학술논문
Local Failure and Survival After Definitive Radiotherapy for Aggressive Prostate Cancer: An Individual Patient-level Meta-analysis of Six Randomized Trials
Document Type
article
Author
Kishan, Amar U; Chu, Fang-I; King, Christopher R; Seiferheld, Wendy; Spratt, Daniel E; Tran, Phuoc; Wang, Xiaoyan; Pugh, Stephanie E; Sandler, Kiri A; Bolla, Michel; Maingon, Philippe; De Reijke, Theo; Nickols, Nicholas G; Rettig, Matthew; Drakaki, Alexandra; Liu, Sandy T; Reiter, Robert E; Chang, Albert J; Feng, Felix Y; Sajed, Dipti; Nguyen, Paul L; Kupelian, Patrick A; Steinberg, Michael L; Boutros, Paul C; Elashoff, David; Collette, Laurence; Sandler, Howard M
Source
European Urology. 77(2)
Subject
Language
Abstract
BackgroundThe importance of local failure (LF) after treatment of high-grade prostate cancer (PCa) with definitive radiotherapy (RT) remains unknown.ObjectiveTo evaluate the clinical implications of LF after definitive RT.Design, setting, and participantsIndividual patient data meta-analysis of 992 patients (593 Gleason grade group [GG] 4 and 399 GG 5) enrolled in six randomized clinical trials.Outcome measurements and statistical analysisMultivariable Cox proportional hazard models were developed to evaluate the relationship between overall survival (OS), PCa-specific survival (PCSS), and distant metastasis (DM)-free survival (DMFS) and LF as a time-dependent covariate. Markov proportional hazard models were developed to evaluate the impact of specific transitions between disease states on these endpoints.Results and limitationsMedian follow-up was 6.4 yr overall and 7.2 yr for surviving patients. LF was significantly associated with OS (hazard ratio [HR] 1.70 [95% confidence interval {CI} 1.37-2.10]), PCSS (3.10 [95% CI 2.33-4.12]), and DMFS (HR 1.92 [95% CI 1.54-2.39]), p