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Artikel ; Online: Local Prostate Radiation Therapy and Symptomatic Local Events in De Novo Metastatic Prostate Cancer.

Kwok, Jaime Kirsten / Martell, Kevin / Sia, Michael / Bhindi, Bimal / Abedin, Tasnima / Lu, Shuang / Quon, Harvey Charles

Practical radiation oncology

2022  Band 13, Heft 1, Seite(n) e61–e67

Abstract: Purpose: Local prostate radiation therapy (LPRT) for low-burden metastatic prostate cancer (mPCa) improves overall survival and is the standard of care. The role of LPRT in reducing symptomatic local events (SLE) remains unclear. We aimed to identify ... ...

Abstract Purpose: Local prostate radiation therapy (LPRT) for low-burden metastatic prostate cancer (mPCa) improves overall survival and is the standard of care. The role of LPRT in reducing symptomatic local events (SLE) remains unclear. We aimed to identify SLE risk factors and to evaluate the association between LPRT and SLE in mPCa.
Methods and materials: We conducted a retrospective, population-based cohort study of patients initially diagnosed with mPCa between 2005 and 2016 in a cancer registry. Patient, tumor, and treatment characteristics were obtained from chart review and the cancer registry. The coprimary endpoints were genitourinary (GU) and gastrointestinal (GI) SLE, identified by physician billing claims between 2004 and 2017 for diagnostic or therapeutic procedures potentially related to GU and GI SLE. The effect of LPRT on SLE was evaluated using both recurrent event (Andersen-Gill model) and time-to-first-event sequential landmark analyses. Risk factors for SLE were assessed by multivariable Cox regression. LPRT was defined as ≥40 Gy within 1 year of diagnosis. Metastatic burden was defined per the STAMPEDE trial.
Results: Of 1363 patients, 46 (3.4%) received LPRT. Median follow-up was 27.3 and 28.9 months in the control and LPRT groups, respectively. LPRT was associated with less recurrent GU SLE (hazard ratio [HR], 0.34; 95% confidence interval [CI], 0.17-0.67; P = .002), upper tract obstruction (HR, 0.20; 95% CI, 0.05-0.84; P = .03), and cystoscopy (HR, 0.38; 95% CI, 0.15-0.96; P = .04). Metastatic burden was not associated with SLE.
Conclusions: LPRT in mPCa was associated with less recurrent GU SLE, specifically for upper tract obstruction and cystoscopy.
Mesh-Begriff(e) Humans ; Male ; Cohort Studies ; Prostate/pathology ; Prostatic Neoplasms/pathology ; Retrospective Studies
Sprache Englisch
Erscheinungsdatum 2022-09-05
Erscheinungsland United States
Dokumenttyp Journal Article
ZDB-ID 2655748-4
ISSN 1879-8519 ; 1879-8500
ISSN (online) 1879-8519
ISSN 1879-8500
DOI 10.1016/j.prro.2022.08.005
Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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