| Title: |
Radiotherapy to the prostate for men with metastatic prostate cancer in the UK and Switzerland: Long-term results from the STAMPEDE randomised controlled trial |
| Authors: |
Parker, Chris C; James, Nicholas D; Brawley, Christopher D; Clarke, Noel W; Ali, Adnan; Amos, Claire L; Attard, Gerhardt; Chowdhury, Simon; Cook, Adrian; Cross, William; Dearnaley, David P; Douis, Hassan; Gilbert, Duncan C; Gilson, Clare; Gillessen, Silke; Hoyle, Alex; Jones, Rob J; Langley, Ruth E; Malik, Zafar I; Mason, Malcolm D; Matheson, David; Millman, Robin; Rauchenberger, Mary; Rush, Hannah; Russell, J Martin; Sweeney, Hannah; Bahl, Amit; Birtle, Alison; Capaldi, Lisa; Din, Omar; Ford, Daniel; Gale, Joanna; Henry, Ann; Hoskin, Peter; Kagzi, Mohammed; Lydon, Anna; O’Sullivan, Joe M; Paisey, Sangeeta A; Parikh, Omi; Pudney, Delia; Ramani, Vijay; Robson, Peter; Srihari, Narayanan Nair; Tanguay, Jacob; Parmar, Mahesh KB; Sydes, Matthew R |
| Source: |
PLoS Medicine , 19 (6) , Article e1003998. (2022) |
| Publisher Information: |
Public Library of Science (PLoS) |
| Publication Year: |
2022 |
| Collection: |
University College London: UCL Discovery |
| Description: |
BACKGROUND: STAMPEDE has previously reported that radiotherapy (RT) to the prostate improved overall survival (OS) for patients with newly diagnosed prostate cancer with low metastatic burden, but not those with high-burden disease. In this final analysis, we report long-term findings on the primary outcome measure of OS and on the secondary outcome measures of symptomatic local events, RT toxicity events, and quality of life (QoL). METHODS AND FINDINGS: Patients were randomised at secondary care sites in the United Kingdom and Switzerland between January 2013 and September 2016, with 1:1 stratified allocation: 1,029 to standard of care (SOC) and 1,032 to SOC+RT. No masking of the treatment allocation was employed. A total of 1,939 had metastatic burden classifiable, with 42% low burden and 58% high burden, balanced by treatment allocation. Intention-to-treat (ITT) analyses used Cox regression and flexible parametric models (FPMs), adjusted for stratification factors age, nodal involvement, the World Health Organization (WHO) performance status, regular aspirin or nonsteroidal anti-inflammatory drug (NSAID) use, and planned docetaxel use. QoL in the first 2 years on trial was assessed using prospectively collected patient responses to QLQ-30 questionnaire. Patients were followed for a median of 61.3 months. Prostate RT improved OS in patients with low, but not high, metastatic burden (respectively: 202 deaths in SOC versus 156 in SOC+RT, hazard ratio (HR) = 0·64, 95% CI 0.52, 0.79, p < 0.001; 375 SOC versus 386 SOC+RT, HR = 1.11, 95% CI 0.96, 1.28, p = 0·164; interaction p < 0.001). No evidence of difference in time to symptomatic local events was found. There was no evidence of difference in Global QoL or QLQ-30 Summary Score. Long-term urinary toxicity of grade 3 or worse was reported for 10 SOC and 10 SOC+RT; long-term bowel toxicity of grade 3 or worse was reported for 15 and 11, respectively. CONCLUSIONS: Prostate RT improves OS, without detriment in QoL, in men with low-burden, newly diagnosed, ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
text |
| Language: |
English |
| Relation: |
https://discovery.ucl.ac.uk/id/eprint/10149983/ |
| Availability: |
https://discovery.ucl.ac.uk/id/eprint/10149983/1/Parker-2022-PLOSMed_STAMPEDE-M1RT.pdf; https://discovery.ucl.ac.uk/id/eprint/10149983/ |
| Rights: |
open |
| Accession Number: |
edsbas.43086D79 |
| Database: |
BASE |