Short-Term Neoadjuvant Androgen Deprivation Therapy and External-Beam Radiotherapy for Locally Advanced Prostate Cancer: Long-Term Results of RTOG 8610

Roach, Mack; Bae, Kyounghwa; Speight, Joycelyn L.; Wolkov, Harvey B.; Rubin, P.; Lee, R. Jeffrey; Lawton, C.A.; Valicenti, Richard K.; Grignon, David J.; Pilepich, Miljenko V.

doi:10.1200/jco.2007.13.9881

Cited by 583 publications

(325 citation statements)

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“…[18][19][20] However, the timing of ADT after biochemical failure is more controversial. The NCCN has suggested deferring salvage hormonal therapy until documented metastatic or symptomatic disease.…”

Section: Discussionmentioning

confidence: 99%

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: 99%

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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“…17 The use of ADT in combination with radiotherapy has been shown to contribute to improved therapeutic outcomes in patients with localized prostate cancer. [18][19][20][21][22][23][24][25] According to the NCCN guidelines for prostate cancer risk, long-term ADT lasting 2-3 years is indicated for patients at high risk, whereas short-term ADT lasting 4-6 months can be considered for those at intermediate risk.…”

Section: Introductionmentioning

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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“…With the development of reversible forms of medical castration, indications for androgen deprivation have been expanded to include nonmetastatic disease. [2][3][4] The introduction of prostate-specific antigen (PSA) testing into clinical practice in the early 1990s provided an objective evaluation of the efficacy of definitive treatment; biochemical failure became an accepted end point. The ability to diagnose early treatment failure created a clinical dilemma.…”

mentioning

confidence: 99%

Intermittent Androgen Suppression for Rising PSA Level After Radiotherapy

Crook

O’Callaghan

Duncan

et al. 2013

Obstetrical &Amp; Gynecological Survey

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Short-Term Neoadjuvant Androgen Deprivation Therapy and External-Beam Radiotherapy for Locally Advanced Prostate Cancer: Long-Term Results of RTOG 8610

Abstract: The addition of 4 months of ADT to EBRT appears to have a dramatic impact on clinically meaningful end points in men with locally advanced disease with no statistically significant impact on the risk of fatal cardiac events.

Cited by 583 publications

References 28 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

Intermittent Androgen Suppression for Rising PSA Level After Radiotherapy

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