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Mayo Clinic
researchers say they have developed a model based on Gleason
score, prostate specific antigen (PSA) level and tumor staging
that can help doctors determine when brachytherapy alone will
be sufficient in treating localized prostate cancer.
The researchers
reported in the journal Cancer that they studied 2,905 patients
with localized prostate cancer in an effort to see if doctors
could predict before treatment when the cancer was likely
to have spread to the seminal vesicle and/or lymph nodes.
In cases
where it has spread, brachytherapy -- the implanting of radioactive
seeds -- may not get all of the cancer, and the addition of
external beam radiation is necessary to insure total cancer
coverage.
The researchers
said they came up with three combinations of scores that would
suggest less than a 10 percent likelihood that the prostate
cancer had spread to the seminal vesicle and/or pelvic lymph
nodes.
- Patients
with tumors classified as T1c-T2a, Gleason scores of 2-6,
and a PSA of 16 or lower.
- Patients
with tumors classified as T1c-T2a, Gleason scores of 7-10,
and PSA of 4 or lower.
- Patients
with tumors classified as T2b-T2c, Gleason scores of 2-6,
and PSA of 6 or lower.
"Prostate
brachytherapy alone may be considered in these circumstances,
whereas the addition of external beam radiotherapy may be
reserved for patients with disease that is apt to extend beyond
the brachytherapy target" area, the researchers concluded.
Source:
Prostate Cancer
Week of August 4, 2002
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