BACKGROUND AND PURPOSE: To determine whether radical prostatectomy (RP) or intensity-modulated radiation therapy (IMRT) to > or =72 Gy, plus hormonal therapy if indicated, results in improved biochemical disease-free survival (BDFS) in localized prostate adenocarcinoma. MATERIALS AND METHODS: Between 1997 and 2005, a consecutive sample of 556 patients who underwent RP (n=204) or IMRT (n=352) at two referral centers was analyzed. The patients were stratified into prognostic groups based on clinical stage, Gleason score, and pretreatment prostate-specific antigen (PSA). The outcome measure was BDFS. RESULTS: IMRT patients had more advanced disease at baseline (p<.001). There was no difference in five-year BDFS rates between RP and IMRT in the favorable (92.8% vs. 85.3%, p=.20) or intermediate prognosis (86.7% vs. 82.2%, p=.46) subsets. A difference favoring IMRT plus hormonal therapy was seen in the poor prognosis (38.4% vs. 62.2%, p<.001) subset. Within the entire cohort, after adjustment for confounding variables, Gleason score (p<.001) and clinical stage (p<.001) predicted BDFS, but treatment modality (p=.06) did not. Within the poor prognosis subset, treatment modality (p=.006) predicted BDFS. CONCLUSIONS: BDFS is similar between RP and IMRT for patients with a favorable or intermediate prognosis. Patients with a poor prognosis display higher BDFS when treated with IMRT to > or =72 Gy plus hormonal therapy.
BACKGROUND AND PURPOSE: To determine whether radical prostatectomy (RP) or intensity-modulated radiation therapy (IMRT) to > or =72 Gy, plus hormonal therapy if indicated, results in improved biochemical disease-free survival (BDFS) in localized prostate adenocarcinoma. MATERIALS AND METHODS: Between 1997 and 2005, a consecutive sample of 556 patients who underwent RP (n=204) or IMRT (n=352) at two referral centers was analyzed. The patients were stratified into prognostic groups based on clinical stage, Gleason score, and pretreatment prostate-specific antigen (PSA). The outcome measure was BDFS. RESULTS: IMRT patients had more advanced disease at baseline (p<.001). There was no difference in five-year BDFS rates between RP and IMRT in the favorable (92.8% vs. 85.3%, p=.20) or intermediate prognosis (86.7% vs. 82.2%, p=.46) subsets. A difference favoring IMRT plus hormonal therapy was seen in the poor prognosis (38.4% vs. 62.2%, p<.001) subset. Within the entire cohort, after adjustment for confounding variables, Gleason score (p<.001) and clinical stage (p<.001) predicted BDFS, but treatment modality (p=.06) did not. Within the poor prognosis subset, treatment modality (p=.006) predicted BDFS. CONCLUSIONS:BDFS is similar between RP and IMRT for patients with a favorable or intermediate prognosis. Patients with a poor prognosis display higher BDFS when treated with IMRT to > or =72 Gy plus hormonal therapy.
Authors: Julie M Degroot; Michael D Brundage; Miu Lam; Susan L Rohland; Jeremy Heaton; William J Mackillop; D Robert Siemens; Patti A Groome Journal: Can Urol Assoc J Date: 2013-05-13 Impact factor: 1.862
Authors: Tomás Merino; Ignacio F San Francisco; Pablo A Rojas; Piero Bettoli; Alvaro Zúñiga; Pelayo Besa Journal: BMC Cancer Date: 2013-11-08 Impact factor: 4.430
Authors: David Schreiber; Justin Rineer; Jeffrey P Weiss; Joseph Safdieh; Joseph Weiner; Marvin Rotman; David Schwartz Journal: Radiat Oncol J Date: 2015-03-31
Authors: Christopher B Baker; Andrew M McDonald; Eddy S Yang; Rojymon Jacob; Soroush Rais-Bahrami; Jeffrey W Nix; John B Fiveash Journal: Prostate Cancer Date: 2016-03-09