PURPOSE: To evaluate the effect of whole pelvic radiotherapy (WPRT) in prostate cancer patients treated with RT and long-term (>1 year) androgen deprivation therapy (ADT). METHODS AND MATERIALS: Prostate cancer patients with high-risk features (Stage T3-T4 and/or Gleason score≥7 and/or prostate-specific antigen level≥20 ng/mL) who had undergone RT and long-term ADT were included in the present analysis. Patients with bowel inflammatory disease, colon diverticula, and colon diverticulitis were excluded from WPRT and treated with prostate-only radiotherapy (PORT). Patients were grouped according to nodal risk involvement as assessed by the Roach formula using different cutoff levels (15%, 20%, 25%, and 30%). Biochemical disease-free survival (bDFS) was analyzed in each group according to the RT type (WPRT or PORT). RESULTS: A total of 358 patients treated between 1994 and 2007 were included in the analysis (46.9% with WPRT and 53.1% with PORT). The median duration of ADT was 24 months (range, 12-38). With a median follow-up of 52 months (range, 20-150), the overall 4-year bDFS rate was 90.5%. The 4-year bDFS rate was similar between the patients who had undergone WPRT or PORT (90.4% vs. 90.5%; p=NS). However, in the group of patients with the greatest nodal risk (>30%), a significant bDFS improvement was recorded for the patients who had undergone WPRT (p=.03). No differences were seen in acute toxicity among the patients treated with WPRT or PORT. The late gastrointestinal toxicity was similar in patients treated with PORT or WPRT (p=NS). CONCLUSIONS: Our analysis has supported the use of WPRT in association with long-term ADT for patients with high-risk nodal involvement (>30%), although a definitive recommendation should be confirmed by a randomized trial.
PURPOSE: To evaluate the effect of whole pelvic radiotherapy (WPRT) in prostate cancerpatients treated with RT and long-term (>1 year) androgen deprivation therapy (ADT). METHODS AND MATERIALS: Prostate cancerpatients with high-risk features (Stage T3-T4 and/or Gleason score≥7 and/or prostate-specific antigen level≥20 ng/mL) who had undergone RT and long-term ADT were included in the present analysis. Patients with bowel inflammatory disease, colon diverticula, and colon diverticulitis were excluded from WPRT and treated with prostate-only radiotherapy (PORT). Patients were grouped according to nodal risk involvement as assessed by the Roach formula using different cutoff levels (15%, 20%, 25%, and 30%). Biochemical disease-free survival (bDFS) was analyzed in each group according to the RT type (WPRT or PORT). RESULTS: A total of 358 patients treated between 1994 and 2007 were included in the analysis (46.9% with WPRT and 53.1% with PORT). The median duration of ADT was 24 months (range, 12-38). With a median follow-up of 52 months (range, 20-150), the overall 4-year bDFS rate was 90.5%. The 4-year bDFS rate was similar between the patients who had undergone WPRT or PORT (90.4% vs. 90.5%; p=NS). However, in the group of patients with the greatest nodal risk (>30%), a significant bDFS improvement was recorded for the patients who had undergone WPRT (p=.03). No differences were seen in acute toxicity among the patients treated with WPRT or PORT. The late gastrointestinal toxicity was similar in patients treated with PORT or WPRT (p=NS). CONCLUSIONS: Our analysis has supported the use of WPRT in association with long-term ADT for patients with high-risk nodal involvement (>30%), although a definitive recommendation should be confirmed by a randomized trial.
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Authors: Hanneke J M Meijer; Oscar A Debats; Emile N J Th van Lin; Marco van Vulpen; J Alfred Witjes; Wim J G Oyen; Jelle O Barentsz; Johannes H A M Kaanders Journal: Nat Rev Urol Date: 2013-05-28 Impact factor: 14.432
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Authors: Kiri A Sandler; Ryan R Cook; Jay P Ciezki; Ashley E Ross; Mark M Pomerantz; Paul L Nguyen; Talha Shaikh; Phuoc T Tran; Richard G Stock; Gregory S Merrick; David Jeffrey Demanes; Daniel E Spratt; Eyad I Abu-Isa; Trude B Wedde; Wolfgang Lilleby; Daniel J Krauss; Grace K Shaw; Ridwan Alam; Chandana A Reddy; Daniel Y Song; Eric A Klein; Andrew J Stephenson; Jeffrey J Tosoian; John V Hegde; Sun Mi Yoo; Ryan Fiano; Anthony V D'Amico; Nicholas G Nickols; William J Aronson; Ahmad Sadeghi; Stephen C Greco; Curtiland Deville; Todd McNutt; Theodore L DeWeese; Robert E Reiter; Jonathan W Said; Michael L Steinberg; Eric M Horwitz; Patrick A Kupelian; Christopher R King; Amar U Kishan Journal: Eur Urol Date: 2019-04-13 Impact factor: 20.096
Authors: Neal Andruska; Benjamin W Fischer-Valuck; Michael Waters; Elizabeth Juarez Diaz; Temitope Agabalogun; Eric H Kim; Zachary L Smith; Randall J Brenneman; Hiram A Gay; Gerald L Andriole; Jeff M Michalski; Brian C Baumann Journal: J Urol Date: 2022-01-27 Impact factor: 7.600
Authors: Agata Karklelyte; Konstantinas Povilas Valuckas; Romas Griskevicius; Ernestas Janulionis; Eduardas Aleknavicius Journal: Rep Pract Oncol Radiother Date: 2018-07-26
Authors: Stefan A Koerber; Gerald Stach; Clemens Kratochwil; Matthias F Haefner; Henrik Rathke; Klaus Herfarth; Klaus Kopka; Tim Holland-Letz; Peter L Choyke; Uwe Haberkorn; Juergen Debus; Frederik L Giesel Journal: J Nucl Med Date: 2019-07-13 Impact factor: 11.082