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Title: Retrospective Comparison of External Beam Radiotherapy and Radical Prostatectomy in High-Risk, Clinically Localized Prostate Cancer

Abstract

Purpose: Because of the lack of conclusive and well-conducted randomized studies, the optimal therapy for prostate tumors remains controversial. The aim of this study was to retrospectively compare the results of radical surgery vs. a conservative approach such as external beam radiotherapy (EBRT) plus androgen deprivation therapy using an intent-to-treat analysis on two pretreatment defined, concurrently treated, high-risk patient populations. Methods and Materials: Between January 2003 and December 2007, 162 patients with high-risk prostate cancer underwent an EBRT plus androgen deprivation therapy program at the RT department of our institute. In the same period, 122 patients with the same high-risk disease underwent radical prostatectomy (RP) at the urologic department of our institute. Patients with adverse pathologic factors also underwent adjuvant EBRT with or without androgen deprivation therapy. The primary endpoint was freedom from biochemical failure. Results: The two groups of high-risk patients were homogeneous in terms of freedom from biochemical failure on the basis of the clinical T stage, biopsy Gleason score, and initial prostate-specific antigen level. The median follow-up was 38.6 and 33.8 months in the EBRT and RP groups, respectively. The actuarial analysis of the freedom from biochemical failure showed a 3-year rate of 86.8% and 69.8% inmore » the EBRT and RP group, respectively (p = .001). Multivariate analysis of the whole group revealed the initial prostate-specific antigen level and treatment type (EBRT vs. RP) as significant covariates. Conclusion: This retrospective intention-to-treat analysis showed a significantly better outcome after EBRT than after RP in patients with high-risk prostate cancer, although a well-conducted randomized comparison would be the best procedure to confirm these results.« less

Authors:
 [1];  [2]; ; ; ;  [1]; ; ; ;  [3]
  1. Department of Radiotherapy, Regina Elena National Cancer Institute, Rome (Italy)
  2. Laboratory of Medical Physics and Expert System, Regina Elena National Cancer Institute, Rome (Italy)
  3. Department of Urology, Regina Elena National Cancer Institute, Rome (Italy)
Publication Date:
OSTI Identifier:
21367488
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 75; Journal Issue: 4; Other Information: DOI: 10.1016/j.ijrobp.2008.12.045; PII: S0360-3016(09)00017-0; Copyright (c) 2009 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; ANDROGENS; ANTIGENS; MULTIVARIATE ANALYSIS; NEOPLASMS; PARTICLE BEAMS; PROSTATE; RADIOTHERAPY; SURGERY; ANDROSTANES; BEAMS; BODY; DISEASES; GLANDS; HORMONES; MALE GENITALS; MATHEMATICS; MEDICINE; NUCLEAR MEDICINE; ORGANIC COMPOUNDS; ORGANS; RADIOLOGY; STATISTICS; STEROID HORMONES; STEROIDS; THERAPY

Citation Formats

Arcangeli, Giorgio, Strigari, Lidia, Arcangeli, Stefano, Petrongari, Maria Grazia, Saracino, Biancamaria, Gomellini, Sara, Papalia, Rocco, Simone, Giuseppe, De Carli, Piero, and Gallucci, Michele. Retrospective Comparison of External Beam Radiotherapy and Radical Prostatectomy in High-Risk, Clinically Localized Prostate Cancer. United States: N. p., 2009. Web. doi:10.1016/j.ijrobp.2008.12.045.
Arcangeli, Giorgio, Strigari, Lidia, Arcangeli, Stefano, Petrongari, Maria Grazia, Saracino, Biancamaria, Gomellini, Sara, Papalia, Rocco, Simone, Giuseppe, De Carli, Piero, & Gallucci, Michele. Retrospective Comparison of External Beam Radiotherapy and Radical Prostatectomy in High-Risk, Clinically Localized Prostate Cancer. United States. https://doi.org/10.1016/j.ijrobp.2008.12.045
Arcangeli, Giorgio, Strigari, Lidia, Arcangeli, Stefano, Petrongari, Maria Grazia, Saracino, Biancamaria, Gomellini, Sara, Papalia, Rocco, Simone, Giuseppe, De Carli, Piero, and Gallucci, Michele. 2009. "Retrospective Comparison of External Beam Radiotherapy and Radical Prostatectomy in High-Risk, Clinically Localized Prostate Cancer". United States. https://doi.org/10.1016/j.ijrobp.2008.12.045.
@article{osti_21367488,
title = {Retrospective Comparison of External Beam Radiotherapy and Radical Prostatectomy in High-Risk, Clinically Localized Prostate Cancer},
author = {Arcangeli, Giorgio and Strigari, Lidia and Arcangeli, Stefano and Petrongari, Maria Grazia and Saracino, Biancamaria and Gomellini, Sara and Papalia, Rocco and Simone, Giuseppe and De Carli, Piero and Gallucci, Michele},
abstractNote = {Purpose: Because of the lack of conclusive and well-conducted randomized studies, the optimal therapy for prostate tumors remains controversial. The aim of this study was to retrospectively compare the results of radical surgery vs. a conservative approach such as external beam radiotherapy (EBRT) plus androgen deprivation therapy using an intent-to-treat analysis on two pretreatment defined, concurrently treated, high-risk patient populations. Methods and Materials: Between January 2003 and December 2007, 162 patients with high-risk prostate cancer underwent an EBRT plus androgen deprivation therapy program at the RT department of our institute. In the same period, 122 patients with the same high-risk disease underwent radical prostatectomy (RP) at the urologic department of our institute. Patients with adverse pathologic factors also underwent adjuvant EBRT with or without androgen deprivation therapy. The primary endpoint was freedom from biochemical failure. Results: The two groups of high-risk patients were homogeneous in terms of freedom from biochemical failure on the basis of the clinical T stage, biopsy Gleason score, and initial prostate-specific antigen level. The median follow-up was 38.6 and 33.8 months in the EBRT and RP groups, respectively. The actuarial analysis of the freedom from biochemical failure showed a 3-year rate of 86.8% and 69.8% in the EBRT and RP group, respectively (p = .001). Multivariate analysis of the whole group revealed the initial prostate-specific antigen level and treatment type (EBRT vs. RP) as significant covariates. Conclusion: This retrospective intention-to-treat analysis showed a significantly better outcome after EBRT than after RP in patients with high-risk prostate cancer, although a well-conducted randomized comparison would be the best procedure to confirm these results.},
doi = {10.1016/j.ijrobp.2008.12.045},
url = {https://www.osti.gov/biblio/21367488}, journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 4,
volume = 75,
place = {United States},
year = {Sun Nov 15 00:00:00 EST 2009},
month = {Sun Nov 15 00:00:00 EST 2009}
}