Please use this identifier to cite or link to this item: https://doi.org/10.1111/ajco.13197
Title: Clinical outcomes of external beam radiotherapy in patients with localized prostate cancer: Does dose escalation matter?
Authors: Lee, Chia Ching
Lim, Keith HC 
Chia, David WT 
Chong, Yew Lam 
Png, Keng Siang 
Chong, Kian Tai 
Soon, Yu Yang 
Tey, Jeremy CS 
Keywords: Science & Technology
Life Sciences & Biomedicine
Oncology
dose escalation
external beam radiation therapy
proctitis
prostate cancer
CONFORMAL RADIATION-THERAPY
ANDROGEN DEPRIVATION THERAPY
RADICAL PROSTATECTOMY
GLEASON SCORE
TRIAL
ADJUVANT
MEN
ADENOCARCINOMA
NEOADJUVANT
SUPPRESSION
Issue Date: 22-Jul-2019
Publisher: WILEY
Citation: Lee, Chia Ching, Lim, Keith HC, Chia, David WT, Chong, Yew Lam, Png, Keng Siang, Chong, Kian Tai, Soon, Yu Yang, Tey, Jeremy CS (2019-07-22). Clinical outcomes of external beam radiotherapy in patients with localized prostate cancer: Does dose escalation matter?. ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY. ScholarBank@NUS Repository. https://doi.org/10.1111/ajco.13197
Abstract: © 2019 John Wiley & Sons Australia, Ltd Background: To report outcomes of localized prostate cancer treated with radical external beam radiation therapy (EBRT) in our institution over a 14-year period, and to determine the impact of dose escalation of prostate cancer outcomes. Methods: Patients with T1–T4 N0 M0 prostate cancer who received radical EBRT between January 2002 and December 2015 were reviewed retrospectively. Clinical data were obtained via the institutional electronic medical records. The primary endpoint was 5-year overall survival (OS). The secondary endpoints were 5-year freedom from biochemical failure (FFBF) and treatment toxicities. Results: A total of 200 eligible patients were identified. Median follow-up duration was 48 months. 13%, 36% and 51% of patients had low-, intermediate- and high-risk disease. Median dose was 79.2 Gy. The 5-year OS were 90%, 87% and 78% and FFBF were 94%, 100% and 81% for low-, intermediate- and high-risk patients, respectively. Multivariable analysis showed that Eastern Cooperate Oncology Group performance status 2 and Gleason grade group 5 were independent predictors of worse OS. The incidence of grade ≥2 proctitis was 24.5%. Dose escalation was significantly associated with increased incidence of grade ≥2 proctitis (odd ratio, 4.42; 95% confidence interval, 1.95–10.08; P < 0.01). Conclusion: Men with localized prostate cancer treated with EBRT in our population had excellent 5-year OS and biochemical outcomes. Dose escalation did not significantly improve these outcomes but was associated with significantly increased risk of grade ≥2 proctitis in our population. Future studies should be performed to identify patients who will benefit the most from dose-escalated EBRT.
Source Title: ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY
URI: https://scholarbank.nus.edu.sg/handle/10635/162129
ISSN: 17437555
17437563
DOI: 10.1111/ajco.13197
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