Long-Term Failure Patterns and Survival in a Randomized Dose-Escalation Trial for Prostate Cancer. Who Dies of Disease?

Kuban, Deborah A.; Levy, Lawrence B.; Cheung, Min Rex; Lee, Andrew K.; Choi, Seungtaek; Frank, Steven J.; Pollack, Alan

doi:10.1016/j.ijrobp.2010.01.006

Cited by 225 publications

(125 citation statements)

References 14 publications

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“…16 The dose of RT is relevant because increased dose is more likely to improve local and biochemical control and has been demonstrated to alter the timing of PSA response, which could potentially impact the relevance of a short interval to biochemical failure. 25 Limitations in the current data include the retrospective analysis and the relatively few events. In addition, the duration of ADT can influence the timing of testosterone recovery, 26 which in turn may delay the rise of PSA, 27 thereby altering the prognostic significance of the interval to biochemical failure.…”

Section: Discussionmentioning

confidence: 98%

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

Kapadia

Olson

Sandler

et al. 2011

Cancer

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BACKGROUND:After external beam radiation therapy (EBRT) for prostate cancer, a short interval to biochemical failure of <18 months has been proposed as a surrogate for cause‐specific survival. Because EBRT dose influences biochemical failure, the authors investigated the interval to biochemical failure in a cohort of patients treated with dose‐escalated EBRT.METHODS:From 1998 to 2008, 710 patients were treated with EBRT (≥75 grays) ± androgen deprivation therapy (ADT) at the University of Michigan. Biochemical failure was defined using the Phoenix consensus definition (nadir + 2 ng/mL). A short interval to biochemical failure was defined as <18 months after completing radiotherapy and/or ADT. The associations between biochemical failure, the interval to biochemical failure, and clinical factors with cause‐specific survival (CSS) and overall survival (OS) were evaluated.RESULTS:There were 149 biochemical failures (21%), and short interval to biochemical failure accounted for 14% and 40% of biochemical failures in those with intermediate‐risk or high‐risk disease, respectively. Biochemical failure impacted CSS (P < .0001) but not OS (P = .36). However, a short interval to biochemical failure predicted decreased CSS (P < .0001; hazard ratio [HR], 5.6; 95% confidence interval [CI], 2.4‐13.0) and OS (P < .0001; HR, 4.8; 95% CI, 2.3‐10.3) when compared with a long interval to biochemical failure. The 8‐year OS was 78% without biochemical failure, compared with 87% with a long interval to biochemical failure (P = .1; HR, 0.7; 95% CI, 0.4‐1.1) and 38% with a short interval to biochemical failure (P < .0001; HR, 3.7; 95% CI, 2.3‐5.9). On multivariate analysis, a short interval to biochemical failure increased the risk of prostate cancer death (P < .0001; HR, 18.1; 95% CI, 8.4‐39) and all cause mortality (P = .0027; HR, 1.5; 95% CI, 1.2‐2.1), whereas a long interval to biochemical failure did not.CONCLUSIONS:The relation between the interval to biochemical failure, CSS, and OS was independently validated in patients treated with dose‐escalated EBRT. Further evaluation of the interval to biochemical failure as a surrogate endpoint is warranted. Cancer 2012. © 2011 American Cancer Society.

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Section: Discussionmentioning

confidence: 98%

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

Kapadia

Olson

Sandler

et al. 2011

Cancer

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“…Yoshioka et al reported the change from 2D-RT to 3D-CRT in patients treated between 1998 and 2006, during which the actuarial 5-year grade 2-3 late rectal bleeding rate decreased from 23% to 7%. 3 Meanwhile, around 2000, IMRT for prostate cancer began in Japan. Chiba Cancer Center, along with Kyoto University, should be recognized as pioneers in prostate IMRT in Japan.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic outcomes of neoadjuvant and concurrent androgen‐deprivation therapy and intensity‐modulated radiation therapy with gold marker implantation for intermediate‐risk and high‐risk prostate cancer

et al. 2015

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The 5-year distant metastasis-free survival rate was significantly lower for very high-risk patients than for intermediate-and high-risk patients (82.6% vs 99.4% and 96.5%, respectively; P < 0.01). The 5-year biochemical relapse-free survival rates significantly declined with increasing prostate cancer risk (P < 0.01), and were 95.9%, 87.2%, and 73.1% for the intermediate-risk, high-risk and very high-risk patients, respectively. Acute genitourinary and gastrointestinal toxicity grade !3 were not observed in any of the patients. Late grade 3 genitourinary toxicity occurred in 0.3% of patients. Conclusion: Combination androgen-deprivation therapy and 76-Gy intensity-modulated radiation therapy with gold marker implantation offers good therapeutic outcomes with few serious complications in patients with intermediate-and high-risk prostate cancer.

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“…However, whatever the technique and their degree of sophistication, quality assurance plays a major role in the planning and delivery of RT Randomised studies have shown that escalating the dose into the 74-80 Gy range leads to a significant improvement in 5-year biochemical disease-free survival [62][63][64][65]. In men with intermediate-or high-risk PCa there is also evidence to support an OS benefit from a nonrandomised but well conducted propensity matched retrospective analysis covering a total of 42,481 patients [66].…”

Section: Definitive Radiotherapymentioning

confidence: 99%

EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent

et al. 2017

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Long-Term Failure Patterns and Survival in a Randomized Dose-Escalation Trial for Prostate Cancer. Who Dies of Disease?

Cited by 225 publications

References 14 publications

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

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

Therapeutic outcomes of neoadjuvant and concurrent androgen‐deprivation therapy and intensity‐modulated radiation therapy with gold marker implantation for intermediate‐risk and high‐risk prostate cancer

EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent

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