Postoperative nomogram predicting the 9-year probability of prostate cancer recurrence after permanent prostate brachytherapy using radiation dose as a prognostic variable Journal Article
| Authors: | Potters, L.; Roach, M. 3rd; Davis, B. J.; Stock, R. G.; Ciezki, J. P.; Zelefsky, M. J.; Stone, N. N.; Fearn, P. A.; Yu, C.; Shinohara, K.; Kattan, M. W. |
| Article Title: | Postoperative nomogram predicting the 9-year probability of prostate cancer recurrence after permanent prostate brachytherapy using radiation dose as a prognostic variable |
| Abstract: | Purpose: To report a multi-institutional outcomes study on permanent prostate brachytherapy (PPB) to 9 years that includes postimplant dosimetry, to develop a postimplant nomogram predicting biochemical freedom from recurrence. Methods and Materials: Cox regression analysis was used to model the clinical information for 5,931 patients who underwent PPB for clinically localized prostate cancer from six centers. The model was validated against the dataset using bootstrapping. Disease progression was determined using the Phoenix definition. The biological equivalent dose was calculated from the minimum dose to 90% of the prostate volume (D90) and external-beam radiotherapy dose using an α/β of 2. Results: The 9-year biochemical freedom from recurrence probability for the modeling set was 77% (95% confidence interval, 73-81%). In the model, prostate-specific antigen, Gleason sum, isotope, external beam radiation, year of treatment, and D90 were associated with recurrence (each p < 0.05), whereas clinical stage was not. The concordance index of the model was 0.710. Conclusion: A predictive model for a postimplant nomogram for prostate cancer recurrence at 9-years after PPB has been developed and validated from a large multi-institutional database. This study also demonstrates the significance of implant dosimetry for predicting outcome. Unique to predictive models, these nomograms may be used a priori to calculate a D90 that likely achieves a desired outcome with further validation. Thus, a personalized dose prescription can potentially be calculated for each patient. © 2010 Elsevier Inc. All rights reserved. |
| Keywords: | adult; controlled study; aged; aged, 80 and over; middle aged; major clinical study; cancer localization; cancer recurrence; postoperative period; cancer growth; validation process; cancer radiotherapy; radiation dose; cancer staging; isotopes; prostate specific antigen; neoplasm recurrence, local; radiotherapy dosage; radiotherapy; oncology; prediction; dose-response relationship, radiation; prostate cancer; confidence interval; gleason score; prostate-specific antigen; prostatic neoplasms; iodine 125; dosimetry; probability; nomograms; disease progression; brachytherapy; outcome; external beam radiotherapy; regression analysis; medical computing; nomogram; prostate cancers; palladium 103; data sets; dosimeters; prostate brachytherapy; predictive models; localized prostate cancer; concordance index; apriori; clinical information; cox regression analysis; dose prescription; equivalent dose; external beam radiation; institutional outcomes; postimplant dosimetry; predicting outcomes; prognostic variables; prostate cancer recurrence; prostate volume; recurrence probability; predictive control systems |
| Journal Title: | International Journal of Radiation Oncology, Biology, Physics |
| Volume: | 76 |
| Issue: | 4 |
| ISSN: | 0360-3016 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2010-03-15 |
| Start Page: | 1061 |
| End Page: | 1065 |
| Language: | English |
| DOI: | 10.1016/j.ijrobp.2009.03.031 |
| PUBMED: | 19540064 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 5" - "Export Date: 20 April 2011" - "CODEN: IOBPD" - "Source: Scopus" |
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