Paradoxical metastatic progression following 3 months of neo-adjuvant androgen suppression in the TROG 96.01 trial for men with locally advanced prostate cancer

被引：3

作者：

Denham, James W. ^{[1
]}

Steigler, Allison ^{[1
]}

Tai, Keen-Hun ^{[2
]}

Joseph, David

Matthews, John ^{[3
,4
]}

Atkinson, Chris ^{[5
]}

Spry, Nigel A. ^{[3
]}

Turner, Sandra ^{[6
]}

North, John ^{[7
]}

Christie, David ^{[8
]}

Wynne, Chris ^{[5
]}

Lamb, David S. ^{[9
]}

机构：

[1] Univ Newcastle, Sch Med & Publ Hlth, Callaghan, NSW 2308, Australia

[2] Peter MacCallum Canc Inst, Melbourne, Vic, Australia

[3] Sir Charles Gairdner Hosp, Perth, WA 6000, Australia

[4] Auckland Hosp, Auckland, New Zealand

[5] St Georges Canc Care Ctr, Christchurch, New Zealand

[6] Westmead Hosp, Sydney, NSW, Australia

[7] Dunedin Publ Hosp, Dunedin, New Zealand

[8] Prem Canc Care, Tugun, Australia

[9] Wellington Canc Ctr, Wellington, New Zealand

来源：

RADIOTHERAPY AND ONCOLOGY | 2013年 / 107卷 / 02期

基金：

英国医学研究理事会;

关键词：

Prostate cancer; Radiotherapy; Androgen suppression; Metastatic progression; BEAM RADIATION-THERAPY; RANDOMIZED-TRIAL; DOUBLING TIME; DEPRIVATION; RADIOTHERAPY; ADENOCARCINOMA; DURATION;

D O I：

10.1016/j.radonc.2013.03.025

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose: In the TROG 96.01 trial 6 month neo-adjuvant androgen suppression (NAS) and radiotherapy (RT) for locally advanced prostate cancer preVented distant progressions (DPs) when compared to RT alone, but 3 months did not. We ask why? Methods: Between 1996 and 2000, 802 men with T2-4 NO MO prostate cancers received RT alone (0 month NAS) to 66 Gy, 3 months or 6 months NAS before RT. Interval hazards and cumulative incidences of DP were compared using competing risks methodology. Results: In the first 4 follow-up years 39, 40 and 26 DPs were diagnosed in subjects treated with 0, 3 and 6 month NAS, respectively. Compared with 0 month, significant reductions in PSA doubling time in subjects with DP occurred following 3 month NAS (p = 0.01), but a significant reduction (p = 0.01) and a near significant delay in DPs (p = 0.06) occurred after 6 month NAS. Subsequently 25, 20 and 11 DPs occurred in the three trial arms. After early secondary therapy for PSA or local progression 34, 19 and 12 DPs were diagnosed after median delays of almost 4 years. Conclusions: The data are consistent with the failure of 3 month NAS to prevent the progression of subclinical metastatic deposits already present before treatment. (C) 2013 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 107 (2013) 123-128

引用

页码：123 / 128

页数：6

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