Swetha Sridharan1, Allison Steigler2, Nigel A Spry3, David Joseph3, David S Lamb4, John H Matthews5, Chris Atkinson6, Keen-Hun Tai7, Gillian Duchesne7, David Christie8, John Attia9, Elizabeth G Holliday9, James W Denham10. 1. Calvary Mater Newcastle, Waratah, Australia. 2. School of Medicine and Public Health, University of Newcastle, Australia. 3. Sir Charles Gairdner Hospital, Perth, Australia. 4. Wellington Cancer Centre, New Zealand. 5. Auckland Hospital, New Zealand. 6. St Georges Cancer Care Centre, Christchurch, New Zealand. 7. Peter MacCallum Cancer Centre, Melbourne, Australia. 8. Genesiscare, Tugun, Australia. 9. School of Medicine and Public Health, University of Newcastle, Australia; Hunter Medical Research Institute, Newcastle, Australia. 10. School of Medicine and Public Health, University of Newcastle, Australia. Electronic address: Jim.Denham@newcastle.edu.au.
Abstract
BACKGROUND: It remains unclear whether eradication of oligometastases by stereotactic body radiation therapy or other means will result in cure or prolongation of survival in some cases, or merely provide palliation. We address this issue with prospectively collected progression and treatment data from the TROG 03.04 RADAR randomised controlled trial for men with locally advanced prostate cancer (PC). METHODS: Three Fine and Gray competing risk survival models with time-dependent covariates were used to determine whether metastatic progression status at first diagnosis of bony metastases, i.e. number of bony sites involved and presence of prior or simultaneous other sites of progression, impacts on prostate cancer-specific mortality (PCSM) when adjusted for baseline prognostic factors and allocated primary treatment. RESULTS:Between 2003 and 2014, 176 of the 1071 subjects developed bone metastases, 152 developed other sites of progression and 91 died of PC. All subjects received secondary treatment using androgen suppression but none received extirpative treatments. The three models found evidence: 1 - of a clear prognostic gradient according to number of bony metastatic sites; 2 - that other sites of progression contributed to PCSM to a lesser extent than bone progression; and 3 - that further bony metastatic progression in men with up to 3 bony metastases had a major impact on PCSM. CONCLUSION: Randomised trials are essential to determine the value of extirpative treatment for oligometastatic bony metastases due to PC.
RCT Entities:
BACKGROUND: It remains unclear whether eradication of oligometastases by stereotactic body radiation therapy or other means will result in cure or prolongation of survival in some cases, or merely provide palliation. We address this issue with prospectively collected progression and treatment data from the TROG 03.04 RADAR randomised controlled trial for men with locally advanced prostate cancer (PC). METHODS: Three Fine and Gray competing risk survival models with time-dependent covariates were used to determine whether metastatic progression status at first diagnosis of bony metastases, i.e. number of bony sites involved and presence of prior or simultaneous other sites of progression, impacts on prostate cancer-specific mortality (PCSM) when adjusted for baseline prognostic factors and allocated primary treatment. RESULTS: Between 2003 and 2014, 176 of the 1071 subjects developed bone metastases, 152 developed other sites of progression and 91 died of PC. All subjects received secondary treatment using androgen suppression but none received extirpative treatments. The three models found evidence: 1 - of a clear prognostic gradient according to number of bony metastatic sites; 2 - that other sites of progression contributed to PCSM to a lesser extent than bone progression; and 3 - that further bony metastatic progression in men with up to 3 bony metastases had a major impact on PCSM. CONCLUSION: Randomised trials are essential to determine the value of extirpative treatment for oligometastatic bony metastases due to PC.
Authors: Bert Dhondt; Elise De Bleser; Tom Claeys; Sarah Buelens; Nicolaas Lumen; Jo Vandesompele; Anneleen Beckers; Valerie Fonteyne; Kim Van der Eecken; Aurélie De Bruycker; Jérôme Paul; Pierre Gramme; Piet Ost Journal: World J Urol Date: 2018-12-21 Impact factor: 4.226
Authors: C Leigh Moyer; Ryan Phillips; Matthew P Deek; Noura Radwan; Ashley E Ross; Emmanuel S Antonarakis; Diane Reyes; Jean Wright; Stephanie A Terezakis; Daniel Y Song; Curtiland DeVille; Patrick C Walsh; Theodore L DeWeese; Michael Carducci; Edward M Schaeffer; Kenneth J Pienta; Mario Eisenberger; Phuoc T Tran Journal: World J Urol Date: 2018-09-06 Impact factor: 4.226
Authors: Barbara Alicja Jereczek-Fossa; Barbara Bortolato; Marianna Alessandra Gerardi; Samantha Dicuonzo; Virginia Maria Arienti; Stefania Berlinghieri; Stefano Bracelli; Michela Buglione; Mariangela Caputo; Gianpiero Catalano; Luigi Franco Cazzaniga; Luigi De Cicco; Nadia Di Muzio; Francesco Romeo Filippone; Andrei Fodor; Davide Franceschini; Paolo Frata; Stefania Gottardo; Giovanni Battista Ivaldi; Antonio Laudati; Stefano Maria Magrini; Elisa Mantero; Ilaria Meaglia; Sara Morlino; Mauro Palazzi; Fabio Piccoli; Paola Romanelli; Marta Scorsetti; Flavia Serafini; Luciano Scandolaro; Riccardo Valdagni; Roberto Orecchia; Paolo Antognoni Journal: Radiol Med Date: 2018-12-15 Impact factor: 3.469
Authors: Noura Radwan; Ryan Phillips; Ashley Ross; Steven P Rowe; Michael A Gorin; Emmanuel S Antonarakis; Curtiland Deville; Stephen Greco; Samuel Denmeade; Channing Paller; Daniel Y Song; Maximilian Diehn; Hao Wang; Michael Carducci; Kenneth J Pienta; Martin G Pomper; Theodore L DeWeese; Adam Dicker; Mario Eisenberger; Phuoc T Tran Journal: BMC Cancer Date: 2017-06-29 Impact factor: 4.430
Authors: M Oertel; S Scobioala; K Kroeger; A Baehr; L Stegger; U Haverkamp; M Schäfers; H-T Eich Journal: Radiat Oncol Date: 2018-09-21 Impact factor: 3.481