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Title: Pathological Predictors for Site of Local Recurrence After Radiotherapy for Prostate Cancer

Abstract

Purpose: Rational design of targeted radiotherapy (RT) in prostate cancer (Pca) hinges on a better understanding of spatial patterns of recurrence. We sought to identify pathological factors predictive for site of local recurrence (LR) after external beam RT. Methods and Materials: Prospective databases were reviewed to identify men with LR after RT from 1997 through 2009. Patients with biochemical failure and biopsy-confirmed Pca more than 2 years after RT were evaluated. Prediction for site of recurrence based on the following pretreatment factors was determined on independent and cluster-sextant basis: presence of malignancy, dominant vs. nondominant percentage core length (PCL) involvement, PCL {>=} or <40%, and Gleason score. Sites of dominant PCL were defined as sextants with peak PCL involvement minus 10%, and >5% for each patient. Results: Forty-one patients with low-intermediate risk Pca constituted the study cohort. Median time to biopsy after RT was 51 months (range, 24-145). Of 246 sextants, 74 were involved with tumor at baseline. When sextants are treated as independent observations the presence of malignancy (77% vs. 22%, p = 0.0001), dominant PCL (90% vs. 46%, p = 0.0001), and PCL {>=}40% (89% vs. 68 %, p = 0.04) were found to be significant predictors formore » LR, although PCL {>=}40% did not retain statistical significance if sextants were considered correlated. The vast majority of patients (95%) recurred at the original site of dominant PCL or PCL {>=}40%, and 44% also recurred in regions of nondominant PCL <40% (n = 8) and/or benign sampling (n = 14) at baseline. Conclusions: LR after RT predominantly occurs in regions bearing higher histological tumor burden but are not isolated to these sites. Our data highlights the value of spatially resolved baseline pathological sampling and may assist in the design of clinical trials tailoring RT dose prescriptions to subregions of the prostate gland.« less

Authors:
 [1];  [2];  [3];  [2];  [4];  [3];  [2];  [3];  [2];  [2]; ; ; ;  [1];  [2]; ;  [1];  [2]; ;  [1] more »;  [2];  [1];  [2] « less
  1. Department of Radiation Oncology, University of Toronto, Toronto (Canada)
  2. (Canada)
  3. Princess Margaret Hospital, University Health Network, Toronto (Canada)
  4. Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto (Canada)
Publication Date:
OSTI Identifier:
22056126
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 82; Journal Issue: 3; Other Information: Copyright (c) 2012 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; CLINICAL TRIALS; FAILURES; FORECASTING; HAZARDS; MEN; NEOPLASMS; PATIENTS; PROSTATE; RADIATION DOSES; RADIOTHERAPY

Citation Formats

Chopra, Supriya, Princess Margaret Hospital, University Health Network, Toronto, Toi, Ants, Department of Medical Imaging, University of Toronto, Toronto, Taback, Nathan, Evans, Andrew, Department of Pathology, University of Toronto, Toronto, Haider, Masoom A., Department of Medical Imaging, University of Toronto, Toronto, Sunnybrook Health Sciences Center, Toronto, Milosevic, Michael, Bristow, Robert G., Chung, Peter, Bayley, Andrew, Princess Margaret Hospital, University Health Network, Toronto, Morton, Gerard, Vesprini, Danny, Odette Cancer Center, Sunnybrook Health Sciences Center, Toronto, Warde, Padraig, Catton, Charles, Princess Margaret Hospital, University Health Network, Toronto, Menard, Cynthia, E-mail: Cynthia.Menard@rmp.uhn.on.ca, and Princess Margaret Hospital, University Health Network, Toronto. Pathological Predictors for Site of Local Recurrence After Radiotherapy for Prostate Cancer. United States: N. p., 2012. Web. doi:10.1016/J.IJROBP.2011.05.035.
Chopra, Supriya, Princess Margaret Hospital, University Health Network, Toronto, Toi, Ants, Department of Medical Imaging, University of Toronto, Toronto, Taback, Nathan, Evans, Andrew, Department of Pathology, University of Toronto, Toronto, Haider, Masoom A., Department of Medical Imaging, University of Toronto, Toronto, Sunnybrook Health Sciences Center, Toronto, Milosevic, Michael, Bristow, Robert G., Chung, Peter, Bayley, Andrew, Princess Margaret Hospital, University Health Network, Toronto, Morton, Gerard, Vesprini, Danny, Odette Cancer Center, Sunnybrook Health Sciences Center, Toronto, Warde, Padraig, Catton, Charles, Princess Margaret Hospital, University Health Network, Toronto, Menard, Cynthia, E-mail: Cynthia.Menard@rmp.uhn.on.ca, & Princess Margaret Hospital, University Health Network, Toronto. Pathological Predictors for Site of Local Recurrence After Radiotherapy for Prostate Cancer. United States. doi:10.1016/J.IJROBP.2011.05.035.
Chopra, Supriya, Princess Margaret Hospital, University Health Network, Toronto, Toi, Ants, Department of Medical Imaging, University of Toronto, Toronto, Taback, Nathan, Evans, Andrew, Department of Pathology, University of Toronto, Toronto, Haider, Masoom A., Department of Medical Imaging, University of Toronto, Toronto, Sunnybrook Health Sciences Center, Toronto, Milosevic, Michael, Bristow, Robert G., Chung, Peter, Bayley, Andrew, Princess Margaret Hospital, University Health Network, Toronto, Morton, Gerard, Vesprini, Danny, Odette Cancer Center, Sunnybrook Health Sciences Center, Toronto, Warde, Padraig, Catton, Charles, Princess Margaret Hospital, University Health Network, Toronto, Menard, Cynthia, E-mail: Cynthia.Menard@rmp.uhn.on.ca, and Princess Margaret Hospital, University Health Network, Toronto. Thu . "Pathological Predictors for Site of Local Recurrence After Radiotherapy for Prostate Cancer". United States. doi:10.1016/J.IJROBP.2011.05.035.
@article{osti_22056126,
title = {Pathological Predictors for Site of Local Recurrence After Radiotherapy for Prostate Cancer},
author = {Chopra, Supriya and Princess Margaret Hospital, University Health Network, Toronto and Toi, Ants and Department of Medical Imaging, University of Toronto, Toronto and Taback, Nathan and Evans, Andrew and Department of Pathology, University of Toronto, Toronto and Haider, Masoom A. and Department of Medical Imaging, University of Toronto, Toronto and Sunnybrook Health Sciences Center, Toronto and Milosevic, Michael and Bristow, Robert G. and Chung, Peter and Bayley, Andrew and Princess Margaret Hospital, University Health Network, Toronto and Morton, Gerard and Vesprini, Danny and Odette Cancer Center, Sunnybrook Health Sciences Center, Toronto and Warde, Padraig and Catton, Charles and Princess Margaret Hospital, University Health Network, Toronto and Menard, Cynthia, E-mail: Cynthia.Menard@rmp.uhn.on.ca and Princess Margaret Hospital, University Health Network, Toronto},
abstractNote = {Purpose: Rational design of targeted radiotherapy (RT) in prostate cancer (Pca) hinges on a better understanding of spatial patterns of recurrence. We sought to identify pathological factors predictive for site of local recurrence (LR) after external beam RT. Methods and Materials: Prospective databases were reviewed to identify men with LR after RT from 1997 through 2009. Patients with biochemical failure and biopsy-confirmed Pca more than 2 years after RT were evaluated. Prediction for site of recurrence based on the following pretreatment factors was determined on independent and cluster-sextant basis: presence of malignancy, dominant vs. nondominant percentage core length (PCL) involvement, PCL {>=} or <40%, and Gleason score. Sites of dominant PCL were defined as sextants with peak PCL involvement minus 10%, and >5% for each patient. Results: Forty-one patients with low-intermediate risk Pca constituted the study cohort. Median time to biopsy after RT was 51 months (range, 24-145). Of 246 sextants, 74 were involved with tumor at baseline. When sextants are treated as independent observations the presence of malignancy (77% vs. 22%, p = 0.0001), dominant PCL (90% vs. 46%, p = 0.0001), and PCL {>=}40% (89% vs. 68 %, p = 0.04) were found to be significant predictors for LR, although PCL {>=}40% did not retain statistical significance if sextants were considered correlated. The vast majority of patients (95%) recurred at the original site of dominant PCL or PCL {>=}40%, and 44% also recurred in regions of nondominant PCL <40% (n = 8) and/or benign sampling (n = 14) at baseline. Conclusions: LR after RT predominantly occurs in regions bearing higher histological tumor burden but are not isolated to these sites. Our data highlights the value of spatially resolved baseline pathological sampling and may assist in the design of clinical trials tailoring RT dose prescriptions to subregions of the prostate gland.},
doi = {10.1016/J.IJROBP.2011.05.035},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 3,
volume = 82,
place = {United States},
year = {Thu Mar 01 00:00:00 EST 2012},
month = {Thu Mar 01 00:00:00 EST 2012}
}