Stereotactic radiotherapy for localized prostate cancer: 10-year outcomes from three prospective trials.
Prostate Cancer
SABR
SBRT
Second Malignancy
Stereotactic Radiotherapy
Journal
International journal of radiation oncology, biology, physics
ISSN: 1879-355X
Titre abrégé: Int J Radiat Oncol Biol Phys
Pays: United States
ID NLM: 7603616
Informations de publication
Date de publication:
16 Sep 2024
16 Sep 2024
Historique:
received:
20
06
2024
revised:
15
08
2024
accepted:
02
09
2024
medline:
19
9
2024
pubmed:
19
9
2024
entrez:
18
9
2024
Statut:
aheadofprint
Résumé
Stereotactic ablative radiotherapy (SABR) is growingly accepted for the treatment of localized prostate cancer with recent randomized trials showing non-inferiority compared to conventional or moderately hypofractionated radiotherapy. The natural history of prostate cancer necessitates extended surveillance for recurrence; however, there are few prospective studies reporting long-term outcomes. This study included patients with low and intermediate risk localized prostate cancer from three Canadian clinical trials enrolled from 2006-2013. All patients received SABR to the prostate consisting of 35-40 Gy in 5 fractions over 11-29 days. PSA, distant metastasis, and vital status were prospectively recorded. Occurrence of second malignancy after treatment was assessed by chart review and classified using modified Cahan's criteria. 267 patients were included. Median follow up was 10.3 years (IQR 7.8 - 12.7). 10-year BF (95% CI) was 7.7% (3.9-11.5). 10-year OS, PCSS, and FFM were 84.1% (79.3 - 89.1%), 99.2% (98.1 - 100), and 98.8% (97.5-100), respectively. 27/267 (10.1%) patients experienced a SM, with 6/27 patients (22.2%) classified as having a SM likely (n=3) or possibly (n=3) related to prior radiotherapy. 10-year freedom from SM was 89.2%. SABR shows excellent long-term disease control for low and intermediate risk localized prostate cancer. Patients treated for prostate cancer have a moderate risk of second malignancy, consistent with background rates for the population.
Sections du résumé
BACKGROUND AND PURPOSE
OBJECTIVE
Stereotactic ablative radiotherapy (SABR) is growingly accepted for the treatment of localized prostate cancer with recent randomized trials showing non-inferiority compared to conventional or moderately hypofractionated radiotherapy. The natural history of prostate cancer necessitates extended surveillance for recurrence; however, there are few prospective studies reporting long-term outcomes.
MATERIALS AND METHODS
METHODS
This study included patients with low and intermediate risk localized prostate cancer from three Canadian clinical trials enrolled from 2006-2013. All patients received SABR to the prostate consisting of 35-40 Gy in 5 fractions over 11-29 days. PSA, distant metastasis, and vital status were prospectively recorded. Occurrence of second malignancy after treatment was assessed by chart review and classified using modified Cahan's criteria.
RESULTS
RESULTS
267 patients were included. Median follow up was 10.3 years (IQR 7.8 - 12.7). 10-year BF (95% CI) was 7.7% (3.9-11.5). 10-year OS, PCSS, and FFM were 84.1% (79.3 - 89.1%), 99.2% (98.1 - 100), and 98.8% (97.5-100), respectively. 27/267 (10.1%) patients experienced a SM, with 6/27 patients (22.2%) classified as having a SM likely (n=3) or possibly (n=3) related to prior radiotherapy. 10-year freedom from SM was 89.2%.
CONCLUSION
CONCLUSIONS
SABR shows excellent long-term disease control for low and intermediate risk localized prostate cancer. Patients treated for prostate cancer have a moderate risk of second malignancy, consistent with background rates for the population.
Identifiants
pubmed: 39293531
pii: S0360-3016(24)03368-6
doi: 10.1016/j.ijrobp.2024.09.009
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024. Published by Elsevier Inc.
Déclaration de conflit d'intérêts
Declaration of competing interest AL reports support for this project from CARO-ACURA and Prostate Cancer Canada; consulting fees for Bayer, Astellas, Knight, Tolmar, TerSera, and Sumitomo; honoraria from TerSera, AbbVie, Astellas, Bayer, Janssen, and Sanofi; travel support from Tolmar and TerSera; a patent on Endorectal immobilization device (GU-Lok); being the chair of the Prostate Cure Foundation board; and that his wife is the National Sales Manage, Oncology for Sanofi Canada. All other authors report no conflicts of interest.