The Library
Impact of node status and radiotherapy on failure-free survival in patients with newly-diagnosed non-metastatic prostate cancer : data from > 690 patients in the control arm of the STAMPEDE Trial
Tools
James, Nicholas D., Spears, Melissa R., Clarke, Noel W., Sydes, Matthew R., Parker, Christopher C., Dearnaley, David P., Russell, J. Martin, Ritchie, Alastair W. S., Thalmann, George, de Bono, Johann S., Attard, G., Amos, C., Parmar, Mahesh K. B. and Mason, Malcolm D. (2014) Impact of node status and radiotherapy on failure-free survival in patients with newly-diagnosed non-metastatic prostate cancer : data from > 690 patients in the control arm of the STAMPEDE Trial. Annals of Oncology, Volume 25 (Supplement 4). iv255-iv279. doi:10.1093/annonc/mdu336 ISSN 0923-7534.
Research output not available from this repository.
Request-a-Copy directly from author or use local Library Get it For Me service.
Official URL: http://dx.doi.org/10.1093/annonc/mdu336
Abstract
Aim
The natural history of patients (pts) with newly diagnosed high-risk non-metastatic (M0) prostate cancer receiving androgen deprivation therapy (ADT) either alone or with standard of care radiotherapy (RT) at 6 to 9 months is not well documented. Further, no RCT has tested RT in N + M0 patients; none are planned. The STAMPEDE RCT (NCT00268476; MRC PR08; CRUK/06/019) includes such pts & allows exploratory multivariate analysis of radical RT's impact. We report data from trial pts. We hypothesised that planning RT in N + M0 pts improves survival outcomes.
Methods
Newly diagnosed pts with confirmed M0 disease in the control arm (standard of care = ADT planned for >2yr), diagnosed <6 months pre-randomisation & on ADT for 0-12 weeks already, were identified from trial records in Jan-2014. RT is encouraged in this group, but only mandated for N0M0 pts since Nov-2011. We report failure-free survival (FFS), driven by PSA failure, & overall survival (OS); split by nodal involvement & reported RT status. Standard survival analysis methods were used, adjusting for age & PSA.
Results
5272 men were recruited Oct-2005 to Jan-2014, including a cohort of 694 M0 pts with newly diagnosed disease allocated to the control arm: median age 66yr (IQR 61-71), median time from diagnosis to randomisation 2.6m (IQR 2.0-3.3) & median PSA 42ng/ml (IQR 17-88) at diagnosis. By Jan-2014, there were 34 deaths; 25 from prostate cancer. Median follow-up is short, but 2yr OS is 95% (95%CI 92, 97) & 2yr FFS is 79% (95%CI 75, 83). Median FFS is 63 months; 79% (94/119) report PSA failure-only as first FFS event. Time to FFS is worse in N+ pts (HR 1.87, 95%CI 1.29-2.72). Baseline characteristics were comparable by planned RT status, but N0M0 pts planned for RT had lower PSA at diagnosis & more WHO PS = 0. The Table shows that FFS outcomes clearly favour the planned use of RT.
Item Type: | Journal Article | ||||
---|---|---|---|---|---|
Alternative Title: | |||||
Divisions: | Faculty of Social Sciences > School of Health and Social Studies | ||||
Journal or Publication Title: | Annals of Oncology | ||||
Publisher: | Oxford University Press | ||||
ISSN: | 0923-7534 | ||||
Official Date: | August 2014 | ||||
Dates: |
|
||||
Volume: | Volume 25 | ||||
Number: | Supplement 4 | ||||
Page Range: | iv255-iv279 | ||||
DOI: | 10.1093/annonc/mdu336 | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Restricted or Subscription Access |
Request changes or add full text files to a record
Repository staff actions (login required)
View Item |