Completion time in prostate cancer treated with proton beam therapy: Do interruptions matter?
e17553 Background: The association between completion time of proton therapy(PT) in prostate cancer and biochemical control is unknown. Methods: We queried the multi-institutional, prospectively collected, proton collaborative group registry for prostate cases treated definitively with PT. Kaplan meier methodology was used for biochemical failure free (bFF) rates and multivariable regression analyses (MVA) were used to identify correlates of treatment interruptions (TI) and bF. Results: After exclusion, 2794 men with 693 low, 869 favorable intermediate, 627 unfavorable intermediate, and 605 high risk prostate cancers had available data. The median age was 68 years(40-92), 90% were white and 8% were black. Androgen deprivation therapy (ADT) was given to 676 patients, 312 treatments were hypofractionated, and median EQD2 dose = 75(74-86) GyE1.5. Kaplan-meier median follow-up was 79 months. In total 900 patients (32%) had at least one TI. Shorter treatments (HR = 0.95 per day, P < 0.01) and high risk (HR = 0.72, P < 0.04) cases were less likely to have Tis on MVA. There was no difference in 5-year bFF rate with (92.7) and without (93.1%) TIs. In a subset of only high risk patients treated with ADT (n = 385), the 5-year bFF was 83% without TIs and 75% with TIs (HR = 2.10, P = 0.06). This discrepancy was significant with multivariable binomial regression (HR = 2.36, P = 0.03), and the bF difference was greatest when > 5 treatment days were missed per receiver operating characteristic curve. Conclusions: Largely, there was no correlation between TIs and bF in prostate cancer treated with PT, however completion time may play a more significant role in high risk disease.