ASCENDE-RT: An Analysis of Health-Related Quality of Life for a Randomized Trial Comparing Low-Dose-Rate Brachytherapy Boost With Dose-Escalated External Beam Boost for High- and Intermediate-Risk Prostate Cancer

Rodda, S.; Morris, William; Hamm, Jeremy; Duncan, Graeme

doi:10.1016/j.ijrobp.2017.02.027

Cited by 89 publications

(51 citation statements)

References 24 publications

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“…noninterpretable (1-4), severe (5-7), moderate (8)(9)(10)(11), mild to moderate (12)(13)(14)(15)(16), mild (17)(18)(19)(20)(21), and normal erectile function (22-25). The noninterpretable category corresponds to patients who have fully completed the assessment but whose score is equal to or lower than 4.…”

Section: Ipss and International Index Of Erectile Function Assessmentmentioning

confidence: 99%

A Multicenter Phase 2 study of Hypofractionated Stereostatic Boost in Intermediate Risk Prostate Carcinoma: A 5-Year Analysis of the CKNO-PRO Trial

Pasquier

Peiffert

Nickers

et al. 2020

International Journal of Radiation Oncology*Biology*Physics

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Section: Ipss and International Index Of Erectile Function Assessmentmentioning

confidence: 99%

A Multicenter Phase 2 study of Hypofractionated Stereostatic Boost in Intermediate Risk Prostate Carcinoma: A 5-Year Analysis of the CKNO-PRO Trial

Pasquier

Peiffert

Nickers

et al. 2020

International Journal of Radiation Oncology*Biology*Physics

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“…Of note, 43% of the RP patients received some form of postoperative RT, while only 11.3% received adjuvant systemic therapy. While there was a clear benefit of EBRT+brachytherapy+ADT over RP and EBRT+ADT in this singular study, it potentially came at the expense of increased side‐effects, as was seen in the Androgen Suppression Combined with Elective Nodal and Dose Escalated Radiation Therapy (ASCENDE‐RT) trial (5 year cumulative incidence of ≥Grade 3 genitourinary toxicity of 18.4% vs 5.2%) .…”

Section: Discussionmentioning

confidence: 77%

“…Log-rank P = 0.29 at the expense of increased side-effects, as was seen in the Androgen Suppression Combined with Elective Nodal and Dose Escalated Radiation Therapy (ASCENDE-RT) trial (5 year cumulative incidence of ≥Grade 3 genitourinary toxicity of 18.4% vs 5.2%) [26].…”

mentioning

confidence: 91%

Radical prostatectomy or radiotherapy for high‐ and very high‐risk prostate cancer: a multidisciplinary prostate cancer clinic experience of patients eligible for either treatment

et al. 2019

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Objective To compare radical prostatectomy (RP) vs radiotherapy (RT) with androgen‐deprivation therapy (ADT) in the setting of patients with high‐risk and very high‐risk (VHR) prostate cancer who were deemed eligible for either therapy and made a treatment choice after consultation in a multidisciplinary prostate cancer clinic (MDPCC), and to compare the MDPCC patients’ outcomes to a matched Surveillance, Epidemiology and End Results (SEER) cohort. Patients and methods Prospectively collected, retrospective study comparing patients who underwent RP (231 patients) vs RT+ADT (73) from 2004 to 2013. Biochemical recurrence (BCR), local recurrence, distant metastasis failure, and overall survival (OS) were calculated for each treatment group overall and according to National Comprehensive Cancer Network risk strata. A propensity score matched comparison with a SEER cohort was performed for OS. Results There was no difference in local recurrence (hazard ratio [HR] 2.7, 95% confidence interval [CI] 1.0–7.9; P = 0.06), distant metastasis failure (HR 2.5, 95% CI 0.8–7.8; P = 0.1) and OS (HR 1.35, 95% CI 0.4–4.8; P = 0.6) between patients undergoing RP vs RT+ADT. Patients treated via the MDPCC survived on average 16.9 months (95% CI 13.1–20.8) longer than those in the matched SEER cohort. Conclusions Long‐term outcomes appear similar amongst patients with high‐risk and VHR prostate cancer deemed eligible for either RP or RT, and treated after consultation in a MDPCC. Outcomes of the MDPCC patients were superior to those of the matched SEER cohort.

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“…There was also a trend toward increased gastrointestinal toxicity with the brachytherapy boost, 8 vs. 3% (p = 0.12) (42). However, at the 6-years follow-up time point, health-related quality of life was similar between the two groups in most domains with the exception that physical and urinary function scales were lower in the LDR arm (43). Regardless, the increased toxicity observed in the combined EBRT plus LDR boost arm ASCENDE-RT highlights the importance of careful patient selection and diligent treatment planning as well as early intervention with symptom management as needed for these patients.…”

Section: Hdr Vs Ldr Boostmentioning

confidence: 89%

A Brief Review of Low-Dose Rate (LDR) and High-Dose Rate (HDR) Brachytherapy Boost for High-Risk Prostate

et al. 2019

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For patients with unfavorable or high-risk prostate cancer, dose escalated radiation therapy leads to improved progression free survival but attempts to deliver increased dose by external beam radiation therapy (EBRT) alone can be limited by late toxicities to nearby genitourinary and gastrointestinal organs at risk. Brachytherapy is a method to deliver dose escalation in conjunction with EBRT with a potentially improved late toxicity profile and improved prostate cancer related outcomes. At least three randomized controlled trials have demonstrated improved biochemical control with the addition of either low-dose rate (LDR) or high-dose rate (HDR) brachytherapy to EBRT, although only ASCENDE-RT compared brachytherapy to dose-escalated EBRT but did report an over 50% improvement in biochemical failure with a LDR boost. Multiple single institution and comparative research series also support the use of a brachytherapy boost in the DE-EBRT era and demonstrate excellent prostate cancer specific outcomes. Despite improved oncologic outcomes with a brachytherapy boost in the high-risk setting, the utilization of both LDR, and HDR brachytherapy use is declining. The acute genitourinary toxicities when brachytherapy boost is combined with EBRT, particularly a LDR boost, are of concern in comparison to EBRT alone. HDR brachytherapy boost has many physical properties inherent to its rapid delivery of a large dose which may reduce acute toxicities and also appeal to the radiobiology of prostate cancer. We herein review the evidence for use of either LDR or HDR brachytherapy boost for high-risk prostate cancer and summarize comparisons between the two treatment modalities.

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ASCENDE-RT: An Analysis of Health-Related Quality of Life for a Randomized Trial Comparing Low-Dose-Rate Brachytherapy Boost With Dose-Escalated External Beam Boost for High- and Intermediate-Risk Prostate Cancer

Cited by 89 publications

References 24 publications

A Multicenter Phase 2 study of Hypofractionated Stereostatic Boost in Intermediate Risk Prostate Carcinoma: A 5-Year Analysis of the CKNO-PRO Trial

A Multicenter Phase 2 study of Hypofractionated Stereostatic Boost in Intermediate Risk Prostate Carcinoma: A 5-Year Analysis of the CKNO-PRO Trial

Radical prostatectomy or radiotherapy for high‐ and very high‐risk prostate cancer: a multidisciplinary prostate cancer clinic experience of patients eligible for either treatment

A Brief Review of Low-Dose Rate (LDR) and High-Dose Rate (HDR) Brachytherapy Boost for High-Risk Prostate

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