Ryan Smith, MD
University of Pennsylvania Cancer Center
Last Modified: November 7, 2001
Presenter: L.L. Kestin
Presenter's Affiliation: William Beaumont Hospital
Type of Session: Scientific
The standard dose of radiation delivered in the treatment of prostate cancer has increased in recent years. This is being done with a paucity of data regarding long term toxicity. With increasing doses, it is important to limit the volume being treated. This study makes strides in defining the extent of SVs that need to be treated. As expected, with higher "classic" prognostic factors (high PSA, higher Gleason Score, higher T stage) comes a a higher involvement of the SVs. Regardless of the prognostic factors, the authors recommend treating, at the most, the proximal 2 cm of the SVs in patients with clinical T1-2 tumors. It should be noted, that also presented during this session, was a paper also looking into SV involvement (Davis, et al, Abstract #250). These authors reached the opposite conclusion, notably that the entire SVs should be treated in those patients at risk for SV involvement. In this study, however, a majority (75%) had stage T2b or higher tumors, and all had Gleason Score >6. In addition, the length of SVs was measured differently in terms of pathologic sectioning. This likely accounts for the discrepency, and the indiviaual patient should be considered when evaluating these data.
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