Ten-year outcomes for pathologic node-positive patients treated in RTOG 75-06

Purpose: This study was conducted to see what fraction of prostate cancer patients with biopsy-proven nodes are free of cancer 10 years after radiation treatment, Methods and Materials: RTOG protocol #75-06 included 90 patients with biopsy-proven pelvic nodal involvement treated with radiation. They have been continuously follow-up since treatment, When feasible, current prostate-specific antigen (PSA) levels have been solicited from patients clinically cancer-free (no evidence of disease, NED) at 10 years, to confirm cure, Results: The 10-year survival was 29%, the 10-year clinical NED survival 7%, PSA levels were obtained in 2 of 5 10-year clinical NED patients, they were both less than 0.8 ng/ml, The 2 proven cures were both clinical stage T-3, Gleason Score 6 and 8, and had 2 and 1 positive nodes, respectively, Multivariate analysis showed Gleason sum was significantly associated with clinical survival without disease, Conclusion: A small fraction of node-positive patients are cured at 10-year follow-up by radiation therapy (2 of 90 with PSA +3 of 90 by clinical endpoints), Innovative treatment programs should be directed at node-positive patients in an effort to improve the fraction cured. (C) 1998 Elsevier Science Inc.