Defining a doseresponse relationship for prostate external beam radiotherapy

Trada, Yuvnik, Plank, Ash and Martin, Jarad (2013) Defining a doseresponse relationship for prostate external beam radiotherapy. Journal of Medical Imaging and Radiation Oncology, 57 2: 237-246. doi:10.1111/1754-9485.12008

Author Trada, Yuvnik
Plank, Ash
Martin, Jarad
Title Defining a doseresponse relationship for prostate external beam radiotherapy
Journal name Journal of Medical Imaging and Radiation Oncology   Check publisher's open access policy
ISSN 1754-9477
Publication date 2013-04
Year available 2012
Sub-type Article (original research)
DOI 10.1111/1754-9485.12008
Volume 57
Issue 2
Start page 237
End page 246
Total pages 10
Place of publication Richmond, VIC, Australia
Publisher Wiley-Blackwell Publishing Asia
Collection year 2014
Language eng
Formatted abstract
Introduction: We aimed to quantify a relationship between radiotherapy dose and freedom from biochemical failure (FFBF) in low- and intermediate-risk prostate cancer. To reduce confounding we used data with a standardisedend–point, mature follow-up, low competing risk of metastatic failure, conventional fractionation and separate reporting for outcomes with hormonal therapy (HT).
Methods: A systematic review of the literature was carried out. Studies that reported the use of radiotherapy alone in 1.8–2 Gy fractions in low- and intermediate-risk prostate cancer were included. The primary end–point was Phoenix definition 5-year FFBF. A logistic regression was used to quantify the dose–response relationship.
Results: Data from eight studies with 3037 patients met the inclusion criteria. The data from 810 low-risk patients and 2245 intermediate-risk patients were analysed. A strong association between radiotherapy dose and FFBF was found in low- and intermediate-risk patients managed with radiotherapy alone. In low-risk patients not treated with HT the dose required to achieve 50% biochemical tumour control (TCD50) is 52.0 Gy and the slope of the dose–response curve at TCD50 (y50) is 2.1%/Gy. At 78 Gy this represented a FFBF of 90.3%. In intermediate-risk patients not treated with HT the TCD50 is 64.7 Gy and y50 is 3.2%/Gy. At 78 Gy this translated into a FFBF of 84.3%. HT had a small effect for low-risk patients and an inconsistent effect for intermediate-risk men.
Conclusion: A strong association was found between radiation dose and biochemical outcome in both low- and intermediate-risk patients. Standardised reporting of results from future studies will make future analyses more robust.
Keyword Biochemical failure
Doseresponse relationship
Prostatic neoplasm
Systemic review
III Randomized-Trial
Conformal Radiotherapy
Androgen Deprivation
Escalation Trial
Cancer Treatment
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article first published online 28 DEC 2012

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
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