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Title: Clinically Significant Prostate Cancer Local Recurrence After Radiation Therapy Occurs at the Site of Primary Tumor: Magnetic Resonance Imaging and Step-Section Pathology Evidence

Abstract

Purpose: To determine whether prostate cancer local recurrence after radiation therapy (RT) occurs at the site of primary tumor by retrospectively comparing the tumor location on pre-RT and post-RT magnetic resonance imaging (MRI) and using step-section pathology after salvage radical prostatectomy (SRP) as the reference standard. Methods and Materials: Nine patients with localized prostate cancer were treated with intensity modulated RT (69-86.4 Gy), and had pre-RT and post-RT prostate MRI, biopsy-proven local recurrence, and SRP. The location and volume of lesions on pre-RT and post-RT MRI were correlated with step-section pathology findings. Tumor foci >0.2 cm{sup 3} and/or resulting in extraprostatic disease on pathology were considered clinically significant. Results: All nine significant tumor foci (one in each patient; volume range, 0.22-8.63 cm{sup 3}) were detected both on pre-RT and post-RT MRI and displayed strikingly similar appearances on pre-RT and post-RT MRI and step-section pathology. Two clinically insignificant tumor foci ({<=}0.06 cm{sup 3}) were not detected on imaging. The ratios between tumor volumes on pathology and on post-RT MRI ranged from 0.52 to 2.80. Conclusions: Our study provides a direct visual confirmation that clinically significant post-RT local recurrence occurs at the site of primary tumor. Our results are in agreement withmore » reported clinical and pathologic results and support the current practice of boosting the radiation dose within the primary tumor using imaging guidance. They also suggest that monitoring of primary tumor with pre-RT and post-RT MRI could lead to early detection of local recurrence amenable to salvage treatment.« less

Authors:
 [1];  [2];  [2];  [3];  [4];  [5];  [6]; ;  [4];  [7]
  1. Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States), E-mail: pucard@mskcc.org
  2. Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)
  3. (United States)
  4. Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)
  5. (Japan)
  6. Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)
  7. Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)
Publication Date:
OSTI Identifier:
21036199
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 69; Journal Issue: 1; Other Information: DOI: 10.1016/j.ijrobp.2007.03.065; PII: S0360-3016(07)00674-8; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BIOPSY; CARCINOMAS; NMR IMAGING; PATHOLOGY; PATIENTS; PROSTATE; RADIATION DOSES; RADIOTHERAPY

Citation Formats

Pucar, Darko, Hricak, Hedvig, Shukla-Dave, Amita, Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY, Kuroiwa, Kentaro, Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Drobnjak, Marija, Eastham, James, Scardino, Peter T., and Zelefsky, Michael J. Clinically Significant Prostate Cancer Local Recurrence After Radiation Therapy Occurs at the Site of Primary Tumor: Magnetic Resonance Imaging and Step-Section Pathology Evidence. United States: N. p., 2007. Web. doi:10.1016/j.ijrobp.2007.03.065.
Pucar, Darko, Hricak, Hedvig, Shukla-Dave, Amita, Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY, Kuroiwa, Kentaro, Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Drobnjak, Marija, Eastham, James, Scardino, Peter T., & Zelefsky, Michael J. Clinically Significant Prostate Cancer Local Recurrence After Radiation Therapy Occurs at the Site of Primary Tumor: Magnetic Resonance Imaging and Step-Section Pathology Evidence. United States. doi:10.1016/j.ijrobp.2007.03.065.
Pucar, Darko, Hricak, Hedvig, Shukla-Dave, Amita, Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY, Kuroiwa, Kentaro, Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Drobnjak, Marija, Eastham, James, Scardino, Peter T., and Zelefsky, Michael J. Sat . "Clinically Significant Prostate Cancer Local Recurrence After Radiation Therapy Occurs at the Site of Primary Tumor: Magnetic Resonance Imaging and Step-Section Pathology Evidence". United States. doi:10.1016/j.ijrobp.2007.03.065.
@article{osti_21036199,
title = {Clinically Significant Prostate Cancer Local Recurrence After Radiation Therapy Occurs at the Site of Primary Tumor: Magnetic Resonance Imaging and Step-Section Pathology Evidence},
author = {Pucar, Darko and Hricak, Hedvig and Shukla-Dave, Amita and Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY and Kuroiwa, Kentaro and Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka and Drobnjak, Marija and Eastham, James and Scardino, Peter T. and Zelefsky, Michael J.},
abstractNote = {Purpose: To determine whether prostate cancer local recurrence after radiation therapy (RT) occurs at the site of primary tumor by retrospectively comparing the tumor location on pre-RT and post-RT magnetic resonance imaging (MRI) and using step-section pathology after salvage radical prostatectomy (SRP) as the reference standard. Methods and Materials: Nine patients with localized prostate cancer were treated with intensity modulated RT (69-86.4 Gy), and had pre-RT and post-RT prostate MRI, biopsy-proven local recurrence, and SRP. The location and volume of lesions on pre-RT and post-RT MRI were correlated with step-section pathology findings. Tumor foci >0.2 cm{sup 3} and/or resulting in extraprostatic disease on pathology were considered clinically significant. Results: All nine significant tumor foci (one in each patient; volume range, 0.22-8.63 cm{sup 3}) were detected both on pre-RT and post-RT MRI and displayed strikingly similar appearances on pre-RT and post-RT MRI and step-section pathology. Two clinically insignificant tumor foci ({<=}0.06 cm{sup 3}) were not detected on imaging. The ratios between tumor volumes on pathology and on post-RT MRI ranged from 0.52 to 2.80. Conclusions: Our study provides a direct visual confirmation that clinically significant post-RT local recurrence occurs at the site of primary tumor. Our results are in agreement with reported clinical and pathologic results and support the current practice of boosting the radiation dose within the primary tumor using imaging guidance. They also suggest that monitoring of primary tumor with pre-RT and post-RT MRI could lead to early detection of local recurrence amenable to salvage treatment.},
doi = {10.1016/j.ijrobp.2007.03.065},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 1,
volume = 69,
place = {United States},
year = {Sat Sep 01 00:00:00 EDT 2007},
month = {Sat Sep 01 00:00:00 EDT 2007}
}