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Cure Rates for Prostate Cancer


External beam
More external beam (older data with low dose radiation)
3D conformal external or IMRT
More external beam (high dose, conformal)
External 3D nomogram (Kattan nomogram)new nomogram for external
Risk of metastases after external (Kattan),
Seeds
Surgery
Surgery (Graefen nomogram)
Watchful waiting (no treatment)
Memorial Sloan-Kettering Calculator
surgery , external and seeds compared go here

Also note that after radiation the PSA should decline slowly over a period of many months and then stabilize ideally at a level of less than one. If after a period it starts rising again... then by definition the patient has relapsed. In many cases the patient does well without further treatment even if the treatment did not cure him. For a discussion of this subject go here.

National survival data for prostate cancer from SEER showed a 96% adjusted 5 year survival rate (100% local/ regional and 34% distant) the NCDB data relative survival for all was 85% and by stages I-IV was 92%, 94% 91% and 48% and NCDB observed survival by stages I-IV was 73%, 80%, 81%, 39%.

 

Recent data shows that even men who have bone mets at the time of diagnosis live over 5 years (go here).


Some studies are using proton beam, but the early results do not appear better than modern high dose 3D conformal irradiation as noted in the recent publication from Loma Linda:
Conformal proton beam therapy of prostate cancer--update on the Loma Linda University medical center experience.
Rossi CJ. Loma Linda University Medical Center, USA. Strahlenther Onkol. 1999 Jun;175 Suppl 2:82-4.

643 patients with localized prostate cancer were treated with protons alone or a combination of protons and photons. All treatment was planned on a 3-D planning system and all received doses between 74-75 CGE (Cobalt Gray Equivalent) at 1.8-2.0 CGE/day. Patients were evaluated for toxicity and response to treatment. RESULTS: Five-year actuarial clinical and biochemical disease-free survival rates for the entire group are 89 and 79% respectively. A statistically significant difference in biochemical disease-free survival was seen between patients in the "early" (T1b-2b, PSA < 15) and "advanced" (T1b-2b, PSA > 15 or T2c-T4, PSA < 50) subgroups (89% vs. 68% at 4.5 years, p < 0.001). A PSA nadir of less than 0.51 ng/ml predicted for the highest chance of freedom from biochemical recurrence. Minimal radiation proctitis was seen in 21% of patients; toxicity of greater severity was seen in less than 1%. CONCLUSIONS: Conformal proton beams therapy produced high rates of response and minimal toxicity. A phase III dose escalation trial is in progress to help define the optimum radiation dose for the treatment of early stage prostate cancer.

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