PMID- 25436827
OWN - NLM
STAT- MEDLINE
DCOM- 20170816
LR  - 20170816
IS  - 1537-453X (Electronic)
IS  - 0277-3732 (Linking)
VI  - 40
IP  - 4
DP  - 2017 Aug
TI  - High-risk Prostate Cancer Treated With Dose-escalated RT: An Analysis of Hormonal 
      Therapy Use and Duration, and Prognostic Implications of PSA Nadir </=0.2 to Select 
      Men for Short-term Hormonal Therapy.
PG  - 348-352
LID - 10.1097/COC.0000000000000161 [doi]
AB  - OBJECTIVES: To determine prognostic factors to select high-risk men receiving 
      dose-escalated radiation therapy (RT) who will have favorable outcomes with 
      short-term (ST) or no androgen deprivation therapy (ADT). METHODS: Medical 
      records of 458 men treated with definitive RT for high-risk, nonmetastatic 
      prostate cancer at 3 academic referral centers from 1988 to 2009 were examined. 
      Median dose was 76.4 Gy. Men received no ADT (n=105), STADT (<12 mo, n=194), or 
      long-term ADT (LTADT: >/=12 mo, n=160). Univariate and multivariable analysis for 
      freedom from distant metastases (FFDM) and cause-specific survival (CSS) were 
      performed. Median follow-up was 71 months. RESULTS: Seven-year FFDM was 83% and 
      CSS was 91%. Multivariable analysis demonstrated that prostate-specific antigen 
      (PSA) nadir </=0.2 (HR=0.36; 95% CI, 0.20-0.64) and Gleason score (GS) were 
      associated with FFDM and CSS (all P<0.05). ADT duration was not associated 
      (P>0.05). Those with PSA nadir </=0.2 ng/mL had improved outcomes. Men with GS 9 
      disease did poorly despite a PSA nadir </=0.2 ng/mL and had improved CSS with LTADT 
      (95% vs. 71%, P<0.05). CONCLUSIONS: Select men with high-risk disease treated 
      with dose-escalated RT may not require LTADT. In men treated with ADT, PSA nadir 
      </=0.2 is an independent prognostic factor associated with FFDM and CSS. Men 
      without GS 9 may have acceptable outcomes with STADT if PSA nadir is </=0.2 ng/mL. 
      Further investigation is necessary to elucidate the role of PSA nadir in 
      determining the optimal length of adjuvant ADT.
FAU - Son, Christina H
AU  - Son CH
AD  - *Department of Radiation and Cellular Oncology, The University of Chicago 
      Medicine, Chicago, IL daggerDepartment of Radiation Oncology, University of Michigan 
      Health System, Ann Arbor, MI.
FAU - Hamstra, Daniel A
AU  - Hamstra DA
FAU - Feng, Felix Y
AU  - Feng FY
FAU - Liauw, Stanley L
AU  - Liauw SL
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PL  - United States
TA  - Am J Clin Oncol
JT  - American journal of clinical oncology
JID - 8207754
RN  - 0 (Androgen Antagonists)
RN  - 0 (Antineoplastic Agents)
RN  - EC 3.4.21.77 (Prostate-Specific Antigen)
SB  - IM
MH  - Adenocarcinoma/*drug therapy/mortality/pathology/*radiotherapy
MH  - Aged
MH  - Androgen Antagonists/*therapeutic use
MH  - Antineoplastic Agents/therapeutic use
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Prostate-Specific Antigen/analysis
MH  - Prostatic Neoplasms/*drug therapy/mortality/pathology/*radiotherapy
MH  - Radiotherapy Dosage
MH  - Treatment Outcome
EDAT- 2014/12/02 06:00
MHDA- 2017/08/17 06:00
CRDT- 2014/12/02 06:00
PHST- 2014/12/02 06:00 [pubmed]
PHST- 2017/08/17 06:00 [medline]
PHST- 2014/12/02 06:00 [entrez]
AID - 10.1097/COC.0000000000000161 [doi]
PST - ppublish
SO  - Am J Clin Oncol. 2017 Aug;40(4):348-352. doi: 10.1097/COC.0000000000000161.