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.
