Jeremiah F de Leon1, Andrew Kneebone2,3, Val Gebski3,4,5, Shamira Cross5,6, Viet Do6,7,8, Amy Hayden5,6, Diana Ngo7, Mark Sidhom7,8, Sandra Turner3,5. 1. Department of Radiation Oncology, Illawarra Cancer Care Centre, Wollongong, New South Wales, Australia. 2. Northern Sydney Cancer Centre, Sydney, New South Wales, Australia. 3. University of Sydney, Sydney, New South Wales, Australia. 4. NHMRC Clinical Trials Centre, Sydney, New South Wales, Australia. 5. Crown Princess Mary Cancer Centre, Westmead Hospital, Sydney, New South Wales, Australia. 6. Nepean Cancer Centre, Sydney, New South Wales, Australia. 7. Liverpool and Macarthur Cancer Therapy Centre, Sydney, New South Wales, Australia. 8. University of New South Wales, New South Wales, Australia.
Abstract
INTRODUCTION: Optimal definitive treatment of prostate cancer is controversial, especially in high-risk patients. We report the largest prospective cohort of Australian patients treated with radiotherapy for localised prostate cancer. METHODS: One thousand, one hundred and twenty-one patients with prostate cancer were prospectively registered and treated to a dose of 70-74 Gy. Patients were classified as low, intermediate or high risk based on PSA, clinical staging and Gleason score. Intermediate-risk patients were treated with 0-6 months of hormonal therapy (ADT) and high-risk patients were offered neoadjuvant and adjuvant ADT. Overall survival (OS) and biochemical relapse-free survival (bNED) were calculated using the Kaplan-Meier method. RESULTS: Median follow-up was 92 months. Eight-year OS and bNED were 78.4% and 68.1% respectively in the entire cohort. OS for the low, intermediate and high-risk groups was 84.5%, 78.4% and 68% respectively. For these risk groups, bNED was 80.3%, 65.7% and 53.7% respectively. In the intermediate and high-risk group, OS and bNED decreased with increasing number of risk factors. CONCLUSION: Definitive radiotherapy is an effective treatment for prostate cancer, including in high-risk cases.
INTRODUCTION: Optimal definitive treatment of prostate cancer is controversial, especially in high-risk patients. We report the largest prospective cohort of Australian patients treated with radiotherapy for localised prostate cancer. METHODS: One thousand, one hundred and twenty-one patients with prostate cancer were prospectively registered and treated to a dose of 70-74 Gy. Patients were classified as low, intermediate or high risk based on PSA, clinical staging and Gleason score. Intermediate-risk patients were treated with 0-6 months of hormonal therapy (ADT) and high-risk patients were offered neoadjuvant and adjuvant ADT. Overall survival (OS) and biochemical relapse-free survival (bNED) were calculated using the Kaplan-Meier method. RESULTS: Median follow-up was 92 months. Eight-year OS and bNED were 78.4% and 68.1% respectively in the entire cohort. OS for the low, intermediate and high-risk groups was 84.5%, 78.4% and 68% respectively. For these risk groups, bNED was 80.3%, 65.7% and 53.7% respectively. In the intermediate and high-risk group, OS and bNED decreased with increasing number of risk factors. CONCLUSION: Definitive radiotherapy is an effective treatment for prostate cancer, including in high-risk cases.
Authors: Matthias Moll; Andreas Renner; Christian Kirisits; Christopher Paschen; Alexandru Zaharie; Gregor Goldner Journal: Strahlenther Onkol Date: 2021-08-05 Impact factor: 3.621