Assessing the variability of outcome for patients treated with localized prostate irradiation using different definitions of biochemical control

Horwitz, Eric M.; Vicini, Frank A.; Ziaja, Ellen L.; González, José; Dmuchowski, Carl; Stromberg, Jannifer S.; Brabbins, D.; Hollander, Jay B.; Chen, Peter Y.; Martínez, Álvaro

doi:10.1016/s0360-3016(96)00360-4

Cited by 71 publications

(25 citation statements)

References 37 publications

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“…The level and timing of PSA nadir have both been correlated with biochemical failure, distant metastasis (DM), and CSS in radiotherapy (RT) series [4][5][6][7][8][9] ; both PSA velocity and/or doubling time [10][11][12] have also been evaluated as potential surrogates. However, each of these has been demonstrated as an incomplete surrogate for CSS, with even worse correlation with OS.…”

Section: Introductionmentioning

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: Introductionmentioning

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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“…As previously reported, statistically significant differences in outcome can be observed in outcome by changing the time points and the definition of end points [16]. Obviously, serum PSA level will rise a little after withdrawal of androgen deprivation.…”

Section: Discussionmentioning

confidence: 86%

Neoadjuvant Hormonal Treatment and Radiotherapy for Prostate Cancer

Wachter¹,

Wachter-Gerstner²,

Pötter³

2003

Oncology

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Adjuvant hormone treatment with radiotherapy has been demonstrated in two studies (Bolla and RTOG 8531) to be beneficial in patients with locally advanced prostate cancer. However, the vast majority of patients with early prostate cancer can be cured with radiotherapy alone. Subset analysis combining RTOG 8610 and RTOG 8531 has demonstrated a survival benefit only for patients with a biopsy Gleason score ≤6 after short-term neoadjuvant hormonal therapy. The results of ongoing research will further clarify the use of hormone treatment with radiotherapy in patients with low and intermediate risk.

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“…Current results of treatment with conventional doses of radiation (<70 Gy) show similar rates of bNED control when patients are stratified by pretreatment PSA levels [35,40,[45][46][47][48]. However, as pretreatment PSA levels increase, rates of bNED control decrease.…”

Section: Discussionmentioning

confidence: 95%

“…Multiple studies in both the radiation and surgical literature have demonstrated that the pretreatment PSA level is the single most important independent prognostic variable to predict and assess treatment efficacy [4,36,40,[49][50][51].…”

Section: Discussionmentioning

confidence: 99%

“…This was especially true in the radiation literature. As has recently been shown, depending upon which definition of bNED control is used (based upon definitions from several academic radiation oncology departments), statistically significant differences in treatment outcome are obtained attributable only to the definition chosen [40].…”

Section: Bned Outcome For External Beam and Retropubic Prostatectomy mentioning

confidence: 99%

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Update on the treatment of prostate cancer with external beam irradiation

Horwitz¹,

Hanlon²,

Hanks³

1998

Prostate

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Assessing the variability of outcome for patients treated with localized prostate irradiation using different definitions of biochemical control

Cited by 71 publications

References 37 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

Neoadjuvant Hormonal Treatment and Radiotherapy for Prostate Cancer

Update on the treatment of prostate cancer with external beam irradiation

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