Definitive radiotherapy for prostate cancer in Norway 2006-2015: Temporal trends, performance and survival.

Autor: Fosså SD; Department of Oncology, Oslo University Hospital & University of Oslo, Medical Faculty & Department of Registration, Cancer Registry of Norway, Norway. Electronic address: sdf@ous-hf.no., Aas K; Department of Urology, Bærum Hospital, Drammen, Norway., Müller C; Cancer Treatment Centre, Sorlandet Hospital, Kristiansand, Norway., Jerm MB; Department of Registration, Cancer Registry of Norway, Oslo, Norway., Tandstad T; The Cancer Clinic, St. Olavs University Hospital, & Department of Clinical and Molecular Medicine, The Norwegian University of Science and Technology, Trondheim, Norway., Lilleby W; Department of Oncology, Oslo University Hospital, Norway., Kvåle R; Department of Oncology, Haukeland University Hospital, Bergen, Norway; Department of Health Registry Research and Development, National Institute of Public Health, Bergen, Norway., Gulbrandsen J; Department of Registration, Cancer Registry of Norway, Oslo, Norway., Haug E; Department of Urology, Vestfold Hospital Trust & Institute of Cancer Genomics and Informatics, Oslo University Hospital, Norway., Myklebust TA; Department of Registration, Cancer Registry of Norway, Oslo, Norway; Department of Research and Innovation, Møre and Romsdal Hospital Trust, Ålesund, Norway. Electronic address: tor.age.myklebust@kreftregisteret.no.
Jazyk: angličtina
Zdroj: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology [Radiother Oncol] 2021 Feb; Vol. 155, pp. 33-41. Date of Electronic Publication: 2020 Oct 21.
DOI: 10.1016/j.radonc.2020.10.022
Abstrakt: Background: More studies are needed to document nation-wide use and effectiveness of curative definitive radiotherapy (Def-RT) in the treatment of prostate cancer (PCa).
Patients and Methods: For 38,960 men diagnosed with PCa without distant metastases from 2006 to 2015 data from the Norwegian Prostate Cancer Registry and a national radiotherapy database (NoRadBase) was analyzed. Overall survival and PCa-specific mortality were described comparing EQD-2 < 74 Gy ("low-dose") with EQD-2 ≥ 74 Gy ("escalated dose").
Results: Use of Def-RT decreased (27-24%) whereas the proportion of radical prostatectomies (RPs) increased (31-38%). In high-risk patients the use of RP doubled (18-36%), while the proportion of Def-RT remained stable (about 35%). Before 2010, almost a quarter of patients received low-dose Def-RT with gradual increase of escalated Def-RT thereafter. Escalated Def-RT was associated with significantly more favorable 10-year PCa-specific mortality (4.4% [95% CI: 2.7-10.7%]) than observed after low-dose Def- RT (8.8% [95% CI: 6.2-9.8%), with the most beneficial effects in high-risk patients. Our analyses indicated the need to expand the NoRadBase by consensus-based quality measures.
Conclusion: In this nationwide cohort, the overall use of Def-RT decreased slightly. In high-risk patients the provision of Def-RT remained stable and was accompanied by doubling of patients with RP and reduction of a "no curative treatment" strategy. Escalated dose Def-RT significantly reduced 10-year PCa-specific mortality compared to low-dose Def-RT. Aiming for cancer care equity national radiotherapy registries for PCa should regularly monitor data based on consensus-based quality measures enabling feedback to the responsible hospitals.
(Copyright © 2020 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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