scholarly journals Interval to biochemical failure as a biomarker for cause-specific and overall survival after dose-escalated external beam radiation therapy for prostate cancer

Cancer ◽  
2011 ◽  
Vol 118 (8) ◽  
pp. 2059-2068 ◽  
Author(s):  
Nirav S. Kapadia ◽  
Karin Olson ◽  
Howard M. Sandler ◽  
Felix Y. Feng ◽  
Daniel A. Hamstra
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Radiation Therapy ◽  
External Beam Radiation Therapy ◽  
Biochemical Failure ◽  
External Beam Radiation ◽  
External Beam ◽  
Beam Radiation

Ten year treatment outcomes of radical prostatectomy vs external beam radiation therapy vs. brachytherapy for 1,503 patients with intermediate risk prostate cancer.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 47-47 ◽  
Author(s):  
Barry W. Goy ◽  
Margaret S. Soper ◽  
Raoul J. Burchette ◽  
Tangel C. Chang ◽  
Harry A. Cosmatos
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
External Beam Radiation Therapy ◽  
Biochemical Failure ◽  
External Beam Radiation ◽  
External Beam ◽  
Intermediate Risk ◽  
Beam Radiation ◽  
Risk Prostate Cancer ◽  
Iodine 125

47 Background: To compare 10-year treatment outcomes of RP (radical prostatectomy) vs EBRT (external beam radiation therapy) vs BT (brachytherapy) for patients with IRPC (intermediate risk prostate cancer). Methods: A retrospective analysis using propensity score matching was performed on 1,503 IRPC patients who underwent treatment from 2004 to 2007. 819 underwent RP, 574 underwent EBRT to a median dose of 75.3 Gray, and 110 underwent BT using iodine-125. Biochemical failure was defined by the AUA (American Urological Association) definition of PSA (prostate specific antigen) failure for RP patients, and the ASTRO-Phoenix definition (American Society of Therapeutic Radiology and Oncology) for the EBRT and BT patients. Results: Median follow up was 10 years for RP, 9.6 for EBRT, and 9.8 for BT (range 1-13.4 years). With RP 76.3% had Gleason score 7 vs 72.8% for EBRT vs 57.3% for BT, p = 0.0001. Median initial PSA was 7.4 for RP, 9.4 for EBRT, and 8.3 for BT, p < 0.0001. Neoadjuvant androgen deprivation therapy was given in 58.9% of EBRT patients vs 12.7% of BT vs 0.6% for RP, p < 0.0001. Only 14% of BT received supplemental external radiation. The 10-year FFBF (freedom from biochemical failure) was 82.0% for BT vs 58.0% for RP vs 58.8% for EBRT, p < 0.0001. Subset analysis of unfavorable IRPC patients showed a 10 year FFBF of 81.6% for BT vs 55.8% for RP vs 51.0% for EBRT, p < 0.0001. The 10-year freedom from salvage therapy was 89.5% for BT vs 64.0% for RP vs 73.4% for EBRT, p < 0.0001. There were no significant differences in distant metastases-free survival, prostate cancer-specific survival, or overall survival after adjusting for age. Multivariate analysis between pairwise groups with BT balanced by stabilized inverse probability of treatment weights showed that BT remained an independent predictor for improved FFBF, p = 0.049 for BT vs EBRT, and p < 0.0001 for BT vs RP. Conclusions: Brachytherapy using iodine-125 is a reasonable treatment option for IRPC patients. Although BT showed improved FFBF after propensity score matching, this did not impact overall survival.

Comparison of Neoadjuvant vs Concurrent/Adjuvant Androgen Deprivation in Men with High-risk Prostate Cancer Receiving Definitive Radiation Therapy

2017 ◽  
Vol 103 (4) ◽  
pp. 387-393
Author(s):  
Anna Lee ◽  
Daniel J. Becker ◽  
Ariel J. Lederman ◽  
Virginia W. Osborn ◽  
Meng S. Shao ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Overall Survival ◽  
Radiation Therapy ◽  
High Risk ◽  
External Beam Radiation Therapy ◽  
External Beam Radiation ◽  
External Beam ◽  
Beam Radiation ◽  
High Risk Prostate Cancer ◽  
Risk Prostate Cancer

Purpose It is unknown whether there is a benefit to starting androgen deprivation therapy (ADT) prior to rather than concurrently with definitive radiation therapy in men with high-risk prostate cancer. We studied the National Cancer Data Base to determine whether the timing of ADT impacts survival. Methods Men diagnosed with high-risk prostate adenocarcinoma who received external beam radiation therapy (EBRT) to a dose of 70-81 Gy along with ADT from 2004-2011 were included. Those who started ADT 42-90 days before EBRT were identified as having received neoadjuvant hormonal therapy (N-HT) and those who received ADT from 14 days before their radiation until 84 days after the start of EBRT were categorized as receiving concurrent/adjuvant treatment (C-HT). We used the log-rank test to compare Kaplan-Meier survival curves and multivariable Cox regression to assess the impact of covariables on overall survival (OS). Results Among 11,491 included patients, those receiving N-HT were 1 year older ( p<0.001) and more likely to have Gleason 8-10 disease ( p = 0.01) and cT3-4 disease ( p = 0.002). Men receiving N-HT had a 5-year and median OS of 80.6% and 111.4 months, respectively, compared to 78.3% and 108.9 months, respectively, in those receiving C-HT ( p = 0.03). This benefit remained significant on multivariable analysis (hazard ratio 0.86, 95% confidence interval 0.77-0.96, p = 0.008). Duration of ADT was not available to report. Conclusions External beam radiation therapy with N-HT was associated with improved overall survival compared to C-HT. This study is hypothesis-generating and further studies are needed to best qualify the sequencing of hormone therapy with the duration of treatment.

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