the post-RT biopsy specimen. Lower total RT dose and dose per implant and greater serum PSA level were associated with an increasing percentage of needle cores with residual post-RT adenocarcinoma. Lower RT dose, an increasing percentage of pre-RT needle cores with adenocarcinoma, and a greater serum PSA level were associated with an increasing percentage of post-RT needle cores with no to moderate RT effect scores in adenocarcinoma. The mean percentage of pre-RT and post-RT needle cores with adenocarcinoma was greater in patients with post-RT biopsy specimens with no to moderate RT effect. The percentage of pre-RT needle cores with adenocarcinoma (a surrogate marker of adenocarcinoma volume), serum PSA level, and RT dose are the key components in the dose-response relationship. Gleason score and gland volume did not contribute significantly to this relationship.
authors.affiliation: Department of Anatomic Pathology, William Beaumont Hospital, Royal Oak, MI 48073, USA.
authors.forename: Neal S
authors.initials: NS
authors.lastname: Goldstein
authors.forename: Larry L
authors.initials: LL
authors.lastname: Kestin
authors.forename: Frank A
authors.initials: FA
authors.lastname: Vicini
authors.forename: Alvaro A
authors.initials: AA
authors.lastname: Martinez
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000473:pathology* / Q000532:radiotherapy*; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D001918:Brachytherapy; D004307:Dose-Response Relationship, Radiation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D018365:Neoplasm, Residual; D011467:Prostate / Q000473:pathology* / Q000528:radiation effects; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology* / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D016037:Single-Blind Method; D017211:Treatment Failure
chemical_list: D017430:Prostate-Specific Antigen