Radiation dose escalation or longer androgen suppression for locally advanced prostate cancer? Data from the TROG 03.04 RADAR trial

Denham, James W., Steigler, Allison, Joseph, David, Lamb, David S, Spry, Nigel A, Duchesne, Gillian, Atkinson, Chris, Matthews, John, Turner, Sandra, Kenny, Lizbeth, Tai, Keen-Hun, Gogna, Nirdosh Kumar, Gill, Suki, Tan, Hendrick, Kearvell, Rachel, Murray, Judy, Ebert, Martin, Haworth, Annette, Kennedy, Angel, Delahunt, Brett, Oldmeadow, Christopher, Holliday, Elizabeth G. and Attia, John (2015) Radiation dose escalation or longer androgen suppression for locally advanced prostate cancer? Data from the TROG 03.04 RADAR trial. Radiotherapy and Oncology, 115 3: 301-307. doi:10.1016/j.radonc.2015.05.016


Author Denham, James W.
Steigler, Allison
Joseph, David
Lamb, David S
Spry, Nigel A
Duchesne, Gillian
Atkinson, Chris
Matthews, John
Turner, Sandra
Kenny, Lizbeth
Tai, Keen-Hun
Gogna, Nirdosh Kumar
Gill, Suki
Tan, Hendrick
Kearvell, Rachel
Murray, Judy
Ebert, Martin
Haworth, Annette
Kennedy, Angel
Delahunt, Brett
Oldmeadow, Christopher
Holliday, Elizabeth G.
Attia, John
Title Radiation dose escalation or longer androgen suppression for locally advanced prostate cancer? Data from the TROG 03.04 RADAR trial
Journal name Radiotherapy and Oncology   Check publisher's open access policy
ISSN 1879-0887
0167-8140
Publication date 2015-06
Sub-type Article (original research)
DOI 10.1016/j.radonc.2015.05.016
Open Access Status Not Open Access
Volume 115
Issue 3
Start page 301
End page 307
Total pages 7
Place of publication Shannon, Clare, Ireland
Publisher Elsevier
Collection year 2016
Language eng
Formatted abstract
Background: The relative effects of radiation dose escalation (RDE) and androgen suppression (AS) duration on local prostatic progression (LP) remain unclear.

Methods: We addressed this in the TROG 03.04 RADAR trial by incorporating a RDE programme by stratification at randomisation. Men were allocated 6 or 18 months AS ± 18 months zoledronate (Z). The main endpoint was a composite of clinically diagnosed LP or PSA progression with a PSA doubling time ≥6 months. Fine and Gray competing risk modelling with adjustment for site clustering produced cumulative incidence estimates at 6.5 years for each RDE group.

Results: Composite LP declined coherently in the 66, 70 and 74 Gy external beam dosing groups and was lowest in the high dose rate brachytherapy boost (HDRB) group. At 6.5 years, adjusted cumulative incidences were 22%, 15%, 13% and 7% respectively. Compared to 6 months AS, 18 months AS also significantly reduced LP (p < 0.001). Post-radiation urethral strictures were documented in 45 subjects and increased incrementally in the dosing groups. Crude incidences were 0.8%, 0.9%, 3.8% and 12.7% respectively.

Conclusion: RDE and increasing AS independently reduce LP and increase urethral strictures. The risks and benefits to the individual must be balanced when selecting radiation dose and AS duration.
Keyword Androgen suppression
Dose escalation
High dose rate brachytherapy boost
Prostate cancer
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Mater Research Institute-UQ (MRI-UQ)
Non HERDC
 
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Created: Thu, 31 Mar 2016, 14:15:31 EST by Julia McCabe on behalf of Learning and Research Services (UQ Library)