Gregory R Pond1, Matthew I Milowsky2, Michael P Kolinsky3, Bernhard J Eigl4, Andrea Necchi5, Lauren C Harshman6, Giuseppe Di Lorenzo7, Tanya B Dorff8, Richard J Lee9, Guru Sonpavde10. 1. McMaster University, Hamilton, Ontario, Canada. 2. University of North Carolina, Chapel Hill, NC. 3. University of Alberta, Edmonton, Alberta, Canada. 4. BC Cancer Agency, Vancouver, British Columbia, Canada. 5. Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy. 6. Dana-Farber Cancer Institute, Boston, MA. 7. University Federico II, Napoli, Italy. 8. University of Southern California, CA. 9. Massachusetts General Hospital Cancer Center, Boston, MA. 10. University of Alabama at Birmingham (UAB) Comprehensive Cancer Center, Birmingham, AL. Electronic address: gsonpavde@uabmc.edu.
Abstract
BACKGROUND: Outcomes with concurrent chemoradiotherapy for penile squamous cell carcinoma (PSCC) are unclear, and only anecdotal reports have been published. This study was a retrospective analysis of patients who received concurrent chemotherapy and radiotherapy for PSCC. PATIENTS AND METHODS: Individual patient-level data were obtained from 5 institutions for outcomes with concurrent chemoradiotherapy for PSCC. Descriptive statistics were calculated, and univariable Cox proportional hazards regression analysis was conducted to examine the prognostic effect of candidate factors on progression-free survival (PFS) and overall survival (OS). RESULTS: A total of 26 men were evaluable. The mean age was 60.3 years. The clinical stage was ≤ III in 9 patients (36%) and stage IV in the rest. Soft tissue and visceral metastasis were present in 35% and 20% of patients, respectively. The chemotherapy was cisplatin-based in 92.3% of patients, and the median (range) of external beam radiotherapy administered was 4900 cGy (range, 1800-7000 cGy). The median OS was 6.9 months (95% CI, 5-14), and the median PFS was 5.1 months (95% CI, 2.5-7.0). When excluding patients with M1 disease, the remaining patients (n = 21) had a median OS and PFS of 10.0 months (95% CI, 5-14) and 6.0 months (95% CI, 2.0-7.0), respectively. Baseline neutrophil to lymphocyte ratio (NLR) was significantly associated with survival, and visceral metastasis showed a trend for association with OS. CONCLUSIONS: Concurrent chemoradiotherapy demonstrated poor outcomes for locally advanced PSCC. Better understanding of tumor biology and study of novel combinations of biologic agents with radiation are warranted.
BACKGROUND: Outcomes with concurrent chemoradiotherapy for penile squamous cell carcinoma (PSCC) are unclear, and only anecdotal reports have been published. This study was a retrospective analysis of patients who received concurrent chemotherapy and radiotherapy for PSCC. PATIENTS AND METHODS: Individual patient-level data were obtained from 5 institutions for outcomes with concurrent chemoradiotherapy for PSCC. Descriptive statistics were calculated, and univariable Cox proportional hazards regression analysis was conducted to examine the prognostic effect of candidate factors on progression-free survival (PFS) and overall survival (OS). RESULTS: A total of 26 men were evaluable. The mean age was 60.3 years. The clinical stage was ≤ III in 9 patients (36%) and stage IV in the rest. Soft tissue and visceral metastasis were present in 35% and 20% of patients, respectively. The chemotherapy was cisplatin-based in 92.3% of patients, and the median (range) of external beam radiotherapy administered was 4900 cGy (range, 1800-7000 cGy). The median OS was 6.9 months (95% CI, 5-14), and the median PFS was 5.1 months (95% CI, 2.5-7.0). When excluding patients with M1 disease, the remaining patients (n = 21) had a median OS and PFS of 10.0 months (95% CI, 5-14) and 6.0 months (95% CI, 2.0-7.0), respectively. Baseline neutrophil to lymphocyte ratio (NLR) was significantly associated with survival, and visceral metastasis showed a trend for association with OS. CONCLUSIONS: Concurrent chemoradiotherapy demonstrated poor outcomes for locally advanced PSCC. Better understanding of tumor biology and study of novel combinations of biologic agents with radiation are warranted.
Authors: Reena Patel; Louise English; Wing K Liu; Alison C Tree; Benjamin Ayres; Nick Watkin; Lisa M Pickering; Mehran Afshar Journal: Int Urol Nephrol Date: 2020-07-23 Impact factor: 2.370
Authors: Mounsif Azizi; Charles C Peyton; David C Boulware; Juan Chipollini; Timothy Juwono; Julio M Pow-Sang; Philippe E Spiess Journal: Eur Urol Focus Date: 2018-06-22