The effect of dose‐escalation radiotherapy with simultaneous‐integrated‐boost on the use of short‐term androgen deprivation therapy in patients with intermediate risk prostate cancer

Author:

Onal Cem12ORCID,Guler Ozan Cem1,Erbay Gurcan3,Elmali Aysenur2ORCID

Affiliation:

1. Department of Radiation Oncology Baskent University Faculty of Medicine Adana Dr Turgut Noyan Research and Treatment Center Adana Turkey

2. Department of Radiation Oncology Baskent University Faculty of Medicine Ankara Turkey

3. Department of Radiology Baskent University Faculty of Medicine Adana Dr Turgut Noyan Research and Treatment Center Adana Turkey

Abstract

AbstractPurposeTo compare the biochemical failure (FFBF) and prostate cancer specific survival (PCSS) rates of patients with intermediate‐risk prostate cancer (IR‐PC) who were treated with 6 months of androgen deprivation therapy (ADT) with 78 Gy to the prostate, those treated with ADT and focal boost (FB) of 86 Gy to intraprostatic lesion (IPL) using the simultaneous‐integrated boost (SIB) technique, and those treated with SIB alone.Materials and MethodsA retrospective analysis of 320 IR‐PC patients treated between January 2012 and April 2021 was performed. Patients were divided into three groups based on their treatment arm: 78 + ADT (109 patients, 34.1%), 78/86 (102 patients, 31.8%), and 78/86 + ADT. Univariable and multivariable analyses were used to determine prognostic factors for FFBF and PCSS.ResultsMedian follow‐up was 8.8 years. The 8‐year FFBF and PCSS rates were 88.6% and 99.0%. Patients who received ADT had significantly higher pretreatment PSA levels and clinical tumor stage. Disease progression occurred in 45 patients (7.3%) at a median of 41.9 months after definitive radiotherapy (RT). Younger age, positive core biopsy (PCB) ≥ 50%, and the absence of ADT were all independent predictors of poor FFBF in multivariate analysis, whereas patients with PCB < 50% who were also given ADT had better PCSS. Patients treated with 78/86 Gy alone had worse FFBF than those treated with 78 Gy and ADT (Hazard ratio [HR] = 3.39 [95% CI = 1.46–7.88]; p = 0.005), as well as than those treated with 78/86 Gy and ADT (HR = 3.21 [95% CI = 1.23–6.46]; p = 0.009). However, FB to IPL has no effect on PCSS in multivariable analysis. There was no significant difference between treatment groups in terms of acute and late Grade ≥2 genitourinary or gastrointestinal toxicity.ConclusionsOur findings demonstrated that patients who received 78/86 alone did worse than patients who received ADT with either 78 or 78/86 Gy. However, because IR‐PC patients are so diverse, additional prospective trials are needed to validate our findings.

Publisher

Wiley

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3