COMPARISON OF TREATMENT EFFICACY FOR PROSTATE CANCER

前列腺癌治疗效果比较

• 批准号: 6185452
• 负责人: PETER Christian ALBERTSEN
• 金额: $ 28.1万
• 依托单位: UNIVERSITY OF CONNECTICUT SCH OF MED/DNT
• 依托单位国家: 美国
• 财政年份: 1998
• 资助国家: 美国
• 起止时间: 1998-09-30 至 2003-09-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6185452
• 关键词: age difference; biopsy; clinical research; comorbidity; histology; human morbidity; human therapy evaluation; longitudinal human study; neoplasm /cancer radiation therapy; outcomes research; pathologic process; patient /disease registry; prostate neoplasms; prostate specific antigen; prostate surgery; racial /ethnic difference

Since the introduction of prostate specific antigen (PSA) testing in the late 1980's, the number of new cases of localized prostate cancer has risen dramatically. Controversy surrounds the treatment of this disease because no randomized trials clearly document the benefit of aggressive treatment versus conservative management. Our research goal is to obtain more accurate estimates of the treatment efficacy of radical surgery and radiation therapy by determining the need for secondary cancer therapy and the length of patient survival stratified by key variables known to impact survival. Using the Connecticut Tumor Registry (CTR) as a case finding tool, we propose to assemble a population-based cohort of over 4000 men diagnosed with localized prostate cancer during the period 1990-1992 and follow them prospectively to achieve the following specific aims: For men who received either radical surgery, radiation therapy or no immediate therapy as their primary therapy, we will (1) Determine the frequency and timing of secondary cancer therapies among men treated in community practices, (2) Determine the frequency and timing of serum PSA elevation among men treated in community practices, (3) Determine the ten year cause-specific and all-cause survival outcomes for men treated in community practices. All results will be stratified according to the following variables that are known to impact progression and survival: patient age, race, co-morbidities, diagnostic biopsy tumor histology estimated by the Gleason score, and tumor volume estimated by pre-biopsy PSA level. Using data collected from this cohort of patients, we will address the following questions: (1) How to do men undergoing radical surgery, radiation therapy or no immediate treatment differ according to age, race, comorbidities, diagnostic biopsy histology or pre-treatment PSA? (2) What is the relative risk of receiving secondary cancer therapy within ten years of initial treatment for men undergoing radical surgery, radiation therapy or no immediate treatment after controlling for patient age, race, co-morbidities, diagnostic biopsy histology or pre-treatment PSA? and (3) What is the relative ability of patient age, race, co-morbidities, diagnostic biopsy histology or pre-treatment PSA to predict disease progression, cause specific and all-cause survival? Since the CTR continually monitors the vital status of patients included in the registry, information available from this study will eventually permit 15 and 20 year all-cause and cause-specific survival analyses for the entire cohort.

自从在美国引入前列腺特异性抗原(PSA)检测以来 20世纪80年代末S，局限性前列腺癌的新发病例数量已经 戏剧性上升。围绕这种疾病的治疗存在争议。 因为没有一项随机试验清楚地证明了积极进取的好处 治疗与保守治疗。我们的研究目标是 获得对根治疗法疗效的更准确估计 通过确定二次手术和放射治疗的必要性 癌症治疗和患者生存时间的关键因素 已知的影响生存的变量。使用康涅狄格州肿瘤 登记处(CTR)作为病例查找工具，我们建议组装一个 4000多名被诊断为本地化疾病的男性的基于人口的队列 1990-1992年期间的前列腺癌及其随访 前瞻性地实现以下具体目标：对于 要么接受根治性手术，要么接受放疗，要么没有立即 作为他们的主要治疗方法，我们将(1)确定频率 社区治疗男性中二次癌症治疗的时机 实践，(2)确定血清PSA升高的频率和时间 在接受社区实践治疗的男性中，(3)确定十年 接受治疗的男性的特定原因和所有原因的生存结果 社区实践。所有结果将根据 以下是已知的影响疾病进展和生存的变量： 患者年龄、种族、合并症、诊断性活检肿瘤组织学 根据Gleason评分和活检前估计的肿瘤体积进行评估 PSA水平。 使用从这群患者中收集的数据，我们将解决 以下问题：(1)如何让接受根治性手术的男性， 放射治疗或不立即治疗因年龄不同而不同， 种族、合并症、诊断性活检组织学或治疗前PSA？ (2)接受二次癌症治疗的相对风险是多少？ 在接受根治性治疗的男性最初治疗的十年内 手术、放射治疗或控制后不立即治疗 对于患者的年龄、种族、合并症、诊断活检组织学或 治疗前PSA？(3)患者年龄的相对能力是什么？ 种族、合并症、诊断性活检组织学或治疗前PSA 预测疾病进展、特定原因和所有原因的存活率？ 由于CTR持续监测患者的生命状况，包括 在登记处，这项研究提供的信息最终将 允许进行15年和20年的全原因和特定原因生存分析 整个队列。