 |
|
Biochemical Outcome Following External Beam Radiation Therapy With or Without Androgen Suppression Therapy for Clinically Localized Prostate Cancer
Anthony V. D'Amico, MD, PhD;
Delray Schultz, PhD;
Marian Loffredo, RN, OCN;
Raymond Dugal, MD;
Mark Hurwitz, MD;
Irving Kaplan, MD;
Clair J. Beard, MD;
Andrew A. Renshaw, MD;
Philip W. Kantoff, MD
JAMA. 2000;284:1280-1283.
Context Combined treatment using radiation therapy (RT) and androgen suppression therapy (AST) is used to treat men with clinically localized adenocarcinoma of the prostate, but outcome using this combined therapy compared with RT alone is not known.
Objective To determine the relative efficacy of RT plus AST vs RT alone among men with clinically localized prostate cancer.
Design, Setting, and Patients Retrospective cohort study of 1586 men with prostate cancer who were treated between January 1989 and August 1999 using 3-dimensional conformal RT with (n = 276) or without (n = 1310) 6 months of AST.
Main Outcome Measure Relative risk (RR) of prostate-specific antigen (PSA) failure (defined according to the American Society for Therapeutic Radiology and Oncology consensus statement), by treatment and high-, intermediate-, or low-risk group based on serum PSA level, biopsy Gleason score, and 1992 American Joint Commission on Cancer clinical tumor category.
Results Estimates of 5-year PSA outcome after RT with or without AST were not statistically different among low-risk patients (P = .09), whereas intermediate- and high-risk patients treated with RT plus AST had significantly better outcomes than those treated with RT alone (P<.001 and = .009, respectively). The RR of PSA failure in low-risk patients treated with RT plus AST was 0.5 (95% confidence interval [CI], 0.3-1.1) compared with patients treated with RT alone. The RRs of PSA failure in intermediate-risk and high-risk patients treated with RT plus AST compared with RT alone were 0.2 (95% CI, 0.1-0.3) and 0.4 (95% CI, 0.2-0.8), respectively.
Conclusions Our data suggest a significant benefit in 5-year PSA outcomes for men with clinically localized prostate cancer in intermediate- and high-risk groups treated with RT plus AST vs those treated with RT alone. Results from prospective randomized trials currently under way are needed to validate these findings.
Author Affiliations: Joint Center for Radiation Therapy, Brigham and Women's Hospital and Dana Farber Cancer Institute (Drs D'Amico, Dugal, and Hurwitz and Ms Loffredo), Beth Israel Deaconess Medical Center Department of Radiation Oncology (Drs Kaplan and Beard), Department of Pathology, Brigham and Women's Hospital (Dr Renshaw), Department of Medical Oncology, Dana Farber Cancer Institute (Dr Kantoff), Boston, Mass; and Department of Mathematics, Millersville University, Millersville, Pa (Dr Schultz).
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
RELATED LETTER
Biochemical Outcomes of Treatment for Prostate Cancer
Frank A. Vicini, Larry Kestin, Alvaro Martinez, and Anthony V. D'Amico
JAMA. 2000;284(22):2869.
EXTRACT
| FULL TEXT
RELATED ARTICLE
September 13, 2000
JAMA. 2000;284(10):1317-1318.
EXTRACT
| FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Definitive Conformal Radiotherapy for Localized Prostate Cancer: A Long-term Follow-up Study
DEICHMUELLER et al.
Anticancer Res 2009;29:2627-2634.
ABSTRACT
| FULL TEXT
Chromosome 17q12 Variants Contribute to Risk of Early-Onset Prostate Cancer
Levin et al.
Cancer Res. 2008;68:6492-6495.
ABSTRACT
| FULL TEXT
Common Variation in the BRCA1 Gene and Prostate Cancer Risk
Douglas et al.
Cancer Epidemiol. Biomarkers Prev. 2007;16:1510-1516.
ABSTRACT
| FULL TEXT
Identifying Susceptibility Genes for Prostate Cancer--A Family-Based Association Study of Polymorphisms in CYP17, CYP19, CYP11A1, and LH-{beta}
Douglas et al.
Cancer Epidemiol. Biomarkers Prev. 2005;14:2035-2039.
ABSTRACT
| FULL TEXT
External Beam Radiotherapy as Curative Treatment of Prostate Cancer
Pisansky
Mayo Clin Proc. 2005;80:883-898.
ABSTRACT
Management of localised prostate cancer
DTB 2004;42:81-85.
ABSTRACT
| FULL TEXT
Radiation Therapy and Androgen Suppression as Treatment for Clinically Localized Prostate Cancer: The New Standard?
DeWeese
JAMA 2004;292:864-866.
FULL TEXT
Sparing of the penile bulb and proximal penile structures with intensity-modulated radiation therapy for prostate cancer
Kao et al.
Br. J. Radiol. 2004;77:129-136.
ABSTRACT
| FULL TEXT
Histone H2AX Phosphorylation as a Predictor of Radiosensitivity and Target for Radiotherapy
Taneja et al.
J. Biol. Chem. 2004;279:2273-2280.
ABSTRACT
| FULL TEXT
Do Older Men Benefit From Curative Therapy of Localized Prostate Cancer?
Alibhai et al.
2003;21:3318-3327.
ABSTRACT
| FULL TEXT
Comparing the Costs of Radiation Therapy and Radical Prostatectomy for the Initial Treatment of Early-Stage Prostate Cancer
Burkhardt et al.
JCO 2002;20:2869-2875.
ABSTRACT
| FULL TEXT
The Current State of Hormonal Therapy for Prostate Cancer
Hellerstedt and Pienta
CA Cancer J Clin 2002;52:154-179.
ABSTRACT
| FULL TEXT
Biochemical Outcomes of Treatment for Prostate Cancer
Vicini et al.
JAMA 2000;284:2869-2869.
FULL TEXT
|
