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- W2336619175 abstract "4767 Background: Standard dose (<=70 Gy) external beam radiotherapy (SD-EBRT) is known to be modestly effective treatment for intermediate risk prostate cancer. Over the last decade, several approaches have emerged to improved on those results. To address the uncertainty of which of these treatments is most effective, we performed a retrospective cohort study of such patients treated at our institution. Methods:Analyzed all intermediate-risk patients as defined by D'Amico. These 346 patients had received either SD-EBRT (N=141), SD-EBRT + androgen deprivation (AD) (N=84; AD 3–40 mos., median 6), high-dose (HD) EBRT (>=72 Gy) +/- AD (N=49, AD 3–24 mos., median 4.5), brachytherapy (BRACHY) (N=10), BRACHY+EBRT (N=39), BRACHY+AD (N=11, AD 1–13 mos., median 3.5), and BRACHY+EBRT+AD (N=12, AD 3–9 mos., median 5). Outcome was biochemical disease-free survival (BDFS) as defined by ASTRO, estimated using Kaplan Meyer method and compared using log rank statistic. Because of uncertainty regarding the appropriateness of the ASTRO definition in AD patients, a second analysis using the definition of PSA > 1.5 ng/ml (as per Bolla et al.) was used. Multivariate analysis: Cox regression analysis. To adjust for stage migration over the study period, years of treatment were grouped and included as a variable in analysis Results: Using ASTRO: Within SD-EBRT and HD-EBRT outcome did not differ +/- AD. Outcome did not differ between different BRACHY-based treatments. BRACHY-based (p=0.0003) is superior to SD-EBRT +/- AD. HD-EBRT +/- AD was borderline significantly better (p=0.07). Multivariate, including year of treatment, confirmed BRACHY-based (p=0.01, RR 3.1) to be superior to SD-EBRT +/- AD. HD-EBRT +/- AD was not (p=0.4). Using PSA > 1.5 definition: SD-EBRT+AD (p=0.0001), BRACHY-based (p<0.00009), HD-EBRT +/- AD (p=0.01) were superior to SD-EBRT. Multivariate: SD-EBRT+AD (p=0.01, RR 2.6), BRACHY-based (p=0.01, RR 4.5) remained superior to SD-EBRT. Conclusions: Brachytherapy-based treatments and possibly the addition of AD to SD-EBRT improve the outcome of intermediate-risk prostate cancer over SD-EBRT. Determination of BDFS of AD treatments is definition dependent. No significant financial relationships to disclose." @default.
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- W2336619175 date "2004-07-15" @default.
- W2336619175 modified "2023-10-02" @default.
- W2336619175 title "Intermediate risk localized prostate cancer: Which radiotherapeutic approach?" @default.
- W2336619175 doi "https://doi.org/10.1200/jco.2004.22.90140.4767" @default.
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