Patterns of recurrence following radiation and ADT for pathologic lymph node positive prostate cancer: A multi-institutional study.

IF 3.4 3区医学 Q2 ONCOLOGY

Practical Radiation Oncology Pub Date : 2024-12-27 DOI:10.1016/j.prro.2024.12.006

Leslie K Ballas, Chandana A Reddy, Hye Ri Han, Jelena B Makar, Omar Mian, James Broughman, Conchita de Bustamante, Scott Eggener, Stanley L Liauw, Matthew Abramowitz, Christopher Montoya, Rahul Tendulkar

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引用次数: 0

Abstract

Background and objective: We evaluate prognostic factors and patterns of recurrence in patients who received RT ± androgen deprivation therapy (ADT) for pathologic node-positive (pN1) prostate cancer (PCa) in a multi-institutional cohort.

Methods: Data from patients with pN1 PCa and received RT with short term (ST, ≤6 mo) or long term (LT, >6 mo) ADT were obtained from 4 academic institutions. Biochemical progression free survival (bPFS) and distant metastasis free survival (DMFS) were evaluated.

Key findings and limitations: 270 patients were included, with a median follow-up of 48 months. 256 (95%) patients had extracapsular extension, 70% had seminal vesicle invasion, 59% had positive surgical margins, 49% had grade group 5, and 64% had a detectable (>0.1 ng/mL) post-operative PSA. ADT was ST (20%) or LT (68%, median 24 months), while 26 (10%) received no ADT. Biochemical failure (bF) was observed in 29%, with 5% having pelvic nodal failure and 11% having distant metastases. The 4-year bPFS was 72% overall, and was 83% for a pre-RT PSA of <0.1 ng/mL, 76% for PSA 0.1-<0.5 ng/mL, 60% for PSA 0.5-2 ng/mL, and 35% for PSA >2 ng/mL (p<0.0001). On multivariable analysis, pre-RT PSA >0.5 (0.5 to 2.0 vs <0.1 HR=2.97; >2.0 vs <0.1 HR=7.63), use of LT ADT vs no ADT (HR=0.43) and use of LT ADT compared to ST ADT (HR= 0.34), Grade group 4 vs 2 (HR=4.11), and positive surgical margins (HR 1.773) were significantly associated with bPFS.

Conclusions: Post-prostatectomy RT at PSA <0.5 ng/mL is associated with favorable bPFS in pN1 prostate cancer.

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来源期刊

Practical Radiation Oncology Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

5.20

自引率

6.10%

发文量

177

审稿时长

34 days

期刊介绍： The overarching mission of Practical Radiation Oncology is to improve the quality of radiation oncology practice. PRO''s purpose is to document the state of current practice, providing background for those in training and continuing education for practitioners, through discussion and illustration of new techniques, evaluation of current practices, and publication of case reports. PRO strives to provide its readers content that emphasizes knowledge "with a purpose." The content of PRO includes: Original articles focusing on patient safety, quality measurement, or quality improvement initiatives Original articles focusing on imaging, contouring, target delineation, simulation, treatment planning, immobilization, organ motion, and other practical issues ASTRO guidelines, position papers, and consensus statements Essays that highlight enriching personal experiences in caring for cancer patients and their families.