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Hallemeier CL, Zhang P, Pisansky TM, Hanks GE, McGowan DG, Roach M, Zeitzer KL, Firat SY, Husain SM, D'Souza DP, Souhami L, Parliament MB, Rosenthal SA, Lukka HR, Rotman M, Horwitz EM, Miles EF, Paulus R, Sandler HM
Prostate-specific antigen after neoadjuvant androgen suppression in prostate cancer patients receiving short-term androgen suppression and external beam radiotherapy: pooled analysis of four NRG Oncology RTOG randomized clinical trials
Int J Radiat Oncol Biol Phys (2019) 104:1057-1065.
PURPOSE: To validate if prostate specific antigen (PSA) level after neoadjuvant androgen suppression (neoAS) is associated with long-term outcome after neoAS and external radiation therapy (RT) with concurrent short-term AS in prostate cancer patients. METHODS: 2404 patients treated with neoAS prior to RT and concurrent AS (without post-RT AS) were pooled from trials A, B, C, and D. Multivariable models were used to test associations between the pre-specified dichotomized post-neoAS, pre-RT PSA (0.1 ng/mL) groupings and clinical outcomes. RESULTS: Median follow-up for surviving patients was 9.4 years. Median post-neoAS, pre-RT PSA was 0.3 ng/mL, with 32% of patients 0.1 ng/mL. In univariate analyses, post-neoAS, pre-RT PSA >0.1 ng/mL was associated with increased risks of biochemical failure (hazard ratio [HR] 2.04; p<0.0001), local failure (HR 2.51; p<0.0001), distant metastases (HR 1.73; p=0.0006), cause-specific mortality (HR 2.36; p<0.0001), and all-cause mortality (HR 1.24; p=0.005). In multivariable models that also included baseline and treatment variables, post-neoAS, pre-RT PSA >0.1 ng/mL was independently associated with increased risk of biochemical failure (HR 2.00; p<0.0001), local failure (HR 2.33; p<0.0001), and cause-specific mortality (HR 1.75; p=0.03). CONCLUSION: Patients with PSA >0.1 ng/mL after neoAS and before RT start had less favorable clinical outcomes than patients with PSA was
Publication Date: 2019-08-01.
PMCID: PMC6646073
Last updated on Saturday, August 15, 2020