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For Release: October 25, 2000
3D-CRT Means Lower Treatment Complications For Some Prostate Cancer Patients
Radiation oncologists can increase the dose of radiation and still lower the rate of complications if they use 3D-CRT when treating patients with early stage prostate cancer, a new study shows.
Earlier studies have indicated that increased doses would increase cure rates, says Jeff Michalski, M.D., at Washington University School of Medicine, St. Louis, MO. However, "we were concerned that as the dose was increased, complication rates would also increase - maybe not right after treatment, but several months and several years later," he says.
This study found that 396 patients, even three years after treatment, had the same or fewer complications than those who were treated with standard external beam radiation therapy, Dr. Michalski says.
Standard radiation doses range between 66.6 Gy and 70 Gy, says Dr. Michalski. One hundred eleven patients received 68.4 Gy, 274 patients received 73.8 Gy.
Only one patient treated to 68.4 Gy suffered a grade-three complication (a complication that requires hospitalization, surgery or medical intervention for six months or longer). "That compares to the 18 we would have expected to see with standard external beam radiation therapy," says Dr. Michalski.
Three patients treated to 73.8 Gy suffered a grade-three complication compared to an expected 42, Dr. Michalski adds.
The results haven't been fully analyzed for patients treated to 79.2 Gy. It looks like there is no increase in complication rates in this group either, says Dr. Michalski.
In addition, this study found that 3D-CRT can be done, and done well, in the community hospitals/centers not just at academic hospitals/facilities, notes Dr. Michalski. This study was conducted as a Radiation Therapy Oncology Group (RTOG) clinical trial at 40 institutions across the U.S. RTOG outlined very specific quality controls that needed to be met at the institutions, he says. Those quality controls are essential in treating with 3D-CRT Dr. Michalski says.
Dr. Michalski presented the data at the American Society for Therapeutic Radiology and Oncology annual meeting, October 25 in Boston, MA.
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