| Title: |
Interplay Between Duration of Androgen Deprivation Therapy and External Beam Radiotherapy With or Without a Brachytherapy Boost for Optimal Treatment of High-risk Prostate Cancer |
| Authors: |
Kishan, Amar U; Steigler, Alison; Denham, James W; Zapatero, Almudena; Guerrero, Araceli; Joseph, David; Maldonado, Xavier; Wong, Jessica K; Stish, Bradley J; Dess, Robert T; Pilar, Avinash; Reddy, Chandana; Wedde, Trude B; Lilleby, Wolfgang A; Fiano, Ryan; Merrick, Gregory S; Stock, Richard G; Demanes, D Jeffrey; Moran, Brian J; Tran, Phuoc T; Martin, Santiago; Martinez-Monge, Rafael; Krauss, Daniel J; Abu-Isa, Eyad I; Pisansky, Thomas M; Choo, C Richard; Song, Daniel Y; Greco, Stephen; Deville, Curtiland; McNutt, Todd; DeWeese, Theodore L; Ross, Ashley E; Ciezki, Jay P; Tilki, Derya; Karnes, R Jeffrey; Tosoian, Jeffrey J; Nickols, Nicholas G; Bhat, Prashant; Shabsovich, David; Juarez, Jesus E; Jiang, Tommy; Ma, T Martin; Xiang, Michael; Philipson, Rebecca; Chang, Albert; Kupelian, Patrick A; Rettig, Matthew B; Feng, Felix Y; Berlin, Alejandro; Tward, Jonathan D; Davis, Brian J; Reiter, Robert E; Steinberg, Michael L; Elashoff, David; Boutros, Paul C; Horwitz, Eric M; Tendulkar, Rahul D; Spratt, Daniel E; Romero, Tahmineh |
| Source: |
JAMA Oncology, vol 8, iss 3 |
| Publisher Information: |
eScholarship, University of California |
| Publication Year: |
2022 |
| Collection: |
University of California: eScholarship |
| Subject Terms: |
32 Biomedical and Clinical Sciences (for-2020); 3202 Clinical Sciences (for-2020); 3211 Oncology and Carcinogenesis (for-2020); Radiation Oncology (rcdc); Clinical Trials and Supportive Activities (rcdc); Clinical Research (rcdc); Prostate Cancer (rcdc); Aging (rcdc); Urologic Diseases (rcdc); Cancer (rcdc); 6.1 Pharmaceuticals (hrcs-rac); Cancer (hrcs-hc); Androgen Antagonists (mesh); Androgens (mesh); Brachytherapy (mesh); Data Analysis (mesh); Humans (mesh); Male (mesh); Middle Aged (mesh); Prostatic Neoplasms (mesh); Retrospective Studies (mesh); 1112 Oncology and Carcinogenesis (for); 1117 Public Health and Health Services (for) |
| Description: |
IMPORTANCE: Radiotherapy combined with androgen deprivation therapy (ADT) is a standard of care for high-risk prostate cancer. However, the interplay between radiotherapy dose and the required minimum duration of ADT is uncertain. OBJECTIVE: To determine the specific ADT duration threshold that provides a distant metastasis-free survival (DMFS) benefit in patients with high-risk prostate cancer receiving external beam radiotherapy (EBRT) or EBRT with a brachytherapy boost (EBRT+BT). DESIGN, SETTINGS, AND PARTICIPANTS: This was a cohort study of 3 cohorts assembled from a multicenter retrospective study (2000-2013); a post hoc analysis of the Randomized Androgen Deprivation and Radiotherapy 03/04 (RADAR; 2003-2007) randomized clinical trial (RCT); and a cross-trial comparison of the RADAR vs the Deprivación Androgénica y Radio Terapía (Androgen Deprivation and Radiation Therapy; DART) 01/05 RCT (2005-2010). In all, the study analyzed 1827 patients treated with EBRT and 1108 patients treated with EBRT+BT from the retrospective cohort; 181 treated with EBRT and 203 with EBRT+BT from RADAR; and 91 patients treated with EBRT from DART. The study was conducted from October 15, 2020, to July 1, 2021, and the data analyses, from January 5 to June 15, 2021. EXPOSURES: High-dose EBRT or EBRT+BT for an ADT duration determined by patient-physician choice (retrospective) or by randomization (RCTs). MAIN OUTCOMES AND MEASURES: The primary outcome was DMFS; secondary outcome was overall survival (OS). Natural cubic spline analysis identified minimum thresholds (months). RESULTS: This cohort study of 3 studies totaling 3410 men (mean age [SD], 68 [62-74] years; race and ethnicity not collected) with high-risk prostate cancer found a significant interaction between the treatment type (EBRT vs EBRT+BT) and ADT duration (binned to |
| Document Type: |
article in journal/newspaper |
| Language: |
unknown |
| Relation: |
qt9m28n0vg; https://escholarship.org/uc/item/9m28n0vg |
| DOI: |
10.1001/jamaoncol.2021.6871 |
| Availability: |
https://escholarship.org/uc/item/9m28n0vg; https://doi.org/10.1001/jamaoncol.2021.6871 |
| Rights: |
public |
| Accession Number: |
edsbas.DFD7195A |
| Database: |
BASE |