Residual Prostate Cancer in Patients Treated With Endocrine Therapy With or Without Radical Radiotherapy: A Side Study of the SPCG-7 Randomized Trial

Journal Article · Sun May 01 04:00:00 EDT 2011 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2010.01.072· OSTI ID:21491736

Solberg, Arne ^[1]; Haugen, Olav A ^[2]; Viset, Trond ^[3]; Bergh, Anders ^[4]; Tasdemir, Ilker ^[5]; Ahlgren, Goeran ^[6]; Widmark, Anders ^[7]; Angelsen, Anders ^[8]

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1. Department of Oncology and Radiotherapy, St. Olav's Hospital, Trondheim University Hospital, Trondheim (Norway)
2. Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim (Norway)
3. Department of Pathology and Medical Genetics, St. Olav's Hospital, Trondheim University Hospital, Trondheim (Norway)
4. Department of Medical Biosciences/Pathology, Umea University Hospital, Umea (Sweden)
5. Department of Urology, Stavanger University Hospital, Stavanger (Norway)
6. Department of Urology, Malmoe University Hospital, UMAS (Sweden)
7. Department of Radiation Sciences, Oncology, Umea University Hospital, Umea (Sweden)
8. Department of Urology, St. Olav's Hospital, Trondheim University Hospital, Trondheim (Norway)

Purpose: The Scandinavian Prostate Cancer Group-7 randomized trial demonstrated a survival benefit of combined endocrine therapy and external-beam radiotherapy over endocrine therapy alone in patients with high-risk prostate cancer. In a subset of the study population, the incidence and clinical implications of residual prostate cancer in posttreatment prostate biopsy specimens was evaluated. Methods and Materials: Biopsy specimens were obtained from 120 of 875 men in the Scandinavian Prostate Cancer Group-7 study. Results: Biopsies were performed at median of 45 months follow-up. In 63 patients receiving endocrine treatment only and 57 patients receiving combined treatment, residual cancer was found in 66% (n = 41) and 22% (n = 12), respectively (p < 0.0001). The vast majority of residual tumors were poorly differentiated (Gleason score {>=}8). Endocrine therapy alone was predictive of residual prostate cancer: odds ratio 7.49 (3.18-17.7), p < 0.0001. In patients with positive vs. negative biopsy the incidences of clinical events were as follows: biochemical recurrence 74% vs. 27% (p < 0.0001), local progression 26% vs. 4.7% (p = 0.002), distant recurrence 17% vs. 9.4% (p = 0.27), clinical recurrence 36% vs. 13% (p = 0.006), cancer-specific death 19% vs. 9.7% (p = 0.025). In multivariable analysis, biochemical recurrence was significantly associated with residual cancer: hazard ratio 2.69 (1.45-4.99), p = 0.002, and endocrine therapy alone hazard ratio 3.45 (1.80-6.62), p < 0.0001. Conclusions: Radiotherapy combined with hormones improved local tumor control in comparison with endocrine therapy alone. Residual prostate cancer was significantly associated with serum prostate-specific antigen recurrence, local tumor progression, clinical recurrence, and cancer-specific death in univariable analysis. Residual cancer was predictive of prostate-specific antigen recurrence in multivariable analysis.

• OSTI ID: 21491736
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 1 Vol. 80; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ANTIGENS
BIOPSY
BODY
DIAGNOSTIC TECHNIQUES
DISEASES
GLANDS
HORMONES
MALE GENITALS
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
PROSTATE
RADIOLOGY
RADIOTHERAPY
THERAPY