574 PRIOR DEFINITIVE LOCAL THERAPY DECREASES LOCAL SYMPTOMS/COMPLICATIONS AMONG MEN WITH ADVANCED/METASTATIC PROSTATE CANCER: RESULTS FROM A PHASE III PROSPECTIVE RANDOMIZED TRIAL

This chapter summarizes the findings of a landmark randomized trial comparing total androgen deprivation in the form of bilateral orchiectomy plus the antiandrogen flutamide to bilateral orchiectomy alone. The study found no survival benefit but did find increased side effects from the addition of an antiandrogen.

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Patients’ self-assessment versus investigators’ evaluation in a phase III trial in non-castrate metastatic prostate cancer (GETUG-AFU 15)

European Journal of Cancer ◽

10.1016/j.ejca.2013.11.034 ◽

2014 ◽

Vol 50 (5) ◽

pp. 953-962 ◽

Cited By ~ 42

Author(s):

Gwenaelle Gravis ◽

Patricia Marino ◽

Florence Joly ◽

Stéphane Oudard ◽

Franck Priou ◽

...

Keyword(s):

Prostate Cancer ◽

Metastatic Prostate Cancer ◽

Phase Iii ◽

Self Assessment ◽

Phase Iii Trial

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Dose-Response in Radiotherapy for Localized Prostate Cancer: Results of the Dutch Multicenter Randomized Phase III Trial Comparing 68 Gy of Radiotherapy With 78 Gy

Journal of Clinical Oncology ◽

10.1200/jco.2005.05.2530 ◽

2006 ◽

Vol 24 (13) ◽

pp. 1990-1996 ◽

Cited By ~ 688

Author(s):

Stephanie T.H. Peeters ◽

Wilma D. Heemsbergen ◽

Peter C.M. Koper ◽

Wim L.J. van Putten ◽

Annerie Slot ◽

...

Keyword(s):

Prostate Cancer ◽

Randomized Trial ◽

Cancer Patients ◽

Radiation Therapy Oncology Group ◽

Three Dimensional ◽

Conformal Radiotherapy ◽

Phase Iii ◽

Clinical Failure ◽

Multicenter Randomized Trial ◽

Genitourinary Toxicity

Purpose To determine whether a dose of 78 Gy improves outcome compared with a conventional dose of 68 Gy for prostate cancer patients treated with three-dimensional conformal radiotherapy. Patients and Methods Between June 1997 and February 2003, stage T1b-4 prostate cancer patients were enrolled onto a multicenter randomized trial comparing 68 Gy with 78 Gy. Patients were stratified by institution, age, (neo)adjuvant hormonal therapy (HT), and treatment group. Four treatment groups (with specific radiation volumes) were defined based on the probability of seminal vesicle involvement. The primary end point was freedom from failure (FFF). Failure was defined as clinical failure or biochemical failure, according to the American Society of Therapeutic Radiation Oncology definition. Other end points were freedom from clinical failure (FFCF), overall survival (OS), and toxicity. Results Median follow-up time was 51 months. Of the 669 enrolled patients, 664 were included in the analysis. HT was prescribed for 143 patients. FFF was significantly better in the 78-Gy arm compared with the 68-Gy arm (5-year FFF rate, 64% v 54%, respectively), with an adjusted hazard ratio of 0.74 (P = .02). No significant differences in FFCF or OS were seen between the treatment arms. There was no difference in late genitourinary toxicity of Radiation Therapy Oncology Group and European Organisation for Research and Treatment of Cancer grade 2 or more and a slightly higher nonsignificant incidence of late gastrointestinal toxicity of grade 2 or more. Conclusion This multicenter randomized trial shows a significantly improved FFF in prostate cancer patients treated with a higher dose of radiotherapy.

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The role of radical prostatectomy for the treatment of metastatic prostate cancer: a systematic review and meta-analysis

Bioscience Reports ◽

10.1042/bsr20171379 ◽

2018 ◽

Vol 38 (1) ◽

Cited By ~ 5

Author(s):

Yi Wang ◽

Zhiqiang Qin ◽

Yamin Wang ◽

Chen Chen ◽

Yichun Wang ◽

...

Keyword(s):

Prostate Cancer ◽

Radical Prostatectomy ◽

Gleason Score ◽

Metastatic Prostate Cancer ◽

Meta Analysis ◽

Local Therapy ◽

Quality Data ◽

N Stage ◽

High Level

The recommended therapy by EAU guidelines for metastatic prostate cancer (mPCa) is androgen deprivation therapy (ADT) with or without chemotherapy. The role of radical prostatectomy (RP) in the treatment of mPCa is still controversial. Hence, a meta-analysis was conducted by comprehensively searching the databases PubMed, EMBASE and Web of Science for the relevant studies published before September 1st, 2017. Our results successfully shed light on the relationship that RP for mPCa was associated with decreased cancer-specific mortality (CSM) (pooled HR = 0.41, 95%CI = 0.36–0.47) and enhanced overall survival (OS) (pooled HR = 0.49, 95%CI = 0.44–0.55). Subsequent stratified analysis demonstrated that no matter how RP compared with no local therapy (NLT) or radiation therapy (RT), it was linked to a lower CSM (pooled HR = 0.36, 95%CI = 0.30–0.43 and pooled HR = 0.56, 95%CI 0.43–0.73, respectively) and a higher OS (pooled HR = 0.49, 95%CI = 0.44–0.56 and pooled HR = 0.46, 95%CI 0.33–0.65, separately). When comparing different levels of Gleason score, M-stage or N-stage, our results indicated that high level of Gleason score, M-stage or N-stage was associated with increased CSM. In summary, the outcomes of the present meta-analysis demonstrated that RP for mPCa was correlated with decreased CSM and enhanced OS in eligible patients of involved studies. In addition, patients with less aggressive tumors and good general health seemed to benefit the most. Moreover, no matter compared with NLT or RT, RP showed significant superiority in OS or CSM. Upcoming prospective randomized controlled trials were warranted to provide more high-quality data.

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