Is There a Role for Pelvic Irradiation in Localized Prostate Adenocarcinoma? Update of the Long-Term Survival Results of the GETUG-01 Randomized Study
| Autor: | Pierre Richaud, Jean-Léon Lagrange, Véronique Beckendorf, Sylvie Chabaud, David Pérol, Elisabeth Le Prisé, Jean-Philippe Suchaud, Pascal Pommier, David Azria, Jean-Philippe Wagner, Valérie Bernier, Christian Carrie |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Oncology
Male Cancer Research medicine.medical_specialty Time Factors Antineoplastic Agents Hormonal medicine.medical_treatment Population Subgroup analysis Disease-Free Survival 030218 nuclear medicine & medical imaging Pelvis Gonadotropin-Releasing Hormone 03 medical and health sciences Prostate cancer 0302 clinical medicine Prostate Internal medicine medicine Humans Radiology Nuclear Medicine and imaging education Lymph node Aged Neoplasm Staging education.field_of_study Radiation Lymphatic Irradiation business.industry Prostatic Neoplasms Prostate-Specific Antigen medicine.disease Radiation therapy medicine.anatomical_structure 030220 oncology & carcinogenesis Concomitant Hormonal therapy Dose Fractionation Radiation France Neoplasm Grading Neoplasm Recurrence Local Radiotherapy Conformal business Follow-Up Studies |
| Zdroj: | International journal of radiation oncology, biology, physics. 96(4) |
| ISSN: | 1879-355X |
| Popis: | To report the long-term results of the French Genitourinary Study Group (GETUG)-01 study in terms of event-free survival (EFS) and overall survival (OS) and assess the potential interaction between hormonotherapy and pelvic nodes irradiation.Between December 1998 and June 2004, 446 patients with T1b-T3, N0pNx, M0 prostate carcinoma were randomly assigned to either pelvic nodes and prostate or prostate-only radiation therapy. Patients were stratified into 2 groups: "low risk" (T1-T2 and Gleason score 6 and prostate-specific antigen3× the upper normal limit of the laboratory) (92 patients) versus "high risk" (T3 or Gleason score6 or prostate-specific antigen3× the upper normal limit of the laboratory). Short-term 6-month neoadjuvant and concomitant hormonal therapy was allowed only for high-risk patients. Radiation therapy was delivered with a 3-dimensional conformal technique, using a 4-field technique for the pelvic volume (46 Gy). The total dose recommended to the prostate moved from 66 Gy to 70 Gy during the course of the study. Criteria for EFS included biologic prostate-specific antigen recurrences and/or a local or metastatic progression.With a median follow-up of 11.4 years, the 10-year OS and EFS were similar in the 2 treatment arms. A higher but nonsignificant EFS was observed in the low-risk subgroup in favor of pelvic nodes radiation therapy (77.2% vs 62.5%; P=.18). A post hoc subgroup analysis showed a significant benefit of pelvic irradiation when the risk of lymph node involvement was15% (Roach formula). This benefit seemed to be limited to patients who did not receive hormonal therapy.Pelvic nodes irradiation did not statistically improve EFS or OS in the whole population but may be beneficial in selected low- and intermediate-risk prostate cancer patients treated with exclusive radiation therapy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|