Lack of benefit for the addition of androgen deprivation therapy to dose-escalated radiotherapy in the treatment of intermediate- and high-risk prostate cancer.

Hdl Handle:
http://hdl.handle.net/10147/207251
Title:
Lack of benefit for the addition of androgen deprivation therapy to dose-escalated radiotherapy in the treatment of intermediate- and high-risk prostate cancer.
Authors:
Krauss, Daniel; Kestin, Larry; Ye, Hong; Brabbins, Donald; Ghilezan, Michel; Gustafson, Gary; Vicini, Frank; Martinez, Alvaro
Affiliation:
Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI 48073,, USA. dkrauss@beaumont.edu
Citation:
Int J Radiat Oncol Biol Phys. 2011 Jul 15;80(4):1064-71. Epub 2010 Jun 26.
Journal:
International journal of radiation oncology, biology, physics
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207251
DOI:
10.1016/j.ijrobp.2010.04.004
PubMed ID:
20584576
Abstract:
PURPOSE: Assessment of androgen deprivation therapy (ADT) benefits for prostate cancer treated with dose-escalated radiotherapy (RT). METHODS AND MATERIALS: From 1991 to 2004, 1,044 patients with intermediate- (n = 782) or high-risk (n = 262) prostate cancer were treated with dose-escalated RT at William Beaumont Hospital. Patients received external-beam RT (EBRT) alone, brachytherapy (high or low dose rate), or high dose rate brachytherapy plus pelvic EBRT. Intermediate-risk patients had Gleason score 7, prostate-specific antigen (PSA) 10.0-19.9 ng/mL, or Stage T2b-T2c. High-risk patients had Gleason score 8-10, PSA >/=20, or Stage T3. Patients were additionally divided specifically by Gleason score, presence of palpable disease, and PSA level to further define subgroups benefitting from ADT. RESULTS: Median follow-up was 5 years; 420 patients received ADT + dose-escalated RT, and 624 received dose-escalated RT alone. For all patients, no advantages in any clinical endpoints at 8 years were associated with ADT administration. No differences in any endpoints were associated with ADT administration based on intermediate- vs. high-risk group or RT modality when analyzed separately. Patients with palpable disease plus Gleason >/=8 demonstrated improved clinical failure rates and a trend toward improved survival with ADT. Intermediate-risk patients treated with brachytherapy alone had improved biochemical control when ADT was given. CONCLUSION: Benefits of ADT in the setting of dose-escalated RT remain poorly defined. This question must continue to be addressed in prospective study.
Language:
eng
MeSH:
Aged; Androgen Antagonists/*therapeutic use; Brachytherapy/methods; Combined Modality Therapy/methods; Humans; Male; Prostate-Specific Antigen/blood; Prostatic Neoplasms/blood/*drug therapy/mortality/pathology/*radiotherapy; Radiotherapy Dosage; Regression Analysis; Survival Analysis; Treatment Outcome
ISSN:
1879-355X (Electronic); 0360-3016 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorKrauss, Danielen_GB
dc.contributor.authorKestin, Larryen_GB
dc.contributor.authorYe, Hongen_GB
dc.contributor.authorBrabbins, Donalden_GB
dc.contributor.authorGhilezan, Michelen_GB
dc.contributor.authorGustafson, Garyen_GB
dc.contributor.authorVicini, Franken_GB
dc.contributor.authorMartinez, Alvaroen_GB
dc.date.accessioned2012-02-01T10:03:07Z-
dc.date.available2012-02-01T10:03:07Z-
dc.date.issued2012-02-01T10:03:07Z-
dc.identifier.citationInt J Radiat Oncol Biol Phys. 2011 Jul 15;80(4):1064-71. Epub 2010 Jun 26.en_GB
dc.identifier.issn1879-355X (Electronic)en_GB
dc.identifier.issn0360-3016 (Linking)en_GB
dc.identifier.pmid20584576en_GB
dc.identifier.doi10.1016/j.ijrobp.2010.04.004en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207251-
dc.description.abstractPURPOSE: Assessment of androgen deprivation therapy (ADT) benefits for prostate cancer treated with dose-escalated radiotherapy (RT). METHODS AND MATERIALS: From 1991 to 2004, 1,044 patients with intermediate- (n = 782) or high-risk (n = 262) prostate cancer were treated with dose-escalated RT at William Beaumont Hospital. Patients received external-beam RT (EBRT) alone, brachytherapy (high or low dose rate), or high dose rate brachytherapy plus pelvic EBRT. Intermediate-risk patients had Gleason score 7, prostate-specific antigen (PSA) 10.0-19.9 ng/mL, or Stage T2b-T2c. High-risk patients had Gleason score 8-10, PSA >/=20, or Stage T3. Patients were additionally divided specifically by Gleason score, presence of palpable disease, and PSA level to further define subgroups benefitting from ADT. RESULTS: Median follow-up was 5 years; 420 patients received ADT + dose-escalated RT, and 624 received dose-escalated RT alone. For all patients, no advantages in any clinical endpoints at 8 years were associated with ADT administration. No differences in any endpoints were associated with ADT administration based on intermediate- vs. high-risk group or RT modality when analyzed separately. Patients with palpable disease plus Gleason >/=8 demonstrated improved clinical failure rates and a trend toward improved survival with ADT. Intermediate-risk patients treated with brachytherapy alone had improved biochemical control when ADT was given. CONCLUSION: Benefits of ADT in the setting of dose-escalated RT remain poorly defined. This question must continue to be addressed in prospective study.en_GB
dc.language.isoengen_GB
dc.subject.meshAgeden_GB
dc.subject.meshAndrogen Antagonists/*therapeutic useen_GB
dc.subject.meshBrachytherapy/methodsen_GB
dc.subject.meshCombined Modality Therapy/methodsen_GB
dc.subject.meshHumansen_GB
dc.subject.meshMaleen_GB
dc.subject.meshProstate-Specific Antigen/blooden_GB
dc.subject.meshProstatic Neoplasms/blood/*drug therapy/mortality/pathology/*radiotherapyen_GB
dc.subject.meshRadiotherapy Dosageen_GB
dc.subject.meshRegression Analysisen_GB
dc.subject.meshSurvival Analysisen_GB
dc.subject.meshTreatment Outcomeen_GB
dc.titleLack of benefit for the addition of androgen deprivation therapy to dose-escalated radiotherapy in the treatment of intermediate- and high-risk prostate cancer.en_GB
dc.contributor.departmentDepartment of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI 48073,, USA. dkrauss@beaumont.eduen_GB
dc.identifier.journalInternational journal of radiation oncology, biology, physicsen_GB
dc.description.provinceLeinster-

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