Brachytherapy boost and cancer-specific mortality in favorable high-risk versus other high-risk prostate cancer
View/ Open
Author
Xiang, Michael
Orio, Peter F.
Martin, Neil E.
Beard, Clair J.
Feng, Felix Y.
Hoffman, Karen E.
Nguyen, Paul L.
Published Version
https://doi.org/10.5114/jcb.2016.58080Metadata
Show full item recordCitation
Muralidhar, Vinayak, Michael Xiang, Peter F. Orio, Neil E. Martin, Clair J. Beard, Felix Y. Feng, Karen E. Hoffman, and Paul L. Nguyen. 2016. “Brachytherapy boost and cancer-specific mortality in favorable high-risk versus other high-risk prostate cancer.” Journal of Contemporary Brachytherapy 8 (1): 1-6. doi:10.5114/jcb.2016.58080. http://dx.doi.org/10.5114/jcb.2016.58080.Abstract
Purpose Recent retrospective data suggest that brachytherapy (BT) boost may confer a cancer-specific survival benefit in radiation-managed high-risk prostate cancer. We sought to determine whether this survival benefit would extend to the recently defined favorable high-risk subgroup of prostate cancer patients (T1c, Gleason 4 + 4 = 8, PSA < 10 ng/ml or T1c, Gleason 6, PSA > 20 ng/ml). Material and methods We identified 45,078 patients in the Surveillance, Epidemiology, and End Results database with cT1c-T3aN0M0 intermediate- to high-risk prostate cancer diagnosed 2004-2011 treated with external beam radiation therapy (EBRT) only or EBRT plus BT. We used multivariable competing risks regression to determine differences in the rate of prostate cancer-specific mortality (PCSM) after EBRT + BT or EBRT alone in patients with intermediate-risk, favorable high-risk, or other high-risk disease after adjusting for demographic and clinical factors. Results: EBRT + BT was not associated with an improvement in 5-year PCSM compared to EBRT alone among patients with favorable high-risk disease (1.6% vs. 1.8%; adjusted hazard ratio [AHR]: 0.56; 95% confidence interval [CI]: 0.21-1.52, p = 0.258), and intermediate-risk disease (0.8% vs. 1.0%, AHR: 0.83, 95% CI: 0.59-1.16, p = 0.270). Others with high-risk disease had significantly lower 5-year PCSM when treated with EBRT + BT compared with EBRT alone (3.9% vs. 5.3%; AHR: 0.73; 95% CI: 0.55-0.95; p = 0.022). Conclusions: Brachytherapy boost is associated with a decreased rate of PCSM in some men with high-risk prostate cancer but not among patients with favorable high-risk disease. Our results suggest that the recently-defined “favorable high-risk” category may be used to personalize therapy for men with high-risk disease.Other Sources
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4793071/pdf/Terms of Use
This article is made available under the terms and conditions applicable to Other Posted Material, as set forth at http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAACitable link to this page
http://nrs.harvard.edu/urn-3:HUL.InstRepos:26318700
Collections
- FAS Scholarly Articles [18295]
- HMS Scholarly Articles [17922]
Contact administrator regarding this item (to report mistakes or request changes)