Long-term Outcomes Following Igrt For Localized Prostate Cancer: Dose Escalation To Spect/ct Determined Biologic Target Volumes And The Bdfs Predictive Value Of Capromab Pendetide
Nuclear Medicine & Medical Imaging; Oncology; Radiology
Ellis R J; Kaminsky D A; Zhou E H; Fu P; Brelin A; Faulhaber P F; Bodner D
International Journal of Radiation Oncology Biology Physics
2009
2009
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1016/j.ijrobp.2009.07.124" target="_blank" rel="noreferrer noopener">10.1016/j.ijrobp.2009.07.124</a>
RADIOTHERAPY AND SURVIVAL IN PROSTATE CANCER PATIENTS: A POPULATION-BASED STUDY
active surveillance; brachytherapy; carcinoma; external-beam radiotherapy; failure; management; Nuclear Medicine & Medical Imaging; Oncology; outcomes; Population-based study; Prostate cancer; radiation-therapy; radical prostatectomy; Radiology; risk; survival; Treatment modalities
Purpose: To investigate the association of overall and disease-specific survival with the five standard treatment modalities for prostate cancer (CaP): radical prostatectomy (RP), brachytherapy (BT), external beam radiotherapy, androgen deprivation therapy, and no treatment (NT) within 6 months after CaP diagnosis. Methods and Materials: The study population included 10,179 men aged 65 years and older with incident CaP diagnosed between 1999 and 2001. Using the linked Ohio Cancer Incidence Surveillance System, Medicare, and death certificate files, overall and disease-specific survival through 2005 among the five clinically accepted therapies were analyzed. Results: Disease-specific survival rates were 92.3% and 23.9% for patients with localized vs. distant disease at 7 years, respectively. Controlling for age, race, comorbidities, stage, and Gleason score, results from the Cox multiple regression models indicated that the risk of CaP-specific death was significantly reduced in patients receiving RP or BT, compared with NT. For localized disease, compared with NT, in the monotherapy cohort, RP and BT were associated with reduced hazard ratios (HR) of 0.25 and 0.45 (95% confidence intervals 0.13-0.48 and 0.23-0.87, respectively), whereas in the combination therapy cohort, HR were 0.40 (0.17-0.94) and 0.46 (0.270.80), respectively. Conclusions: The present population-based study indicates that RP and BT are associated with improved survival outcomes. Further studies are warranted to improve clinical determinates in the selection of appropriate management of CaP and to improve predictive modeling for which patient subsets may benefit most from definitive therapy vs. conservative management and/or observation. (C) 2009 Elsevier Inc.
Zhou E H; Ellis R T; Cherullo E; Colussi V; Xu F; Chen W D; Gupta S; Whalen C C; Bodner D; Resnick M I; Rimm A A; Koroukian S M
International Journal of Radiation Oncology Biology Physics
2009
2009-01
Journal Article
<a href="http://doi.org/10.1016/j.ijrobp.2008.04.001" target="_blank" rel="noreferrer noopener">10.1016/j.ijrobp.2008.04.001</a>
Single Photon Emission Computerized Tomography With Capromab Pendetide Plus Computerized Tomography Image Set Co-registration Independently Predicts Biochemical Failure
capromab pendetide; emission-computed; localized prostate-cancer; prostatic neoplasms; radiation-therapy; radiotherapy; recommendations; single-photon; tomography; Urology & Nephrology
Ellis R J; Zhou E H; Fu P; Kaminsky D A; Sodee D B; Faulhaber P F; Bodner D; Resnick M I
Journal of Urology
2008
2008-05
Journal Article or Conference Abstract Publication
<a href="http://doi.org/10.1016/j.juro.2008.01.025" target="_blank" rel="noreferrer noopener">10.1016/j.juro.2008.01.025</a>
Ten-year outcomes: the clinical utility of single photon emission computed tomography/computed tomography capromab pendetide (Prostascint) in a cohort diagnosed with localized prostate cancer.
Male; Aged; Multivariate Analysis; Prognosis; Tomography; Antibodies; Human; Regression; Emission-Computed; Kaplan-Meier Estimator; X-Ray Computed – Methods; Prostate-Specific Antigen – Blood; Prostatic Neoplasms – Pathology; Brachytherapy – Methods; Monoclonal – Diagnostic Use; Prostate – Radiography; Prostatic Neoplasms – Blood; Prostatic Neoplasms – Radiography; Radioisotopes – Diagnostic Use; Single-Photon – Methods
Purpose: To evaluate the clinical utility of capromab pendetide imaging with single photon emission computed tomography coregistration with computed tomography (SPECT/CT) in primary prostate cancer (CaP) for pretreatment prognostic staging and localization of biologic target volumes (BTV) for individualized image-guided radiotherapy dose escalation (IGRT-DE). Methods and Materials: Patients consecutively presenting for primary radiotherapy (February 1997 to December 2002), having a clinical diagnosis of localized CaP, were evaluated for tumor stage using conventional staging and SPECT/CT (N=239). Distant metastatic uptake (mets) were identified by SPECT/CT in 22 (9.2%). None of the suspected mets could be clinically confirmed. Thus, all subjects were followed without alteration in disease management. The SPECT/CT pelvic images defined BTV for IGRT-DE (+150% brachytherapy dose) without (n=150) or with (n=89) external radiation of 45 Gy. The National Comprehensive Cancer Network criteria defined risk groups (RG). The median survivor follow-up was 7 years. Biochemical disease-free survival (bDFS) was reported by clinical nadir +2 ng/mL (CN+2) criteria. Statistical analyses included Kaplan-Meier, multivariate analysis, and Concordance-index models. Results: At 10-year analyses, overall survival was 84.8% and bDFS was 84.6%. With stratification by RG, CN+2 bDFS was 93.5% for the low-RG (n=116), 78.7% for the intermediate-RG (n=94), and 68.8% for the high-RG (n=29), p=0.0002. With stratification by pretreatment SPECT/CT findings, bDFS was 65.5% in patients with suspected mets (n=22) vs. 86.6% in patients with only localized uptake (n=217), p=0.0014. CaP disease-specific survival (DSS) was 97.7% for the cohort. With stratification by SPECT/CT findings, DSS was 86.4% (with suspected mets) vs. 99.0% (localized only), p=0.0001. Using multivariate analysis, the DSS hazard ratio for SPECT/CT findings (mets vs. localized) was 3.58 (p=0.0026). Concordance-index tests, based on all data, by CN+2 bDFS criteria were 0.710 for RG alone and 0.773 for SPECT/CT + RG. Conclusions: Through long-term outcomes we demonstrate statistically significant bDFS and DSS predictive value for pretreatment capromab pendetide SPECT/CT imaging in primary CaP. Dual clinical utility is demonstrated, using SPECT/CT to define BTV for individualized IGRT-DE.
Ellis RJ; Kaminsky DA; Zhou EH; Fu P; Chen WD; Brelin A; Faulhaber PF; Bodner D; Ellis Rodney J; Kaminsky Deborah A; Zhou Esther H; Fu Pingfu; Chen Wei-Dong; Brelin Alaina; Faulhaber Peter F; Bodner Donald
International Journal of Radiation Oncology, Biology, Physics
2011
2011-09
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.ijrobp.2010.05.053" target="_blank" rel="noreferrer noopener">10.1016/j.ijrobp.2010.05.053</a>