Pd10-10 a Prospective, Randomized Controlled Trial Evaluating Overall Survival in Patients With Primary Bone Metastatic Prostate Cancer (Mpca) Receiving Either Androgen Deprivation Therapy (Adt) or Adt Combined With Concurrent Radiation Therapy to the Prostate, Final Data From the Horrad Trial

Boevé, Liselotte M.S.; Hulshof, Maarten C.C.M.; Vis, André N.; Zwinderman, Koos; Twisk, Jos W. R.; Delaere, K.P.J.; Moorselaar, Jeroen van; Verhagen, Paul C.M.S.; Andel, George van

doi:10.1016/j.juro.2018.02.620

Cited by 8 publications

(19 citation statements)

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“…An exploratory analysis using the HORRAD definition [20] provided evidence that the effect of prostate radiotherapy on survival varied by volume of disease (interaction HR = 1.44, 95% CI 1.07-1.95, p = 0.017; Supplementary Fig. 2), which was supported by similar analyses of PFS (HR = 1.28, 95% CI 1.00-1.64, p = 0.054; Supplementary Fig.…”

Section: Treatment Effects By Patient Characteristicsmentioning

confidence: 68%

“…As the HORRAD trial did not collect data on nonbone metastases, it was not possible to use the CHAARTED [8] or LATITUDE [9] trial definitions of disease volume. However, the STAMPEDE team were able to reclassify patients according to the HORRAD definition [20] (low volume: Gleason sum score <9, fewer than five bone lesions, and PSA ≤142; the HORRAD median). Few men in the HORRAD trial (17%) had low-volume disease compared with around half of the men in the STAMPEDE trial (45%).…”

Section: Resultsmentioning

confidence: 99%

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Prostate Radiotherapy for Metastatic Hormone-sensitive Prostate Cancer: A STOPCAP Systematic Review and Meta-analysis

et al. 2019

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Background Many trials are evaluating therapies for men with metastatic hormone-sensitive prostate cancer (mHSPC). Objective To systematically review trials of prostate radiotherapy. Design, setting, and participants Using a prospective framework (framework for adaptive meta-analysis [FAME]), we prespecified methods before any trial results were known. We searched extensively for eligible trials and asked investigators when results would be available. We could then anticipate that a definitive meta-analysis of the effects of prostate radiotherapy was possible. We obtained prepublication, unpublished, and harmonised results from investigators. Intervention We included trials that randomised men to prostate radiotherapy and androgen deprivation therapy (ADT) or ADT only. Outcome measurements and statistical analysis Hazard ratios (HRs) for the effects of prostate radiotherapy on survival, progression-free survival (PFS), failure-free survival (FFS), biochemical progression, and subgroup interactions were combined using fixed-effect meta-analysis. Results and limitations We identified one ongoing (PEACE-1) and two completed (HORRAD and STAMPEDE) eligible trials. Pooled results of the latter (2126 men; 90% of those eligible) showed no overall improvement in survival (HR = 0.92, 95% confidence interval [CI] 0.81–1.04, p = 0.195) or PFS (HR = 0.94, 95% CI 0.84–1.05, p = 0.238) with prostate radiotherapy. There was an overall improvement in biochemical progression (HR = 0.74, 95% CI 0.67–0.82, p = 0.94 × 10 −8 ) and FFS (HR = 0.76, 95% CI 0.69–0.84, p = 0.64 × 10 −7 ), equivalent to ∼10% benefit at 3 yr. The effect of prostate radiotherapy varied by metastatic burden—a pattern consistent across trials and outcome measures, including survival (<5, ≥5; interaction HR = 1.47, 95% CI 1.11–1.94, p = 0.007). There was 7% improvement in 3-yr survival in men with fewer than five bone metastases. Conclusions Prostate radiotherapy should be considered for men with mHSPC with a low metastatic burden. Patient summary Prostate cancer that has spread to other parts of the body (metastases) is usually treated with hormone therapy. In men with fewer than five bone metastases, addition of prostate radiotherapy helped them live longer and should be considered.

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Section: Treatment Effects By Patient Characteristicsmentioning

confidence: 68%

Section: Resultsmentioning

confidence: 99%

Prostate Radiotherapy for Metastatic Hormone-sensitive Prostate Cancer: A STOPCAP Systematic Review and Meta-analysis

et al. 2019

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“…After the exclusion of 1,073 duplicate articles, 8,538 records were excluded based on the titles or abstracts for various reasons (reviews, letters, case reports, or unrelated to mPCa or unrelated to RT). After reading the remaining 20 articles in full text, 13 articles were excluded because 2 studies focused on the effect of prior LT on mPCa [15,16], 2 studies focused on the effect of LT on mPCa [7,8], 4 studies of repeated research [17][18][19][20], 3 repeated data studies [21][22][23], and 2 papers did not provide adequate data [24,25]. Finally, 7 studies [26][27][28][29][30][31][32] contributed to the systematic review and meta-analysis (Fig.…”

Section: Resultsmentioning

confidence: 99%

Impact of Radiotherapy on Prognosis in Patients Diagnosed with Metastatic Prostate Cancer: A Systematic Review and Meta-Analysis

et al. 2020

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Background: It has been reported that compared with no local therapy (NLT), patients treated with local therapy (LT) using radiotherapy (RT) possess higher survival rate in metastatic prostate cancer (mPCa). The aim of this meta-analysis was to evaluate the impact of RT on prognosis in patients with mPCa. Methods: We retrieved the literature in PubMed, Embase, and Cochrane Library databases until June 2019 using structured search terms. Several studies were included, which evaluated patients with mPCa who received RT versus NLT. Results: A total of 14,542 patients were analyzed in 7 included papers (2 randomized controlled trials [RCTs] and 5 cohort retrospective studies [CRS]), and 2,232 mPCa patients were treated with RT and 12,310 with NLT. The data of RCTs and CRS were analyzed separately. In RCTs, RT was associated with no significant difference in overall survival (OS) (pooled hazard ratio [HR] = 0.96; 95% confidence interval [CI]: 0.85–1.09; p = 0.55; I2 = 42%) relative to NLT, while survival benefit was observed in the low-metastatic burden group (pooled HR = 0.68; 95% CI: 0.54–0.86; p = 0.001; I2 = 0%), and no survival benefit was observed in the high-metastatic burden group (pooled HR = 1.07; 95% CI: 0.92–1.24; p = 0.39; I2 = 0%). In CRS, RT results in lower cancer-specific mortality (CSM) (pooled HR = 0.49; 95% CI: 0.34–0.75; p < 0.00001; I2 = 0%) and higher OS (pooled HR = 0.61; 95% CI: 0.55–0.68; p < 0.00001; I2 = 0%) relative to NLT. Subsequent analysis demonstrated that high level of M-stage or N-stage was associated with increased CSM (pooled HR = 2.08; 95% CI: 1.69–2.55; p < 0.00001; I2 = 0% and pooled HR = 1.16; 95% CI: 1.03–1.30; p < 0.00001; I2 = 0%; respectively). Conclusions: Our observations in aggregate indicated that RT at least does not appear to be harmful and may be beneficial for low-metastatic burden patients and better condition patients. More prospective and randomized studies evaluating RT for mPCa are warranted.

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“…Combining cytoreductive prostate radiotherapy with standard hormonal and systemic treatment resulted in more sustained time to biochemical progression (11). In addition, recent studies have reported a clinically meaningful overall survival bene t in oligometastatic prostate cancer patients after receiving local radiotherapy (7,17). This study presents biochemical progression-free survival and overall survival in patients with metastatic prostate cancer treated with cytoreductive prostate-directed radiotherapy.…”

Section: Introductionmentioning

confidence: 86%

Biochemical Outcome in Metastatic Prostate Cancer Patients Following Prostate-Directed Radiotherapy

Ayoub,

Zamzam,

Elsayed

et al. 2023

Preprint

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Background The role of cytoreductive local radiotherapy (RT) in metastatic prostate cancer has recently been established. This study aimed to evaluate the biochemical outcome of local RT in metastatic prostate cancer. Methods This randomized controlled phase III study was conducted at the Clinical Oncology Department, Suez Canal University Hospital. Eligible participants were de-novo or metachronous metastatic prostate cancer patients with Eastern Cooperative Oncology Group performance status of 0–2. Participants were randomized to receive either cytoreductive prostate-directed RT in addition to standard care or standard care alone. The conventional radiation schedule of 70 Gy/35 fractions or the hypofractionated schedule of 55 Gy/20 fractions were delivered. The primary endpoint was biochemical progression-free survival (BPFS), and secondary endpoints included clinical response, and overall survival (OS). Survival and post-hoc analyses were performed using Cox regression and the Kaplan-Meier method with the log-rank test. Results Between November 23, 2020, and November 21, 2022, 70 patients were enrolled in this study. Of them, 34 patients were assigned to the prostate radiotherapy group, and 29 patients were assigned to the control group. At a median follow-up of 12 months, the median BPFS has not been reached for the prostate radiotherapy group compared to 4.067 months for the control group (HR: 0.147, p < 0.001). Subgroup analysis showed that the median BPFS was statistically significantly correlated with low-volume (95% CI, 0.004 to 0.262, p = 0·001) and hormonal-sensitive metastatic disease (95% CI, 0.010 to 0.192, p < 0·001). The median OS was 16.33 months for the prostate-radiotherapy group compared to 11.33 months for the control group (HR: 0.313, p = 0.003). Conclusion Prostate-directed RT improved BPFS and OS in metastatic prostate cancer patients, particularly in those with low volume and hormonal-sensitive disease. Trial Registration: This trial is registered on (27/4/2023) with pactr.samrc.ac.za, PACTR202305854600529, URL: https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=25510

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Pd10-10 a Prospective, Randomized Controlled Trial Evaluating Overall Survival in Patients With Primary Bone Metastatic Prostate Cancer (Mpca) Receiving Either Androgen Deprivation Therapy (Adt) or Adt Combined With Concurrent Radiation Therapy to the Prostate, Final Data From the Horrad Trial

Cited by 8 publications

References 0 publications

Prostate Radiotherapy for Metastatic Hormone-sensitive Prostate Cancer: A STOPCAP Systematic Review and Meta-analysis

Prostate Radiotherapy for Metastatic Hormone-sensitive Prostate Cancer: A STOPCAP Systematic Review and Meta-analysis

Impact of Radiotherapy on Prognosis in Patients Diagnosed with Metastatic Prostate Cancer: A Systematic Review and Meta-Analysis

Biochemical Outcome in Metastatic Prostate Cancer Patients Following Prostate-Directed Radiotherapy

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