The ability to identify who has clinically significant prostate cancer
The ability to cure all patients with prostate cancer
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
Three-dimensional conformal technique and image guidance for radioactive source placement in the prostate gland
Biopsy Gleason score, age, weight, and height
Biopsy Gleason score, PSA level, clinical stage, and height
Biopsy Gleason score, age, height, and weight
Biopsy Gleason score, prostate-specific antigen (PSA) level, percentage of prostate biopsies, and clinical stage
Patient’s age, performance status, height, and weight
equal to the PSA value divided by the biopsy Gleason score.
equal to the number of cores sampled divided by 100.
not an important predictor of PSA failure-free survival after external beam radiation therapy.
not an important predictor of prostate cancer–specific mortality after external beam radiation therapy in low-risk patients.
able to identify the patients at higher risk of prostate cancer–specific mortality despite having low-risk disease.
a and b
(c) Local control is associated with a longer time to PSA nadir and lower nadir.
b and c
(b) Local control improves with higher radiation doses.
(a) It is an unimportant end point because it does not predict for survival.
It may occur anytime between 8 and 30 months after implant.
It is seen in 25% to 30% of prostate brachytherapy cases using permanent seed implant monotherapy.
The patient may be asymptomatic.
All of the above
It may be associated with a positive biopsy showing treatment effect.
PSA value, biopsy Gleason score, and clinical T stage
PSA value, biopsy Gleason score, and age
Patient’s age, performance status, and weight
Patient’s age, PSA level, and weight
Biopsy Gleason score, age, and weight
Less than 0.5 ng/mL
None of the above
Stable and not rising
Both a and b
Tell the patient that radiation therapy has not worked and discuss salvage prostatectomy and cryosurgery.
Tell the patient that the PSA value is still normal and not to worry.
Tell the patient that he likely has a recurrence and that rising PSA may indicate a distant component to the failure.
A nadir greater than 0.5 ng/mL means that treatment has failed.
Patients showing distant failure reach a nadir later.
Patients who are cured may take 24 to 30 months to reach a nadir.
An early nadir is good.
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 equal for all types of radiation treatment.
It is lower in patients with early disease because they receive lower doses of radiation.
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 higher with dose escalation protocols.
They are lower with particle beam therapy.
They are identifiable in the majority of treated patients.
Greater than 75 Gy
patients with favorable tumors (T1 or T2, 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.
patients with unfavorable tumors (T2b or T3, Gleason score of >7) and PSA levels less than 10.
patients with unfavorable tumors (T2b or T3, Gleason score of ≥7) and PSA levels greater than 4.
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