Expanded risk groups help determine which prostate radiotherapy sub-group may benefit from adjuvant androgen deprivation therapy.

Radiation Oncology
Matthew BeasleyBCCA Prostate Outcomes Unit

Abstract

To assess whether an expanded (five level) risk stratification system can be used to identify the sub-group of intermediate risk patients with prostate cancer who benefit from combining androgen deprivation therapy (ADT) with external beam radiotherapy (EBRT). Using a previously validated 5-risk group schema, a prospective non-randomized data set of 1423 men treated at the British Columbia Cancer Agency was assessed for the primary end point of biochemical control (bNED) with the RTOG-ASTRO "Phoenix" definition (lowest PSA to date + 2 ng/mL), both with and without adjuvant ADT. The median follow-up was 5 years. There was no bNED benefit for ADT in the low or low intermediate groups but there was a statistically significant bNED benefit in the high intermediate, high and extreme risk groups. The 5-year bNED rates with and without ADT were 70% and 73% respectively for the low intermediate group (p = non-significant) and 72% and 58% respectively for the high intermediate group (p = 0.002). There appears to be no advantage to ADT where the Gleason score is 6 or less and PSA is 15 or less. ADT is beneficial in patients treated to standard dose radiation with Gleason 6 disease and a PSA greater than 15 or where the Gleason score is 7...Continue Reading

References

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Citations

Nov 24, 2011·Prostate Cancer·Kristene Myklak, Shandra Wilson
Jan 1, 2009·Cancer Management and Research·Shandra Wilson
May 18, 2010·International Journal of Radiation Oncology, Biology, Physics·Scott WilliamsTom Pickles
Nov 20, 2016·Asia-Pacific Journal of Clinical Oncology·Ee Siang ChoongNitya Patanjali
Mar 28, 2017·Journal of Clinical Urology·Keval M Patel, Vincent J Gnanapragasam

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