An 8-year study comparing the results of various cancer treatments concluded that IMRT is equal to or in some cases superior to other treatments such as brachytherapy and surgery.
Among the numbers mentioned were: "Men with localized prostate cancer who are treated with external-beam radiation therapy have a cure rate of 95.5% for intermediate-risk prostate cancer and 91.3% for high-risk prostate cancer.
The 5-year survival rate using this treatment is 98.8% overall."
This was just based on a literature review - many better studies since then.
Allen - could you track down the original paper by Shakespeare? I tried and failed..
I'm really not interested- it is old and outmoded.
Do you know a recent study for men who had rp and then rt and ADT vs rp and adt alone? My goal is to see if adjuvant et is worth it? Does it increase OS?
I don't understand - why would anyone have RP+ADT?
Maybe I didn't say it clearly.
Gleason 9. Stage t3b. Post PSA 4.8.
I was told by the surgeon that radiation does not increase life expectancy. Yet I see most guys do get adjuvant or salvage radiation .
Just wanted to see if there are any studies proving that radiation helps with OS if added to rp, adt.
OS is a very difficult endpoint to use in randomized clinical trials of men with biochemical recurrence. The "problem", if you can call it that, is that men live too long for a short- term trial to have enough deaths to track a difference. It will usually take about 15 years for the difference to become apparent, and funding for the trials don't last that long. For that reason, clinical trials use "surrogate endpoints," which means endpoints that we know (based on other studies) are causally related to overall survival. So, in JCOG0401, which only had median follow-up of 5.5 years, "time to treatment failure" was used as the surrogate endpoint. They found that after 5.5 years of follow-up, that the percent of men who failed treatment was almost twice as large (179%) if they were only treated with permanent ADT (bicalutamide at the time of PSA-recurrence and ADT when that failed) compared to those treated with salvage RT+ADT (ADT only if treatment failed).
europeanurology.com/article...
(It's also worth noting that the salvage radiation dose in that trial was below the dose now considered curative - the study began in 2004, before it was known)
Thank you. We saw dr kishan by video conference today. Dropped your name.
He thinks radiation would be a very good thing for my husband and we agree. Thank you for the referral. It is over an hour each way from our house but he sounds like he will be the best at what we need.
I am a very big fan of his.
I’m in the 5% that had biochemical recurrence after RT and going into it with Gleason7 (3,4) we were all surprised. Should have been slam dunk gone. I’m alive ten years later so that statistic still applies.
In hindsight I wonder if a mistake was made starting RT in November and interrupting the regularly spaced treatments for two and a half weeks over the holidays. Selfish trip to visit grandchildren.
It’s my understanding the radiation kills cancer while the cancer cells are undergoing mitosis, cell division. But mitosis of cancer cells is a bit erratic. I fear that during my holiday break a lot of new cancer cells were formed. Perhaps some of them escaped being zapped in subsequent cell divisions. Nice Monte Carlo problem.
It’s just a thought. No real science. And, if I had it to do over I’d still do RT but with no interruptions. Amazing machines. Lovely technicians. And RT avoids risks of surgery.
As it turned out salvage brachytherapy also failed after a few years so maybe my PCA wasn’t as localized as hoped for in the RT days.
In 2004, the numbers for RP compared to Brachytherapy plus IMRT for a Gleason 7 were exactly the same..... 92-94%.
GD
I agree only ,because I fall into this category ...Whoohoo! I just made five years ,I’m going after five more .. Thanks Don!
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