Phase III trial of androgen suppression using goserelin in unfavorable-prognosis carcinoma of the prostate treated with definitive radiotherapy: report of Radiation Therapy Oncology Group Protocol 85-31.

Pilepich, Miljenko V.; Caplan, Richard; Byhardt, Roger W.; Lawton, C.A.; Gallagher, M.J.; Mesic, J; Hanks, Gerald E.; Coughlin, Christopher T.; Porter, Arthur T.; Shipley, William U.; Grignon, David J.

doi:10.1200/jco.1997.15.3.1013

Cited by 566 publications

(238 citation statements)

References 20 publications

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“…Although the final choice of treatment modalities belonged to patients, many patients with locally advanced cancer underwent XRT in our series, as shown in Table 1. Since phase III studies with large cohorts demonstrated that combination therapy with radiation and hormone improved the survival of patients with locally advanced prostate cancer compared with radiation monotherapy, 14,15 we routinely used neoadjuvant LHRH analogue therapy prior to radiation therapy. Our patients received only 66 Gy of radiation, since conformal radiation is not available in our institute.…”

Section: Discussionmentioning

confidence: 99%

A 3-y prospective study of health-related and disease-specific quality of life in patients with nonmetastatic prostate cancer treated with radical prostatectomy or external beam radiotherapy

Yoshimura

Arai

Ichioka

et al. 2004

Prostate Cancer Prostatic Dis

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We assessed the longitudinal alteration of the quality of life (QOL) of patients with localized prostate cancer after radical prostatectomy or hormonoradiotherapy during 3-y follow-up. In addition, we examined the impact on QOL of initiation of second treatment after failure of primary treatment. In all, 135 patients with localized prostate cancer who underwent radical retropubic prostatectomy (RP) (N ¼ 84) or external beam radiotherapy with neoadjuvant hormone (XRT) (N ¼ 51) at our institute and who had a minimum follow-up of 3 y were included in this study. Data were collected prospectively, at baseline, at 3 months after treatment, at 1 y, and annually thereafter. QOL, generic and disease-targeted was evaluated using the European Organization for Research and Treatment of Cancer Prostate Cancer QOL Questionnaire, the Sapporo Medical University Sexual Function Questionnaire, the International Prostate Symptom Index Quality of Life Score and similar questions regarding bowel function. Repeated-measures ANOVA revealed significantly different patterns of alteration in the domains of QOL, with the exception of several domains, between the RP and XRT groups. Rapid decline of sexual function and increase in sexual bothersomeness were followed by slight amelioration throughout follow-up in the RP group, and did not change thereafter in the XRT group. Overall satisfaction with urinary condition significantly improved after treatment and that with bowel condition was stable during followup in both of the groups. Failure of primary treatment and initiation of salvage treatment had no impact on QOL. This prospective study revealed longitudinal alteration of QOL status of patients undergoing treatment for localized prostate cancer, but did not yield any conclusions regarding effect of treatment failure and second treatment on QOL due to small sample size. It should be noted that different instruments for assessment of QOL can generate different outcomes.

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Section: Discussionmentioning

confidence: 99%

A 3-y prospective study of health-related and disease-specific quality of life in patients with nonmetastatic prostate cancer treated with radical prostatectomy or external beam radiotherapy

Yoshimura

Arai

Ichioka

et al. 2004

Prostate Cancer Prostatic Dis

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“…As early as the 1960s, cytoreductive hormonal therapy was added to radiation therapy to reduce tumour burden and provide a more favourable geometry for external irradiation 57 . Recently, three separate randomized trials have shown the beneficial effects of combining androgen-ablation therapy with radiation, improving times of relapsefree and overall survival [58][59][60] ; also, the incorporation of androgen ablation before, during and after external-beam radiation has become the standard of care.…”

Section: Radiation Therapymentioning

confidence: 99%

A history of prostate cancer treatment

2002

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The increased incidence of prostate cancer has led to remarkable changes in diagnosis and treatment over the past century. What were the first ways in which prostate cancer was treated, and how did these evolve into the variety of therapeutic strategies from which patients have to choose today?In 1853, J. Adams, a surgeon at The London Hospital, described the first case of prostate cancer, which he discovered by histological examination 1 . Adams noted in his report that this condition was "a very rare disease". Remarkably, 150 years later, prostate cancer has become a significant health problem. In the United States, it is the most commonly diagnosed cancer in men, with 180,000 new cases and about 31,000 deaths occurring annually 2 . This dramatic increase in the number of prostate cancer cases can be attributed to several causes. First, prostate cancer was not differentiated from other types of urinary obstruction until the early 1900s. Second, the incidence of prostate cancer increases more rapidly with age than any other cancer type 2 . The number of cases has risen as the average life expectancy has increased over the past century. Third, the increased incidence seems to be, in some way, related to the 'Western' lifestyle: the incidence of clinical prostate cancer is significantly lower in Asian populations, compared with Western populations 3 , and it

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“…In addition, patients with Gleason 8 -10 tumors had statistically significant higher overall survival rates when treated with androgen ablation. 11 A similar randomized prospective trial by Bolla and colleagues in patients with predominantly clinical stage T3 disease also showed a significant survival benefit to a 3-y course of goserelin which began at the start of EBRT. 12 A third prospective trial open to both low-and high-risk patients by Laverdiere and colleagues 10 randomized patients undergoing EBRT into three groups: a control group with no hormonal manipulation, a group which underwent 3 months of combined androgen ablation prior to EBRT, and a third group which underwent androgen ablation 3 months before, during, and 6 months after EBRT.…”

Section: Discussionmentioning

confidence: 86%

“…Our combined EBRT þ BT protocol is outlined in Figure 1. Due to evidence that neoadjuvant hormonal deprivation enhances disease-free survival in EBRT for locally advanced prostate cancer, 11,12 all patients underwent 8 months of combined androgen ablation with an LHRH (luteinizing hormone releasing hormone) agonist (leuprolide) and oral antiandrogen (bicalutamide or flutamide). External beam therapy of 40 -45Gy over 6 weeks began 2 -3 months after initiation of androgen blockade.…”

Section: Brachytherapy Techniquesmentioning

confidence: 99%

Multimodality radiotherapy and androgen ablation in the treatment of clinically localized prostate cancer: early results in high risk patients

Coblentz

Bissonette

Williams

et al. 2002

Prostate Cancer Prostatic Dis

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In patients presenting with clinically localized prostate cancer, the risk of biochemical failure increases significantly with higher Gleason scores, prostate specific antigen (PSA) levels, and clinical stages. Current surgical and radiotherapeutic approaches appear to offer limited success in patients with highly adverse prognostic factors. In an attempt to improve on these outcomes, we have combined external beam radiotherapy (EBRT) with a brachytherapy (BT) boost and neo adjuvant and adjuvant androgen ablation in a population at significant risk of biochemical failure. Here we present early biochemical progression data for this approach. From October 1997 to July 1999, 72 men with a serum PSA 10 ng/ml or Gleason score 7 or clinical stage T2c (AJC/UICC 1992) underwent EBRT followed by palladium-103 BT. All patients underwent 8 months of combined androgen ablation with leuprolide and an oral antiandrogen beginning 3 months prior to initiation of EBRT. Patients were followed by PSA and digital rectal examination (DRE) at 3-month intervals and a chart review on all patients was carried out during July 2001. To allow comparisons to contemporary literature, Kaplan-Meier survival curves were generated utilizing three alternate definitions of biochemical recurrence: PSA > 0.2 ng/ml, PSA > 1.0 ng/ml, and the American Society for Therapeutic Radiology and Oncology (ASTRO) consensus definition of three consecutive rising PSAs. Our results indicate that when PSA > 0.2 ng/ml was used to define biochemical progression, 88% (95% CI 80 -97) of patients remained free of disease at 24 months. When PSA > 1.0 ng/ml was used, 97% (CI 92 -100) of patients remained disease free at 24 months. ASTRO criteria yielded 90% (CI 82 -98) recurrence-free survival at 24 months. In conclusion, this very early report indicates that in patients who are at increased risk of biochemical failure, EBRT with a BT boost in conjunction with short-term androgen ablation offers potentially superior biochemical disease-free survival to contemporary alternative approaches in the literature. Clearly, longer followup is required to confirm the durability of this approach.

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Phase III trial of androgen suppression using goserelin in unfavorable-prognosis carcinoma of the prostate treated with definitive radiotherapy: report of Radiation Therapy Oncology Group Protocol 85-31.

Cited by 566 publications

References 20 publications

A 3-y prospective study of health-related and disease-specific quality of life in patients with nonmetastatic prostate cancer treated with radical prostatectomy or external beam radiotherapy

A 3-y prospective study of health-related and disease-specific quality of life in patients with nonmetastatic prostate cancer treated with radical prostatectomy or external beam radiotherapy

A history of prostate cancer treatment

Multimodality radiotherapy and androgen ablation in the treatment of clinically localized prostate cancer: early results in high risk patients

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