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Old 11-13-2017, 07:20 AM
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rss Multi-institutional Evaluation of Elective Nodal Irradiation and/or Androgen Deprivat

Multi-institutional Evaluation of Elective Nodal Irradiation and/or Androgen Deprivation Therapy with Postprostatectomy Salvage Radiotherapy for Prostate Cancer.

Eur Urol. 2017 Nov 08;:

Authors: Ramey SJ, Agrawal S, Abramowitz MC, Moghanaki D, Pisansky TM, Efstathiou JA, Michalski JM, Spratt DE, Hearn JWD, Koontz BF, Liauw SL, Pollack A, Anscher MS, Den RB, Stephans KL, Zietman AL, Lee WR, Stephenson AJ, Tendulkar RD


Abstract
BACKGROUND: Outcomes with postprostatectomy salvage radiation therapy (SRT) are not ideal. Little evidence exists regarding potential benefits of adding whole pelvic radiation therapy (WPRT) alone or in combination with androgen deprivation therapy (ADT).
OBJECTIVE: To explore whether WPRT and/or ADT added to prostate bed radiation therapy (PBRT) improves freedom from biochemical failure (FFBF) or distant metastases (DM).
DESIGN, SETTING, AND PARTICIPANTS: A database was compiled from 10 academic institutions of patients with postprostatectomy prostate-specific antigen (PSA) >0.01 ng/ml; pT1-4, Nx/0, cM0; and Gleason score (GS) >=7 treated between 1987 and 2013. Median follow-up was 51 mo.
INTERVENTIONS: WPRT and/or ADT in addition to PBRT.
OUTCOME MEASUREMENTS AND STATISTICAL ANALYSES: FFBF and DM were calculated using cumulative incidence estimation. Multivariable analysis (MVA) utilized cumulative incidence regression.
RESULTS AND LIMITATION: Median pre-SRT PSA was 0.5 ng/ml for 1861 patients. Median follow-up for patients not experiencing biochemical failure (BF) was 55 mo. MVA showed increased BF for PBRT versus WPRT (hazard ratio [HR] 1.82, p
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