Prostate Cancer–related Events in Patients with Synchronous Metastatic Hormone-sensitive Prostate Cancer Treated with Androgen Deprivation Therapy with and Without Concurrent Radiation Therapy to the Prostate; Data from the HORRAD Trial

IF 25.3 1区医学 Q1 UROLOGY & NEPHROLOGY

European urology Pub Date : 2024-09-20 DOI:10.1016/j.eururo.2024.08.035

Liselotte M.S. Boevé , Maarten C.C.M. Hulshof , Paul C.M.S. Verhagen , Jos W.R. Twisk , Wim P.J. Witjes , Peter de Vries , R. Jeroen A. van Moorselaar , André N. Vis , George van Andel

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引用次数: 0

Abstract

Background and objective

A survival benefit was demonstrated for patients with low-volume synchronous metastatic hormone-sensitive prostate cancer (mHSPCa) when local radiotherapy to the prostate was added to androgen deprivation therapy. This study aims to determine the incidence of prostate cancer–related events and treatments in those who received and those who did not receive external beam radiotherapy for mHSPCa.

Methods

The HORRAD trial is a multicentre randomised controlled trial recruiting originally 432 patients with mHSPCa diagnosed between 2004 and 2014. In a second updated analysis, 328 patients were studied retrospectively for local and nonlocal prostate cancer–related events and treatments. Outcome measurements included the incidence and treatment of local (bladder outlet or ureter obstruction, catheterisation, surgical intervention, ureteric stents, and nephrostomy tubes) and nonlocal (blood transfusions, hospitalisations, and treatment for painful bone metastases) events. Differences between groups were compared using crude and adjusted logistic regression, while time to occurrence of local events was assessed with Kaplan-Meier curves and Cox regression analysis.

Key findings and limitations

A significant difference in the incidence of local events was observed: 30 events in the radiotherapy group versus 50 in the nonradiotherapy group (p = 0.04). Time to occurrence of local interventions was significantly longer in the radiotherapy group (hazard ratio 0.61, 95% confidence interval 0.37–0.99, p = 0.04). The study’s limitations include its retrospective nature.

Conclusions and clinical implications

Local radiotherapy to the prostate prolongs local event–free survival significantly and reduces local prostate cancer–related interventions in patients with mHSPCa.

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接受雄激素剥夺疗法治疗的同步转移性激素敏感性前列腺癌患者发生的前列腺癌相关事件；来自 HORRAD 试验的数据。

背景和目的：低体积同步转移性激素敏感性前列腺癌（mHSPCa）患者在接受雄激素剥夺治疗的同时接受前列腺局部放疗，可提高生存率。本研究旨在确定接受和未接受体外放射治疗的前列腺癌患者的前列腺癌相关事件和治疗的发生率：HORRAD试验是一项多中心随机对照试验，最初招募了432名在2004年至2014年间确诊的mHSPCa患者。在第二次更新分析中，对328名患者的局部和非局部前列腺癌相关事件和治疗进行了回顾性研究。结果测量包括局部（膀胱出口或输尿管梗阻、导尿、手术干预、输尿管支架和肾造瘘管）和非局部（输血、住院和疼痛性骨转移治疗）事件的发生率和治疗情况。利用粗略和调整后的逻辑回归比较了组间差异，同时利用卡普兰-梅耶曲线和考克斯回归分析评估了发生局部事件的时间：局部事件的发生率存在明显差异：放疗组为30例，而非放疗组为50例（P = 0.04）。放疗组发生局部干预的时间明显更长（危险比为0.61，95%置信区间为0.37-0.99，P = 0.04）。该研究的局限性包括其回顾性：前列腺局部放疗可显著延长mHSPCa患者的局部无事件生存期，并减少与前列腺癌相关的局部干预。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European urology 医学-泌尿学与肾脏学

CiteScore

43.00

自引率

2.60%

发文量

1753

审稿时长

23 days

期刊介绍： European Urology is a peer-reviewed journal that publishes original articles and reviews on a broad spectrum of urological issues. Covering topics such as oncology, impotence, infertility, pediatrics, lithiasis and endourology, the journal also highlights recent advances in techniques, instrumentation, surgery, and pediatric urology. This comprehensive approach provides readers with an in-depth guide to international developments in urology.