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https://mnclhd.intersearch.com.au/mnclhdjspui/handle/123456789/219
Title: | Long-term outcomes from dose-escalated image-guided intensity-modulated radiotherapy with androgen deprivation: encouraging results for intermediate-and high-risk prostate cancer |
Authors: | Wilcox, S. W.;Aherne, N. J.;Benjamin, L. C.;Wu, B.;De Campos Silva, T.;McLachlan, C. S.;McKay, M. J.;Last, A. J.;Shakespeare, T. P. |
MNCLHD Author: | Wilcox, Shea Aherne, Noel Benjamin, Linus C. Wu, Bosco Last, Andrew Shakespeare, Thomas P. |
Issue Date: | Aug-2014 |
Citation: | OncoTargets & Therapy. 2014 Aug 30:7:1519-23. doi: 10.2147/OTT.S65238. |
Abstract: | Purpose: Dose-escalated (DE) radiotherapy in the setting of localized prostate cancer has been shown to improve biochemical disease-free survival (bDFS) in several studies. In the same group of patients, androgen deprivation therapy (ADT) has been shown to confer a survival benefit when combined with radiotherapy doses of up to 70 Gy; however, there is currently little long-term data on patients who have received high-dose intensity-modulated radiotherapy (IMRT) with ADT. We report the long-term outcomes in a large cohort of patients treated with the combination of DE image-guided IMRT (IG-IMRT) and ADT. Methods and materials: Patients with localized prostate cancer were identified from a centralized database across an integrated cancer center. All patients received DE IG-IMRT, combined with ADT, and had a minimum follow up of 12 months post-radiotherapy. All relapse and toxicity data were collected prospectively. Actuarial bDFS, metastasis-free survival, prostate cancer-specific survival, and multivariate analyses were calculated using the SPSS v20.0 statistical package. Results: Seven hundred and eighty-two eligible patients were identified with a median follow up of 46 months. Overall, 4.3% of patients relapsed, 2.0% developed distant metastases, and 0.6% died from metastatic prostate cancer. At 5-years, bDFS was 88%, metastasis-free survival was 95%, and prostate cancer-specific survival was 98%. Five-year grade 2 genitourinary and gastrointestinal toxicity was 2.1% and 3.4%, respectively. No grade 3 or 4 late toxicities were reported. Pretreatment prostate specific antigen (P=0.001) and Gleason score (P=0.03) were significant in predicting biochemical failure on multivariate analysis. Conclusion: There is a high probability of tumor control with DE IG-IMRT combined with androgen deprivation, and this is a technique with a low probability of significant late toxicity. Our long term results corroborate the safety and efficacy of treating with IG-IMRT to high doses and compares favorably with published series for the treatment of prostate cancer. |
URI: | https://mnclhd.intersearch.com.au/mnclhdjspui/handle/123456789/219 |
Keywords: | Prostatic Neoplasms;Radiotherapy, Intensity-Modulated;Androgen Antagonists;Radiotherapy, Image-Guided;Disease-Free Survival |
Appears in Collections: | Oncology / Cancer |
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File | Size | Format | |
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OTT-65238-dose-escalated--image-guided-imrt-with-androgen-deprivation-_083014.pdf | 495.4 kB | Adobe PDF | View/Open |
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