1. Local Failure and Survival After Definitive Radiotherapy for Aggressive Prostate Cancer: An Individual Patient-level Meta-analysis of Six Randomized Trials
- Author
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Kishan, Amar U, Chu, Fang-I, King, Christopher R, Seiferheld, Wendy, Spratt, Daniel E, Tran, Phuoc, Wang, Xiaoyan, Pugh, Stephanie E, Sandler, Kiri A, Bolla, Michel, Maingon, Philippe, De Reijke, Theo, Nickols, Nicholas G, Rettig, Matthew, Drakaki, Alexandra, Liu, Sandy T, Reiter, Robert E, Chang, Albert J, Feng, Felix Y, Sajed, Dipti, Nguyen, Paul L, Kupelian, Patrick A, Steinberg, Michael L, Boutros, Paul C, Elashoff, David, Collette, Laurence, and Sandler, Howard M
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Oncology and Carcinogenesis ,Prostate Cancer ,Radiation Oncology ,Cancer ,Aging ,Clinical Trials and Supportive Activities ,Urologic Diseases ,Clinical Research ,Humans ,Male ,Neoplasm Grading ,Prostatic Neoplasms ,Randomized Controlled Trials as Topic ,Treatment Failure ,Local failure ,Radiotherapy ,High grade ,Urology & Nephrology ,Clinical sciences - Abstract
BackgroundThe importance of local failure (LF) after treatment of high-grade prostate cancer (PCa) with definitive radiotherapy (RT) remains unknown.ObjectiveTo evaluate the clinical implications of LF after definitive RT.Design, setting, and participantsIndividual patient data meta-analysis of 992 patients (593 Gleason grade group [GG] 4 and 399 GG 5) enrolled in six randomized clinical trials.Outcome measurements and statistical analysisMultivariable Cox proportional hazard models were developed to evaluate the relationship between overall survival (OS), PCa-specific survival (PCSS), and distant metastasis (DM)-free survival (DMFS) and LF as a time-dependent covariate. Markov proportional hazard models were developed to evaluate the impact of specific transitions between disease states on these endpoints.Results and limitationsMedian follow-up was 6.4 yr overall and 7.2 yr for surviving patients. LF was significantly associated with OS (hazard ratio [HR] 1.70 [95% confidence interval {CI} 1.37-2.10]), PCSS (3.10 [95% CI 2.33-4.12]), and DMFS (HR 1.92 [95% CI 1.54-2.39]), p
- Published
- 2020