ART for High-Risk Prostate Cancer Improves Outcomes
ORLANDO, Fla.—Adjuvant radiotherapy (ART) for patients with pT3 prostate cancer (PCa) is safe and decreases the risk of biochemical failure, according to findings presented at the annual Genitourinary Cancers Symposium.
The findings are from a 10-year study in which 385 men with pT3 PCa were randomized to receive a 60 Gy dose of radiotherapy (arm A, 193 patients) or to a wait-and-see (WS) group, 192 patients) before achieving an undetectable PSA level after radical prostatectomy (RP).
Seventy-eight patients (20%) did not achieve an undetectable PSA after RP and were considered to have progressive disease (45 patients in arm A and 33 patients in arm B) and were excluded from the study. In addition, 34 patients in the ART arm (23%) did not receive radiotherapy. Thus, 114 patients remained in arm A and 159 patients remained in arm B.
The median follow-up was 111 months for arm A and 113.3 months for arm B. Biochemical control increased to 56% in arm A compared with 35% for arm B, which translated into a 49% decreased risk of biochemical failure with ART, investigators Thomas Wiegel, MD, of the University of Ulm in Ulm, Germany, reported..
ART did not significantly affect metastasis-free survival or overall survival (OS), but the authors noted that the study was not powered to detect differences in OS.
Patients with undetectable PSA after RP were considered to have biochemical progression if they had two consecutive PSA measurements showing increases in PSA.