Unknown

Dataset Information

0

Prostate-only Versus Whole-pelvis Radiation with or Without a Brachytherapy Boost for Gleason Grade Group 5 Prostate Cancer: A Retrospective Analysis.


ABSTRACT: BACKGROUND:The role of elective whole-pelvis radiotherapy (WPRT) remains controversial. Few studies have investigated it in Gleason grade group (GG) 5 prostate cancer (PCa), known to have a high risk of nodal metastases. OBJECTIVE:To assess the impact of WPRT on patients with GG 5 PCa treated with external-beam radiotherapy (EBRT) or EBRT with a brachytherapy boost (EBRT+BT). DESIGN, SETTING, AND PARTICIPANTS:We identified 1170 patients with biopsy-proven GG 5 PCa from 11 centers in the United States and one in Norway treated between 2000 and 2013 (734 with EBRT and 436 with EBRT+BT). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS:Biochemical recurrence-free survival (bRFS), distant metastasis-free survival (DMFS), and prostate cancer-specific survival (PCSS) were compared using Cox proportional hazards models with propensity score adjustment. RESULTS AND LIMITATIONS:A total of 299 EBRT patients (41%) and 320 EBRT+BT patients (73%) received WPRT. The adjusted 5-yr bRFS rates with WPRT in the EBRT and EBRT+BT groups were 66% and 88%, respectively. Without WPRT, these rates for the EBRT and EBRT+BT groups were 58% and 78%, respectively. The median follow-up was 5.6yr. WPRT was associated with improved bRFS among patients treated with EBRT+BT (hazard ratio [HR] 0.5, 95% confidence interval [CI] 0.2-0.9, p=0.02), but no evidence for improvement was found in those treated with EBRT (HR 0.8, 95% CI 0.6-1.2, p=0.4). WPRT was not significantly associated with improved DMFS or PCSS in the EBRT group (HR 1.1, 95% CI 0.7-1.7, p=0.8 for DMFS and HR 0.7, 95% CI 0.4-1.1, p=0.1 for PCSS), or in the EBRT+BT group (HR 0.6, 95% CI 0.3-1.4, p=0.2 for DMFS and HR 0.5 95% CI 0.2-1.2, p=0.1 for PCSS). CONCLUSIONS:WPRT was not associated with improved PCSS or DMFS in patients with GG 5 PCa who received either EBRT or EBRT+BT. However, WPRT was associated with a significant improvement in bRFS among patients receiving EBRT+BT. Strategies to optimize WPRT, potentially with the use of advanced imaging techniques to identify occult nodal disease, are warranted. PATIENT SUMMARY:When men with a high Gleason grade prostate cancer receive radiation with external radiation and brachytherapy, the addition of radiation to the pelvis results in a longer duration of prostate-specific antigen control. However, we did not find a difference in their survival from prostate cancer or in their survival without metastatic disease. We also did not find a benefit for radiation to the pelvis in men who received radiation without brachytherapy.

SUBMITTER: Sandler KA 

PROVIDER: S-EPMC7521828 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

altmetric image

Publications

Prostate-only Versus Whole-pelvis Radiation with or Without a Brachytherapy Boost for Gleason Grade Group 5 Prostate Cancer: A Retrospective Analysis.

Sandler Kiri A KA   Cook Ryan R RR   Ciezki Jay P JP   Ross Ashley E AE   Pomerantz Mark M MM   Nguyen Paul L PL   Shaikh Talha T   Tran Phuoc T PT   Stock Richard G RG   Merrick Gregory S GS   Demanes David Jeffrey DJ   Spratt Daniel E DE   Abu-Isa Eyad I EI   Wedde Trude B TB   Lilleby Wolfgang W   Krauss Daniel J DJ   Shaw Grace K GK   Alam Ridwan R   Reddy Chandana A CA   Song Daniel Y DY   Klein Eric A EA   Stephenson Andrew J AJ   Tosoian Jeffrey J JJ   Hegde John V JV   Yoo Sun Mi SM   Fiano Ryan R   D'Amico Anthony V AV   Nickols Nicholas G NG   Aronson William J WJ   Sadeghi Ahmad A   Greco Stephen C SC   Deville Curtiland C   McNutt Todd T   DeWeese Theodore L TL   Reiter Robert E RE   Said Jonathan W JW   Steinberg Michael L ML   Horwitz Eric M EM   Kupelian Patrick A PA   King Christopher R CR   Kishan Amar U AU  

European urology 20190413 1


<h4>Background</h4>The role of elective whole-pelvis radiotherapy (WPRT) remains controversial. Few studies have investigated it in Gleason grade group (GG) 5 prostate cancer (PCa), known to have a high risk of nodal metastases.<h4>Objective</h4>To assess the impact of WPRT on patients with GG 5 PCa treated with external-beam radiotherapy (EBRT) or EBRT with a brachytherapy boost (EBRT+BT).<h4>Design, setting, and participants</h4>We identified 1170 patients with biopsy-proven GG 5 PCa from 11 c  ...[more]

Similar Datasets

| S-EPMC8772149 | biostudies-literature
| S-EPMC8954568 | biostudies-literature
| S-EPMC7658165 | biostudies-literature
| S-EPMC6611751 | biostudies-literature
| S-EPMC9182297 | biostudies-literature
| S-EPMC8591010 | biostudies-literature
| S-EPMC8741790 | biostudies-literature
| S-EPMC7508714 | biostudies-literature
| S-EPMC3587758 | biostudies-literature
2006-07-14 | GSE5132 | GEO