The ability to remove all uncertainty related to patient setup
The ability to deliver three-dimensional conformal radiation therapy with no risk of side effects
The ability to identify who has clinically significant prostate cancer
The ability to cure all patients with prostate cancer
Three-dimensional conformal technique and image guidance for radioactive source placement in the prostate gland
Biopsy Gleason score, age, weight, and height
Patient’s age, performance status, height, and weight
Biopsy Gleason score, PSA level, clinical stage, and height
Biopsy Gleason score, prostate-specific antigen (PSA) level, percentage of prostate biopsies, and clinical stage
Biopsy Gleason score, age, height, and weight
equal to the PSA value divided by the biopsy Gleason score.
not an important predictor of prostate cancer–specific mortality after external beam radiation therapy in low-risk patients.
not an important predictor of PSA failure-free survival after external beam radiation therapy.
equal to the number of cores sampled divided by 100.
able to identify the patients at higher risk of prostate cancer–specific mortality despite having low-risk disease.
a and b
(a) It is an unimportant end point because it does not predict for survival.
(c) Local control is associated with a longer time to PSA nadir and lower nadir.
(b) Local control improves with higher radiation doses.
b and c
It is seen in 25% to 30% of prostate brachytherapy cases using permanent seed implant monotherapy.
The patient may be asymptomatic.
It may occur anytime between 8 and 30 months after implant.
All of the above
It may be associated with a positive biopsy showing treatment effect.
Biopsy Gleason score, age, and weight
PSA value, biopsy Gleason score, and clinical T stage
PSA value, biopsy Gleason score, and age
Patient’s age, PSA level, and weight
Patient’s age, performance status, and weight
Stable and not rising
None of the above
Less than 0.5 ng/mL
Both a and b
Tell the patient that the PSA value is still normal and not to worry.
Tell the patient that radiation therapy has not worked and discuss salvage prostatectomy and cryosurgery.
Tell the patient that he likely has a recurrence and that rising PSA may indicate a distant component to the failure.
Patients showing distant failure reach a nadir later.
A nadir greater than 0.5 ng/mL means that treatment has failed.
Patients who are cured may take 24 to 30 months to reach a nadir.
An early nadir is good.
It is equal for all types of radiation treatment.
It is lower in patients with early disease because they receive lower doses of radiation.
It is associated with treatment technique and dose of radiation.
It is an unimportant end point because it does not predict for survival.
It is available in almost all radiation centers.
It is a form of particle therapy.
It is unassociated with improved outcomes in prostate cancer patients.
It is more accurate than conventional radiation.
They are related to treatment technique, type of radiation used, and total dose given.
They are lower with particle beam therapy.
They are higher with dose escalation protocols.
They are identifiable in the majority of treated patients.
Greater than 75 Gy
patients with unfavorable tumors (T2b or T3, Gleason score of ≥7) and PSA levels greater than 4.
patients with favorable tumors (T1 or T2, Gleason score of <7) and PSA levels less than 10.
patients with unfavorable tumors (T2b or T3, Gleason score of >7) and PSA levels less than 10.
patients with favorable tumors (T1 or T2, Gleason score of <7) and PSA levels greater than 20.
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