Benefit of Whole Pelvic Radiotherapy Combined with Neoadjuvant Androgen Deprivation for the High‐Risk Prostate Cancer

Milecki, Piotr; Bączyk, Maciej; Skowronek, Janusz; Antczak, Andrzej; Kwias, Zbigniew; Martenka, Piotr

doi:10.1155/2009/625394

Cited by 23 publications

(10 citation statements)

References 44 publications

(37 reference statements)

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“…At a median follow up of 56.5 months, in quite a large cohort, our findings are consistent with the best results reported in literature using radiotherapy and ADT in high-risk prostate cancer, with similar or even higher FFBF and OS rates [14,15,[27][28][29][30][31][32].…”

Section: Discussionsupporting

confidence: 91%

Intensity‐modulated pelvic radiation therapy and simultaneous integrated boost to the prostate area in patients with high‐risk prostate cancer: a preliminary report of disease control

Saracino¹,

Petrongari²,

Marzi³

et al. 2014

Cancer Medicine

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The aim of the study was to report the clinical results in patients with high-risk prostate cancer treated with pelvic intensity-modulated radiation therapy (IMRT) and simultaneous integrated boost (SIB) to the prostate area. A total of 110 patients entered our study, 37 patients presented with localized prostate cancer and radiological evidence of node metastases or ≥15% estimated risk of lymph node (LN) involvement, while 73 patients underwent postoperative adjuvant or salvage irradiation for biochemical or residual/recurrent disease, LN metastases, or high risk of harboring nodal metastases. All patients received androgen deprivation therapy (ADT) for 2 years. The median follow-up was 56.5 months. For the whole patient group, the 3- and 5-year freedom from biochemical failure were 82.6% and 74.6%, respectively, with a better outcome in patients treated with radical approach. The 3- and 5-year freedom from local failure were 94.4% and 90.2%, respectively, while the 3- and 5-year distant metastasis-free survival were 87.8% and 81.7%, respectively. For all study patients, the rate of freedom from G2 acute rectal, intestinal, and urinary toxicities was 60%, 77%, and 61%, respectively. There was no G3 acute toxicity, ≥G2 late intestinal toxicity, or G3 late urinary or rectal toxicity. The 3- and 5-year ≥G2 freedom from late rectal toxicity rate were 98% and 95%, respectively, while the 3- and 5-year ≥G2 freedom from late urinary toxicity rate were 95% and 88%, respectively. The study concludes that pelvic IMRT and SIB to the prostatic area in association with 2-year ADT was a well-tolerated technique, providing high disease control in patients with prostate cancer requiring LN treatment.

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Section: Discussionsupporting

confidence: 91%

Intensity‐modulated pelvic radiation therapy and simultaneous integrated boost to the prostate area in patients with high‐risk prostate cancer: a preliminary report of disease control

Saracino¹,

Petrongari²,

Marzi³

et al. 2014

Cancer Medicine

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“…However, several limitations remained in current study. Firstly, PSM failed to completely eliminate the difference between the two cohorts, especially for Insurance status; Second, The CSS of the DT group was obviously inferior to NDT group, which was inconsistent with previous studies [21,22] .The possible reasons were poor performance status or comorbidities of elderly men and selection bias. Third, Lacking of other information that might be important for prognosis, such as ADT, abiraterone acetate, apalutamide.…”

Section: Discussionmentioning

confidence: 68%

Survival Benefit of Patients Aged≥ 75 Years Diagnosed With High-risk Non-metastatic Prostate Cancerafter Definitive Treatmentof the Primary Tumor: A Population-based Study

Yu¹,

Xu²,

Chen³

2020

Preprint

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Background:The survival benefit of active treatment for high-risk prostate cancer patients aged≥ 75 years remains controversial. We further evaluated the effect of definitive treatment(DT) for those patients in a population-based cohort.Methods:Retrospective analysis of 17848 elderly (≥75 years) men in the Surveillance, Epidemiology, and End Results(SEER) database(2004-2016) who diagnosed non-metastatic high-risk prostate cancer. Kaplan-Meiersurvival curves were used to compare cancer-specific survival (CSS) and overall survival (OS). Propensity-adjusted multivariate Cox regression analysis fitted to identify independent prognostic factors. Logistic regression models were used as a predictor for DT.Results:A total of 17848 patients were identified, 10365 patients receiving DT (including 4284 receiving surgery, 5683 receiving EBRT, 367 receiving BT, 569 receiving EBRT+BT, 92receiving Chemotherapy) and 7473 receiving non-DT. PSM methods wereperformedand compared all baseline factors, including insurance/marital status, age, race,T /N stage, grade, Gleason score(GS),PSA. After PSM, these two groups achieved a median survival time (MST) of 99, 67months for OS, respectively(P<0.01).And older age (age ≥ 80 years) status showed a worse survival benefit (P<0.01). The subgroup analysis illustrated that surgery(MST=122) vsEBRT(MST=111) vs BT(MST=116) vs EBRT+BT(MST=121) subgroups achieved better OS than Chemotherapy group(MST=66)(P<0.01). However, EBRT+BT subgroup had better 3- and 5-year OS (93% and 82.2%). Multivariate Cox proportional hazards model showed unmarried status, older age (age ≥ 80 years), T4 stage, high tumor grade, PSA ≥10 ng/mL were significantly associated with a worse OS, whereas DT (HR, 0.65; p < 0.001) and other race(HR, 0.773; p < 0.001) were associated with a better OS. And logistic regression illustrated that poor differentiated grade was independently predictor (OR=1.427;p=0.022)Conclusions: This study indicated that insurance status, marital status, age, race, T /N stage, grade, GS, PSA and treatment modalities affected OS and CSS in elderly men with non-metastatic high-risk prostate cancer. DT, especially surgery and radiotherapy, might provide favorable OS not CSS compared with NDT for older patients (≥75 years), whereas chemotherapy was not recommended.

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“…Many trials done some of which support improved survival of WP over PO [18,31,[35][36][37] , while others detected no benefit with elective nodal irradiation [21,22,[38][39][40].…”

Section: Discussionmentioning

confidence: 99%

Localised Prostate Versus Whole Pelvic Irradiation in High Risk Prostate Cancer, Single Institute Experience

Latif¹,

Eladawei²

2019

CRJ

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Objectives: Whole pelvic irradiation [WPRT] versus prostate only radiation [PO-RT] in node negative high risk disease is controversial. This study aims to assess survival benefit of PO-RT against WPRT in high risk negative nodes prostate cancer. Patients and Methods: Patients with high risk prostate cancer and negative pelvic lymph nodes treated randomly either with WPRT [arm1] or PORT [arm2] from June-2014-June-2017. Eligible patients were ˃18 years, risk factors selected are ≥T3, GS≥8, or PSA≥20nglml. All patients received hormonal therapy as neo-adjuvant and concurrent with radiation and followed to 2-3 years. Univariate and multivariate analysis are performed. The primary end point was progression free survival [PFS], and the secondary was OAS and toxicity assessment. Results: Ninety four patients included, 48 received WPRT arm and 46 received PORT. With median follow up 26 months there was no significant difference in PFS, or OAS [P=0.994 and 0.505] respectively between both arms. On univariate analysis PFS was significantly better in lower stage [P=0.014], lower GS [P=0.000], lower number of risk factors [P=0.016]. Only 2 cases with late grade 3 gastrointestinal toxicity in observed in WPRT [P=0.044], and one case late grade 3 genitourinary in PORT with no significance [P=0.096]. Conclusion: Addition of pelvic irradiation in high risk node negative prostate cancer has no impact on survival in comparison to PORT.

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Benefit of Whole Pelvic Radiotherapy Combined with Neoadjuvant Androgen Deprivation for the High‐Risk Prostate Cancer

Cited by 23 publications

References 44 publications

Intensity‐modulated pelvic radiation therapy and simultaneous integrated boost to the prostate area in patients with high‐risk prostate cancer: a preliminary report of disease control

Intensity‐modulated pelvic radiation therapy and simultaneous integrated boost to the prostate area in patients with high‐risk prostate cancer: a preliminary report of disease control

Survival Benefit of Patients Aged≥ 75 Years Diagnosed With High-risk Non-metastatic Prostate Cancerafter Definitive Treatmentof the Primary Tumor: A Population-based Study

Localised Prostate Versus Whole Pelvic Irradiation in High Risk Prostate Cancer, Single Institute Experience

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