Treatment Outcomes of Prostate Cancer Patients with Gleason Score 8-10 Treated with Definitive Radiotherapy : TROD 09-001 Multi-institutional Study

Overview

Journal Strahlenther Onkol

Specialties Oncology
Radiology

Date 2019 May 31

PMID 31143994

Citations 3

Authors

Gokhan Ozyigit

Cem Onal

Sefik Igdem

Zumre Arican Alicikus

Ayca Iribas

Mustafa Akin

Deniz Yalman

Ilknur Cetin

Melek Gamze Aksu

Banu Atalar

Fazilet Dincbas

Pervin Hurmuz

Ozan Cem Guler

Barbaros Aydin

Fatma Sert

Cumhur Yildirim

Ilknur Birkay Gorken

Fulya Yaman Agaoglu

Aylin Fidan Korcum

Deniz Yuce

Serdar Ozkok

Emin Darendeliler

Fadil Akyol

Affiliations

Soon will be listed here.

Abstract

Purpose: To validate the clinical outcomes and prognostic factors in prostate cancer (PCa) patients with Gleason score (GS) 8-10 disease treated with external beam radiotherapy (EBRT) + androgen deprivation therapy (ADT) in the modern era.

Methods: Institutional databases of biopsy proven 641 patients with GS 8-10 PCa treated between 2000 and 2015 were collected from 11 institutions. In this multi-institutional Turkish Radiation Oncology Group study, a standard database sheet was sent to each institution for patient enrollment. The inclusion criteria were, T1-T3N0M0 disease according to AJCC (American Joint Committee on Cancer) 2010 Staging System, no prior diagnosis of malignancy, at least 70 Gy total irradiation dose to prostate ± seminal vesicles delivered with either three-dimensional conformal RT or intensity-modulated RT and patients receiving ADT.

Results: The median follow-up time was 5.9 years (range 0.4-18.2 years); 5‑year overall survival (OS), biochemical relapse-free survival (BRFS) and distant metastases-free survival (DMFS) rates were 88%, 78%, and 79%, respectively. Higher RT doses (≥78 Gy) and longer ADT duration (≥2 years) were significant predictors for improved DMFS, whereas advanced stage was a negative prognosticator for DMFS in patients with GS 9-10.

Conclusions: Our results validated the fact that oncologic outcomes after radical EBRT significantly differ in men with GS 8 versus those with GS 9-10 prostate cancer. We found that EBRT dose was important predictive factor regardless of ADT period. Patients receiving 'non-optimal treatment' (RT doses <78 Gy and ADT period <2 years) had the worst treatment outcomes.

Citing Articles

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Does brachytherapy boost improve survival outcomes in Gleason Grade Group 5 patients treated with external beam radiotherapy and androgen deprivation therapy? A systematic review and meta-analysis.

Tang T, Gulstene S, McArthur E, Warner A, Boldt G, Velker V Clin Transl Radiat Oncol. 2022; 38:21-27.

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Pinkawa M, Aebersold D, Bohmer D, Flentje M, Ghadjar P, Schmidt-Hegemann N Strahlenther Onkol. 2021; 197(7):575-580.

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Quality of life more than 10 years after radiotherapy for localized prostate cancer-impact of time after treatment and prescription dose.

Pinkawa M, Gharib A, Schlenter M, Timm L, Eble M Qual Life Res. 2020; 30(2):437-443.

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