Patterns of care in the radiotherapy of prostate cancer in Northern Bavaria 1998-2000.
OBJECTIVE
A patterns-of-care study of radiotherapy (RT) in prostate cancer was performed in Northern Bavaria, Germany, to characterize patient selection, treatment strategies and outcome for the time period 1998-2000.


METHODS
Patients who received curative-intent radical or postoperative RT were identified from the databases of six centers (one university, five teaching/regional hospitals). Two centers treated < 20 patients and were excluded from further analysis. At the remaining four centers, 148 patients receiving radical RT and 134 undergoing postoperative RT were analyzed for pretreatment and RT characteristics and actuarial biochemical control (BC; ASTRO definition).


RESULTS
All patients were treated with three-dimensional conformal external-beam techniques. In radical RT patients, cT- and cN-stages as well as the frequency of (neo)adjuvant hormonal therapy (53-91%) and RT to pelvic nodes (2-97%) and the mean total RT dose (64.8-71.0 Gy) varied significantly between centers. In postoperative RT, centers differed significantly in R-status, initial prostate-specific antigen (PSA) and nodal RT frequency (2-89%), whereas total RT doses were similar (62.3-64.8 Gy). After radical RT, 5-year BC was 68.6% and differed significantly between centers on univariate analysis. In a multivariate model, only total RT dose showed a trend toward an effect on BC. In postoperative RT patients, overall 5-year BC was 82.1%, and age and initial PSA were associated with BC on multivariate analysis.


CONCLUSIONS
From 1998 to 2000, radical RT for prostate cancer at the Northern Bavarian centers now studied was performed with three-dimensional conformal technique to conservative total doses and selection criteria for postoperative RT were highly variable.
Vordermark
Dirk
D
Department of Radiation Oncology, University of Wuerzburg, Josef-Schneider-Strasse 11, 97080 Würzburg, Germany. vordermark_d@klinik.uni-wuerzburg.de
Marold
Dorothee
D
Wirth
Susanne
S
Keilholz
Ludwig
L
Pfändner
Klaus
K
Schimpke
Thomas
T
Thiel
Hans-Joachim
HJ
Willner
Jochen
J
Ziegler
Klaus
K
Guckenberger
Matthias
M
Flentje
Michael
M
D000206:Actuarial Analysis; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D002648:Child; D003131:Combined Modality Therapy; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020360:Neoadjuvant Therapy; D018579:Patient Selection; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D020266:Radiotherapy, Conformal / Q000706:statistics & numerical data*; D015996:Survival Rate
D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen