학술논문
Treatment outcomes of prostate cancer patients with Gleason score 8-10 treated with definitive radiotherapy : TROD 09-001 multi-institutional study.
Document Type
Academic Journal
Author
Ozyigit G; Department of Radiation Oncology, Hacettepe University, Faculty of Medicine, 06100, Ankara, Turkey. gozyigit@hacettepe.edu.tr.; Onal C; Adana Dr Turgut Noyan Research and Treatment Center, Department of Radiation Oncology, Baskent University, Adana, Turkey.; Igdem S; Department of Radiation Oncology, İstanbul Bilim University, Faculty of Medicine, Istanbul, Turkey.; Alicikus ZA; Department of Radiation Oncology, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey.; Iribas A; Istanbul Oncology Institute, Department of Radiation Oncology, İstanbul University, Istanbul, Turkey.; Akin M; Balikesir State Hospital, Balikesir, Turkey.; Yalman D; Department of Radiation Oncology, Ege University, Faculty of Medicine, Izmir, Turkey.; Cetin I; Department of Radiation Oncology, Marmara University, Faculty of Medicine, Istanbul, Turkey.; Aksu MG; Department of Radiation Oncology, Akdeniz University, Faculty of Medicine, Antalya, Turkey.; Atalar B; Department of Radiation Oncology, Acibadem University, Faculty of Medicine, Istanbul, Turkey.; Dincbas F; Cerrahpasa Faculty of Medicine, Department of Radiation Oncology, İstanbul University-Cerrahpasa, Istanbul, Turkey.; Hurmuz P; Department of Radiation Oncology, Hacettepe University, Faculty of Medicine, 06100, Ankara, Turkey.; Guler OC; Adana Dr Turgut Noyan Research and Treatment Center, Department of Radiation Oncology, Baskent University, Adana, Turkey.; Aydin B; Department of Radiation Oncology, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey.; Sert F; Department of Radiation Oncology, Ege University, Faculty of Medicine, Izmir, Turkey.; Yildirim C; Cerrahpasa Faculty of Medicine, Department of Radiation Oncology, İstanbul University-Cerrahpasa, Istanbul, Turkey.; Gorken IB; Department of Radiation Oncology, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey.; Agaoglu FY; Istanbul Oncology Institute, Department of Radiation Oncology, İstanbul University, Istanbul, Turkey.; Korcum AF; Department of Radiation Oncology, Akdeniz University, Faculty of Medicine, Antalya, Turkey.; Yuce D; Department of Prevantive Oncology, Hacettepe University, Hacettepe Cancer Institute, Ankara, Turkey.; Ozkok S; Department of Radiation Oncology, Ege University, Faculty of Medicine, Izmir, Turkey.; Darendeliler E; Istanbul Oncology Institute, Department of Radiation Oncology, İstanbul University, Istanbul, Turkey.; Akyol F; Department of Radiation Oncology, Hacettepe University, Faculty of Medicine, 06100, Ankara, Turkey.
Source
Publisher: Urban & Vogel Country of Publication: Germany NLM ID: 8603469 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1439-099X (Electronic) Linking ISSN: 01797158 NLM ISO Abbreviation: Strahlenther Onkol Subsets: MEDLINE
Subject
Language
English
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.
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.