PATTERNS OF CARE AND RTOG STUDIES IN PROSTATE-CANCER - LONG-TERM SURVIVAL, HAZARD RATE OBSERVATIONS, AND POSSIBILITIES OF CURE

Purpose: This study was undertaken to show the long-term survival and probability of cure of prostate cancer patients treated with external beam radiation in USA national surveys and in the prospective clinical trials of the RTOG. Methods and Materials: Two national patterns of c are surveys of patients treated in 1973 and 1978 are reported along wi th two RTOG prospective trials (7506 and 7706). Hazard rates represent the risk of death and are compared to the rate expected for a normal population. Results: For patients with Stage A cancers, the survival i s not different from the expected survival for any of the reported sur veys. The hazard rate for death does not significantly exceed the expe cted hazard rate out to 15 years. For patients with Stage B cancer, th ere is a decrease in survival below expected and hazard rates show a c ontinuing excess mortality as long as 15 years after treatment. For pa tients with Stage C cancers, there is a more rapid decrease in surviva l that then becomes parallel to the expected survival. Hazard rates in dicate there has been a return to expected mortality at 15 years. Conc lusion: These data make a strong argument for the long-term cure of pr ostate cancer by external beam radiation, and support the continued us e and study of radiation therapy as a curative modality in prostate ca ncer. No similar national data is available for any other method of ma nagement.