Phase III results of adjuvant radiotherapy (RT) versus “wait and see” (WS) in patients with pT3 prostate cancer following radical prostatectomy (RP) (ARO 96–02/AUO AP 09/95)

Wiegel, Thomas; Bottke, Dirk; Willich, Normann; Piechota, Hansjürgen; Souchon, R.; Stöeckle, Michael; Ruebe, Christian; Hinke, Axel; Hinkelbein, W.; Miller, K.

doi:10.1200/jco.2005.23.16_suppl.4513

Cited by 85 publications

(51 citation statements)

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“…[1][2][3] All three demonstrated a significant reduction in the rate of biochemical relapse with the use of early postoperative radiotherapy compared to initial observation. In 2009, Thompson and colleagues, for the first time, demonstrated that this biochemical disease-free survival advantage translated into an overall survival and disease-specific survival advantage at 10 years.…”

Section: Introductionmentioning

confidence: 99%

The need for, and utilization of prostate-bed radiotherapy after radical prostatectomy for patients with prostate cancer in British Columbia

Tyldesley

Peacock

Morris

et al. 2012

CUAJ

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Introduction: Three randomized trials have demonstrated that post-radical prostatectomy (RP) radiotherapy decreases biochemical relapse for those with adverse pathology. Our purpose was to describe the incidence of pathologic risk factors for recurrence in a contemporary series of patients treated with RP and to describe the use of post-RP radiotherapy. Methods: All incident prostate cancers diagnosed between January 2005 and December 2007 were identified from the tumour registry. Cases were then linked to radiotherapy records which included dose and modality (external beam radiotherapy and brachytherapy). The pathology reports in the tumour registry were reviewed for pathologic stage, grade and margin status. Results: We identified 9223 patients with prostate cancer. Overall, 36.3% of patients treated with RP had positive margins, and may have benefited from adjuvant radiotherapy. After RP, 332 (15%) patients had radiotherapy to the prostate bed; of these, only 25 (1.1%) received truly adjuvant radiotherapy (delivered within 6 months with a prostate-specific antigen of <0.2 ng/mL). Of the 2181 patients treated with RP, 270 (12%) were seen by a radiation oncologist within 6 months of RP. Of the 1015 patients (47%) with adverse RP pathology (positive margins, extracapsular extension or seminal vesicle invasion), 230 (23%) were seen by a radiation oncologist within 6 months of RP. Conclusion: Not all patients with adverse prostatectomy pathology were seen by a radiation oncologist post-prostatectomy, and very few received adjuvant radiotherapy despite almost half of them having risk factors for relapse.

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Section: Introductionmentioning

confidence: 99%

The need for, and utilization of prostate-bed radiotherapy after radical prostatectomy for patients with prostate cancer in British Columbia

Tyldesley

Peacock

Morris

et al. 2012

CUAJ

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“…17 This is a small trial of less than 300 men, with a median follow-up of 3 years. Nonetheless, results are also very consistent with the above 2 trials: PSA relapse was reduced from 40% to 19% (HR 0.4).…”

Section: German Cancer Society Trialmentioning

confidence: 99%

“…In 2005, the results of 3 large prospective randomized controlled trials (RCTs) of adjuvant radiation therapy were presented orally, and 2 have since been published. [15][16][17] On behalf of the Cancer Care Ontario Practice Guidelines Group, Dr. Scott Morgan performed a meta-analysis 18 of RCTs, which was also presented and will be incorporated into a future Ontario clinical guideline. Following these presentations, open discussion led to consensus agreement.…”

Section: Introductionmentioning

confidence: 99%

Adjuvant radiotherapy following radical prostatectomy: Genito-Urinary Radiation Oncologists of Canada Consensus Statement

Pickles

Morgan

Morton

et al. 2013

CUAJ

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Until the results of 3 randomized trials became known in 2005, the role of adjuvant postoperative radiation therapy following radical prostatectomy was poorly defined. After the publication of these trials, the Genito-Urinary Radiation Oncologists of Canada (GUROC) met and crafted a consensus statement regarding the current place of adjuvant radiation therapy. GUROC also identified gaps in current knowledge and strongly supports ongoing study protocols to further quantify the benefit of postoperative radiotherapy.This report summarizes the main trial findings and the commentary provided during the consensus-building process. It also outlines the subsequent consensus statement. IntroductionThe Genito-Urinary Radiation Oncologists of Canada (GUROC) meet every 2 years to discuss current issues and, where appropriate, develop consensus guidelines. Since the last meeting in December 2004, 1 new data have been published concerning the role of adjuvant radiation therapy after radical prostatectomy (RRP). Hence, the January 2007 meeting addressed the changing role of adjuvant and salvage radiation therapy. This article describes the background, the current evidence, the new trials under development and the consensus that was reached at this meeting regarding adjuvant radiation. BackgroundRRP is an established curative management for men with low-and intermediate-risk prostate cancer; it is increasingly being used for selected men with high-risk cancers. When compared with watchful waiting in the clinically detected (as opposed to screen detected) population of men with prostate cancer, it has been shown to offer a survival advantage for men aged under 65 years. 2 For men with low-risk cancer as defined by the Canadian consensus definition, 3 the 5-year prostate-specific antigen (PSA) control rates for no biological evidence of disease (bNED) exceed 80%-90%, but as risk category worsens, 5-year control falls to 60%-80%. 4,5 In large case series from surgical

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“…The only published randomized trials report an advantage for early RT in terms of local control and recurrence-free survival, but follow-up is too short to address the issues of cause-specific and overall survival. 2,18,19 Late recurrences of prostate cancer are a well-documented phenomenon. Few series describing the results of adjuvant RT report results beyond 5 years.…”

Section: Introductionmentioning

confidence: 99%

Timing and patterns of recurrences and deaths from prostate cancer following adjuvant pelvic radiotherapy for pathologic stage T3/4 adenocarcinoma of the prostate

Anscher

Clough

Robertson

et al. 2006

Prostate Cancer Prostatic Dis

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To determine the timing and patterns of late recurrence after radical prostatectomy (RP) alone or RP plus adjuvant radiotherapy (RT). Between 1970 and 1983, 159 patients underwent RP for newly diagnosed adenocarcinoma of the prostate and were found to have positive surgical margins, extracapsular extension and/or seminal vesicle invasion. Of these, 46 received adjuvant RT and 113 did not. The RT group generally received 45-50 Gy to the whole pelvis, then a boost to the prostate bed (total dose of 55-65 Gy). In the RP group, 62% received neoadjuvant/adjuvant androgen deprivation vs 17% in the RT group. Patients were analyzed with respect to timing and patterns of failure. Only one patient was lost to follow-up. The median follow-up for surviving patients was nearly 20 years. The median time to failure in the surgery group was 7.5 vs 14.7 years in the RT group (P ¼ 0.1). Late recurrences were less common in the surgery group than the RT group (9 and 1% at 10 and 15 years, respectively vs 17 and 9%). In contrast to recurrences, nearly half of deaths from prostate cancer occurred more than 10 years after treatment. Deaths from prostate cancer represented 55% of all deaths in these patients. Recurrences beyond 10 years after RP in this group of patients were relatively uncommon. Despite its long natural history, death from prostate cancer was the most common cause of mortality in this population with locally advanced tumors, reflecting the need for more effective therapy.

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Phase III results of adjuvant radiotherapy (RT) versus “wait and see” (WS) in patients with pT3 prostate cancer following radical prostatectomy (RP) (ARO 96–02/AUO AP 09/95)

Cited by 85 publications

References 0 publications

The need for, and utilization of prostate-bed radiotherapy after radical prostatectomy for patients with prostate cancer in British Columbia

The need for, and utilization of prostate-bed radiotherapy after radical prostatectomy for patients with prostate cancer in British Columbia

Adjuvant radiotherapy following radical prostatectomy: Genito-Urinary Radiation Oncologists of Canada Consensus Statement

Timing and patterns of recurrences and deaths from prostate cancer following adjuvant pelvic radiotherapy for pathologic stage T3/4 adenocarcinoma of the prostate

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