Improved Survival in Patients with Locally Advanced Prostate Cancer Treated with Radiotherapy and Goserelin

Bolla, M.; González, Dionisio González; Warde, Padraig; Dubois, J.B.; Mirimanoff, René-Olivier; Storme, Guy; Bernier, Jacques; Kuten, Abraham; Sternberg, Cora N.; Gil, Thierry; Collette, Laurence; Piérart, M.

doi:10.1056/nejm199707313370502

Cited by 1,420 publications

(726 citation statements)

References 12 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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“…All these biases may have affected previous reports on late rectal toxicity to some extent (Bolla et al, 1997;Sanguineti et al, 2000;Lawton et al, 2001). Contrary to our previous analysis, we tried to minimise the impact of such biases by considering a homogeneously treated group of patients for whom treatment details were available.…”

Section: Discussionmentioning

confidence: 99%

“…Several trials have shown some advantage of adding androgen deprivation (AD) to conventional radiotherapy to 66 -70 Gy for prostate carcinoma (Bolla et al, 1997;Lawton et al, 2001;Zagars et al, 1988;Granfors et al, 1998) although improved overall survival was observed only in one (Bolla et al, 1997).…”

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Adjuvant androgen deprivation impacts late rectal toxicity after conformal radiotherapy of prostate carcinoma

Sanguineti¹,

Agostinelli²,

Foppiano³

et al. 2002

Br J Cancer

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To evaluate whether androgen deprivation impacts late rectal toxicity in patients with localised prostate carcinoma treated with three-dimensional conformal radiotherapy. One hundred and eighty-two consecutive patients treated with 3DCRT between 1995 and 1999 at our Institution and with at least 12 months follow-up were analysed. three-dimensional conformal radiotherapy consisted in 70 -76 Gy delivered with a conformal 3-field arrangement to the prostate+seminal vesicles. As part of treatment, 117 patients (64%) received neo-adjuvant and concomitant androgen deprivation while 88 (48.4%) patients were continued on androgen deprivation at the end of three-dimensional conformal radiotherapy as well. Late rectal toxicity was graded according to the RTOG morbidity scoring scale. Median follow up is 25.8 (range: 12 -70.2 months). The 2-year actuarial likelihood of grade 2 -4 rectal toxicity was 21.8+3.2%. A multivariate analysis identified the use of adjuvant androgen deprivation (P=0.0196) along with the dose to the posterior wall of the rectum on the central axis (P=0.0055) and the grade of acute rectal toxicity (P=0.0172) as independent predictors of grade 2 -4 late rectal toxicity. The 2-year estimates of grade 2 -4 late rectal toxicity for patients receiving or not adjuvant hormonal treatment were 30.3+5.2% and 14.1+3.8%, respectively. Rectal tolerance is reduced in presence of adjuvant androgen deprivation.

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“…ADT with gonadotropin-releasing hormone agonist or bilateral orchiectomy is the mainstay of treatment for metastatic and recurrent prostate cancer 6 and may be beneficial to men with locally advanced disease. [7][8][9] Although ADT offers important clinical benefits, it is associated with a variety of complications such as hot flushes, anaemia, sexual dysfunction, changing body composition, osteoporosis and fractures, and increased risk for diabetes and cardiovascular diseases. [10][11][12] Some of the complications have negative effects on quality of life assessments, while others may induce serious problems including myocardial infarction and sudden cardiac death.…”

Section: Introductionmentioning

confidence: 99%

Androgen deprivation therapy through bilateral orchiectomy: increased metabolic risks

Jiang¹,

Zhang²,

Zhang³

et al. 2011

Asian J Androl

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Prostate cancer is one of the most common malignancies in men. Previous research has determined that androgen deprivation therapy (ADT) may be accompanied by an unfavourable metabolic profile. In this prospective study, 133 men were recruited, including 46 prostate cancer patients who had undergone bilateral orchiectomy and been on flutamide (the ADT group), 37 men with prostate cancer who had undergone radical prostatectomy (the non-ADT group) and 50 normal control subjects (the control group). All subjects were followed for at least 12 months. From baseline to 3 months, men in the ADT group had increased levels of fasting serum insulin and low-density lipoprotein compared to the other two groups (P,0.05). No obvious changes were found in the other parameters (P.0.05). After 12 months, men in the ADT group had increased levels of waist circumference, fasting serum insulin and glucose, total cholesterol, high-density lipoprotein and low-density lipoprotein compared to the other two groups (P,0.05). Additionally, the morbidity rate of metabolic syndrome in the ADT group was higher (P,0.05) compared to the other two groups. ADT through surgical castration for men with prostate cancer may be associated with unfavourable metabolic changes. The benefits of the therapy should be balanced prudently against these risks.

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Improved Survival in Patients with Locally Advanced Prostate Cancer Treated with Radiotherapy and Goserelin

Abstract: Improved survival in patients with locally advanced prostate cancer treated radiotherapy and goserelin Bolla, M.; González González, D.; Warde, P.; Dubois, J.B.; Mirimanoff, R-O.; Storme, G.; Bernier, J.; Kuten, A.; Sternberg, C.; Gil, T.; Collette, L.; Pierart, M.

Cited by 1,420 publications

References 12 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

Adjuvant androgen deprivation impacts late rectal toxicity after conformal radiotherapy of prostate carcinoma

Androgen deprivation therapy through bilateral orchiectomy: increased metabolic risks

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