Survival outcomes of combined external beam radiotherapy and brachytherapy vs. brachytherapy alone for intermediate-risk prostate cancer patients using the National Cancer Data Base
Abstract Purpose The purpose was to evaluate survival outcomes between external beam radiotherapy (EBRT) plus brachytherapy and brachytherapy alone for intermediate-risk prostate cancer, using the National Cancer Data Base. Methods and Materials The National Cancer Data Base was queried for cN0M0 in...
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| Veröffentlicht in: | Brachytherapy 2016-03, Vol.15 (2), p.136-146 |
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| creator | Amini, Arya Jones, Bernard L Jackson, Matthew W Rusthoven, Chad G Maroni, Paul Kavanagh, Brian D Raben, David |
| description | Abstract Purpose The purpose was to evaluate survival outcomes between external beam radiotherapy (EBRT) plus brachytherapy and brachytherapy alone for intermediate-risk prostate cancer, using the National Cancer Data Base. Methods and Materials The National Cancer Data Base was queried for cN0M0 intermediate-risk patients treated from 2004 to 2006, with available data for Gleason score (GS), prostate-specific antigen (PSA), tumor stage, and receipt of radiation therapy (RT) and androgen deprivation therapy. RT comparison groups were the following: EBRT (40–50.4 Gy) plus brachytherapy and brachytherapy alone. Results A total of 10,571 patients were included: 3,148 received EBRT plus brachytherapy and 7,423 received brachytherapy alone. Median followup was 84 months (2–122 months); median age was 68 years (40–90 years). Unadjusted 5- and 7-year overall survival (OS) rates between EBRT plus brachytherapy vs. brachytherapy alone were 91.4% vs. 90.2% and 85.7% vs. 82.9%, respectively ( p < 0.001). EBRT plus brachytherapy was associated with longer OS compared with brachytherapy alone under multivariate (hazard ratio [HR], 0.84; 95% confidence interval [CI], 0.75–0.93; p = 0.001) and propensity score-matched analyses (HR, 0.85; 95% CI, 0.75–0.97; p = 0.006). Further subset analysis performed based on the Radiation Therapy Oncology Group 0232 inclusion criteria (GS 7 if PSA |
| doi_str_mv | 10.1016/j.brachy.2015.11.006 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1772834812</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S1538472115006078</els_id><sourcerecordid>1772834812</sourcerecordid><originalsourceid>FETCH-LOGICAL-c533t-a47c1025dd05e267ab058b0442b84f04fd99ac40ffca75eb266e70d0969485e53</originalsourceid><addsrcrecordid>eNqFUk1v1DAQjRCIlsI_QMhHLgm2YyfOBQm2fEkVHApna-JMqLeJvdjOiv1h_D8cpeXQCyePx2_ezLznonjJaMUoa97sqz6AuTlVnDJZMVZR2jwqzplq65IJ0T3OsaxVKVrOzopnMe5pLuvq-mlxxhvFpZLNefHneglHe4SJ-CUZP2MkfiQ56K3DgeDvhMHl1x5hJgEG69MNBjicCLiBbBPcZ46xepCByTskow_Eukw042AhYRlsvCWH4GPKN2LAGQzkAMmiS5Es0bqfJFOQrznl1-67DXIJCch7iPi8eDLCFPHF3XlR_Pj44fvuc3n17dOX3bur0si6TiWI1jDK5TBQibxpoadS9VQI3isxUjEOXQdG0HE00ErsedNgSwfaNZ1QEmV9UbzeePOwvxaMSc82GpwmcOiXqFnbclULxXiGig1q8l4x4KgPwc4QTppRvRqm93oTR6-GacZ0NiyXvbrrsPRZnn9F9w5lwNsNgHnPo8Wgo8k6mSxlQJP04O3_OjwkMJN11sB0iyeMe7-sBudddOSa6uv106x_hslcTVtV_wWEycJM</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1772834812</pqid></control><display><type>article</type><title>Survival outcomes of combined external beam radiotherapy and brachytherapy vs. brachytherapy alone for intermediate-risk prostate cancer patients using the National Cancer Data Base</title><source>MEDLINE</source><source>Access via ScienceDirect (Elsevier)</source><creator>Amini, Arya ; Jones, Bernard L ; Jackson, Matthew W ; Rusthoven, Chad G ; Maroni, Paul ; Kavanagh, Brian D ; Raben, David</creator><creatorcontrib>Amini, Arya ; Jones, Bernard L ; Jackson, Matthew W ; Rusthoven, Chad G ; Maroni, Paul ; Kavanagh, Brian D ; Raben, David</creatorcontrib><description>Abstract Purpose The purpose was to evaluate survival outcomes between external beam radiotherapy (EBRT) plus brachytherapy and brachytherapy alone for intermediate-risk prostate cancer, using the National Cancer Data Base. Methods and Materials The National Cancer Data Base was queried for cN0M0 intermediate-risk patients treated from 2004 to 2006, with available data for Gleason score (GS), prostate-specific antigen (PSA), tumor stage, and receipt of radiation therapy (RT) and androgen deprivation therapy. RT comparison groups were the following: EBRT (40–50.4 Gy) plus brachytherapy and brachytherapy alone. Results A total of 10,571 patients were included: 3,148 received EBRT plus brachytherapy and 7,423 received brachytherapy alone. Median followup was 84 months (2–122 months); median age was 68 years (40–90 years). Unadjusted 5- and 7-year overall survival (OS) rates between EBRT plus brachytherapy vs. brachytherapy alone were 91.4% vs. 90.2% and 85.7% vs. 82.9%, respectively ( p < 0.001). EBRT plus brachytherapy was associated with longer OS compared with brachytherapy alone under multivariate (hazard ratio [HR], 0.84; 95% confidence interval [CI], 0.75–0.93; p = 0.001) and propensity score-matched analyses (HR, 0.85; 95% CI, 0.75–0.97; p = 0.006). Further subset analysis performed based on the Radiation Therapy Oncology Group 0232 inclusion criteria (GS 7 if PSA < 10 or GS < 7 if PSA 10–20) also demonstrated longer OS with EBRT plus brachytherapy (HR, 0.87; 95% CI, 0.77–0.98; p = 0.026). Conclusions EBRT plus brachytherapy is associated with a modest OS improvement compared with brachytherapy alone in this population-based analysis. Although this benefit appears statistically significant, the relatively small difference in OS raises the question of overall clinical benefit with combined modality RT for intermediate-risk prostate cancer, given the potential increased risk for toxicities. Future results from Radiation Therapy Oncology Group 0232 should provide further insight on this topic.</description><identifier>ISSN: 1538-4721</identifier><identifier>EISSN: 1873-1449</identifier><identifier>DOI: 10.1016/j.brachy.2015.11.006</identifier><identifier>PMID: 26825856</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Androgen Antagonists - therapeutic use ; Brachytherapy ; Brachytherapy - mortality ; Combined Modality Therapy - methods ; Combined Modality Therapy - mortality ; Databases, Factual ; External beam radiotherapy (EBRT) ; Follow-Up Studies ; Hematology, Oncology and Palliative Medicine ; Humans ; Male ; Middle Aged ; NCDB ; Neoplasm Grading ; Propensity Score ; Proportional Hazards Models ; Prostate cancer ; Prostate-Specific Antigen - blood ; Prostatic Neoplasms - drug therapy ; Prostatic Neoplasms - mortality ; Prostatic Neoplasms - pathology ; Prostatic Neoplasms - radiotherapy ; Radiation therapy ; Radiology ; Survival Rate ; United States</subject><ispartof>Brachytherapy, 2016-03, Vol.15 (2), p.136-146</ispartof><rights>American Brachytherapy Society</rights><rights>2016 American Brachytherapy Society</rights><rights>Copyright © 2016 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c533t-a47c1025dd05e267ab058b0442b84f04fd99ac40ffca75eb266e70d0969485e53</citedby><cites>FETCH-LOGICAL-c533t-a47c1025dd05e267ab058b0442b84f04fd99ac40ffca75eb266e70d0969485e53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.brachy.2015.11.006$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26825856$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Amini, Arya</creatorcontrib><creatorcontrib>Jones, Bernard L</creatorcontrib><creatorcontrib>Jackson, Matthew W</creatorcontrib><creatorcontrib>Rusthoven, Chad G</creatorcontrib><creatorcontrib>Maroni, Paul</creatorcontrib><creatorcontrib>Kavanagh, Brian D</creatorcontrib><creatorcontrib>Raben, David</creatorcontrib><title>Survival outcomes of combined external beam radiotherapy and brachytherapy vs. brachytherapy alone for intermediate-risk prostate cancer patients using the National Cancer Data Base</title><title>Brachytherapy</title><addtitle>Brachytherapy</addtitle><description>Abstract Purpose The purpose was to evaluate survival outcomes between external beam radiotherapy (EBRT) plus brachytherapy and brachytherapy alone for intermediate-risk prostate cancer, using the National Cancer Data Base. Methods and Materials The National Cancer Data Base was queried for cN0M0 intermediate-risk patients treated from 2004 to 2006, with available data for Gleason score (GS), prostate-specific antigen (PSA), tumor stage, and receipt of radiation therapy (RT) and androgen deprivation therapy. RT comparison groups were the following: EBRT (40–50.4 Gy) plus brachytherapy and brachytherapy alone. Results A total of 10,571 patients were included: 3,148 received EBRT plus brachytherapy and 7,423 received brachytherapy alone. Median followup was 84 months (2–122 months); median age was 68 years (40–90 years). Unadjusted 5- and 7-year overall survival (OS) rates between EBRT plus brachytherapy vs. brachytherapy alone were 91.4% vs. 90.2% and 85.7% vs. 82.9%, respectively ( p < 0.001). EBRT plus brachytherapy was associated with longer OS compared with brachytherapy alone under multivariate (hazard ratio [HR], 0.84; 95% confidence interval [CI], 0.75–0.93; p = 0.001) and propensity score-matched analyses (HR, 0.85; 95% CI, 0.75–0.97; p = 0.006). Further subset analysis performed based on the Radiation Therapy Oncology Group 0232 inclusion criteria (GS 7 if PSA < 10 or GS < 7 if PSA 10–20) also demonstrated longer OS with EBRT plus brachytherapy (HR, 0.87; 95% CI, 0.77–0.98; p = 0.026). Conclusions EBRT plus brachytherapy is associated with a modest OS improvement compared with brachytherapy alone in this population-based analysis. Although this benefit appears statistically significant, the relatively small difference in OS raises the question of overall clinical benefit with combined modality RT for intermediate-risk prostate cancer, given the potential increased risk for toxicities. Future results from Radiation Therapy Oncology Group 0232 should provide further insight on this topic.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Androgen Antagonists - therapeutic use</subject><subject>Brachytherapy</subject><subject>Brachytherapy - mortality</subject><subject>Combined Modality Therapy - methods</subject><subject>Combined Modality Therapy - mortality</subject><subject>Databases, Factual</subject><subject>External beam radiotherapy (EBRT)</subject><subject>Follow-Up Studies</subject><subject>Hematology, Oncology and Palliative Medicine</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>NCDB</subject><subject>Neoplasm Grading</subject><subject>Propensity Score</subject><subject>Proportional Hazards Models</subject><subject>Prostate cancer</subject><subject>Prostate-Specific Antigen - blood</subject><subject>Prostatic Neoplasms - drug therapy</subject><subject>Prostatic Neoplasms - mortality</subject><subject>Prostatic Neoplasms - pathology</subject><subject>Prostatic Neoplasms - radiotherapy</subject><subject>Radiation therapy</subject><subject>Radiology</subject><subject>Survival Rate</subject><subject>United States</subject><issn>1538-4721</issn><issn>1873-1449</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFUk1v1DAQjRCIlsI_QMhHLgm2YyfOBQm2fEkVHApna-JMqLeJvdjOiv1h_D8cpeXQCyePx2_ezLznonjJaMUoa97sqz6AuTlVnDJZMVZR2jwqzplq65IJ0T3OsaxVKVrOzopnMe5pLuvq-mlxxhvFpZLNefHneglHe4SJ-CUZP2MkfiQ56K3DgeDvhMHl1x5hJgEG69MNBjicCLiBbBPcZ46xepCByTskow_Eukw042AhYRlsvCWH4GPKN2LAGQzkAMmiS5Es0bqfJFOQrznl1-67DXIJCch7iPi8eDLCFPHF3XlR_Pj44fvuc3n17dOX3bur0si6TiWI1jDK5TBQibxpoadS9VQI3isxUjEOXQdG0HE00ErsedNgSwfaNZ1QEmV9UbzeePOwvxaMSc82GpwmcOiXqFnbclULxXiGig1q8l4x4KgPwc4QTppRvRqm93oTR6-GacZ0NiyXvbrrsPRZnn9F9w5lwNsNgHnPo8Wgo8k6mSxlQJP04O3_OjwkMJN11sB0iyeMe7-sBudddOSa6uv106x_hslcTVtV_wWEycJM</recordid><startdate>20160301</startdate><enddate>20160301</enddate><creator>Amini, Arya</creator><creator>Jones, Bernard L</creator><creator>Jackson, Matthew W</creator><creator>Rusthoven, Chad G</creator><creator>Maroni, Paul</creator><creator>Kavanagh, Brian D</creator><creator>Raben, David</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20160301</creationdate><title>Survival outcomes of combined external beam radiotherapy and brachytherapy vs. brachytherapy alone for intermediate-risk prostate cancer patients using the National Cancer Data Base</title><author>Amini, Arya ; Jones, Bernard L ; Jackson, Matthew W ; Rusthoven, Chad G ; Maroni, Paul ; Kavanagh, Brian D ; Raben, David</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c533t-a47c1025dd05e267ab058b0442b84f04fd99ac40ffca75eb266e70d0969485e53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Androgen Antagonists - therapeutic use</topic><topic>Brachytherapy</topic><topic>Brachytherapy - mortality</topic><topic>Combined Modality Therapy - methods</topic><topic>Combined Modality Therapy - mortality</topic><topic>Databases, Factual</topic><topic>External beam radiotherapy (EBRT)</topic><topic>Follow-Up Studies</topic><topic>Hematology, Oncology and Palliative Medicine</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>NCDB</topic><topic>Neoplasm Grading</topic><topic>Propensity Score</topic><topic>Proportional Hazards Models</topic><topic>Prostate cancer</topic><topic>Prostate-Specific Antigen - blood</topic><topic>Prostatic Neoplasms - drug therapy</topic><topic>Prostatic Neoplasms - mortality</topic><topic>Prostatic Neoplasms - pathology</topic><topic>Prostatic Neoplasms - radiotherapy</topic><topic>Radiation therapy</topic><topic>Radiology</topic><topic>Survival Rate</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Amini, Arya</creatorcontrib><creatorcontrib>Jones, Bernard L</creatorcontrib><creatorcontrib>Jackson, Matthew W</creatorcontrib><creatorcontrib>Rusthoven, Chad G</creatorcontrib><creatorcontrib>Maroni, Paul</creatorcontrib><creatorcontrib>Kavanagh, Brian D</creatorcontrib><creatorcontrib>Raben, David</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Brachytherapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Amini, Arya</au><au>Jones, Bernard L</au><au>Jackson, Matthew W</au><au>Rusthoven, Chad G</au><au>Maroni, Paul</au><au>Kavanagh, Brian D</au><au>Raben, David</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Survival outcomes of combined external beam radiotherapy and brachytherapy vs. brachytherapy alone for intermediate-risk prostate cancer patients using the National Cancer Data Base</atitle><jtitle>Brachytherapy</jtitle><addtitle>Brachytherapy</addtitle><date>2016-03-01</date><risdate>2016</risdate><volume>15</volume><issue>2</issue><spage>136</spage><epage>146</epage><pages>136-146</pages><issn>1538-4721</issn><eissn>1873-1449</eissn><abstract>Abstract Purpose The purpose was to evaluate survival outcomes between external beam radiotherapy (EBRT) plus brachytherapy and brachytherapy alone for intermediate-risk prostate cancer, using the National Cancer Data Base. Methods and Materials The National Cancer Data Base was queried for cN0M0 intermediate-risk patients treated from 2004 to 2006, with available data for Gleason score (GS), prostate-specific antigen (PSA), tumor stage, and receipt of radiation therapy (RT) and androgen deprivation therapy. RT comparison groups were the following: EBRT (40–50.4 Gy) plus brachytherapy and brachytherapy alone. Results A total of 10,571 patients were included: 3,148 received EBRT plus brachytherapy and 7,423 received brachytherapy alone. Median followup was 84 months (2–122 months); median age was 68 years (40–90 years). Unadjusted 5- and 7-year overall survival (OS) rates between EBRT plus brachytherapy vs. brachytherapy alone were 91.4% vs. 90.2% and 85.7% vs. 82.9%, respectively ( p < 0.001). EBRT plus brachytherapy was associated with longer OS compared with brachytherapy alone under multivariate (hazard ratio [HR], 0.84; 95% confidence interval [CI], 0.75–0.93; p = 0.001) and propensity score-matched analyses (HR, 0.85; 95% CI, 0.75–0.97; p = 0.006). Further subset analysis performed based on the Radiation Therapy Oncology Group 0232 inclusion criteria (GS 7 if PSA < 10 or GS < 7 if PSA 10–20) also demonstrated longer OS with EBRT plus brachytherapy (HR, 0.87; 95% CI, 0.77–0.98; p = 0.026). Conclusions EBRT plus brachytherapy is associated with a modest OS improvement compared with brachytherapy alone in this population-based analysis. Although this benefit appears statistically significant, the relatively small difference in OS raises the question of overall clinical benefit with combined modality RT for intermediate-risk prostate cancer, given the potential increased risk for toxicities. Future results from Radiation Therapy Oncology Group 0232 should provide further insight on this topic.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26825856</pmid><doi>10.1016/j.brachy.2015.11.006</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Androgen Antagonists - therapeutic use Brachytherapy Brachytherapy - mortality Combined Modality Therapy - methods Combined Modality Therapy - mortality Databases, Factual External beam radiotherapy (EBRT) Follow-Up Studies Hematology, Oncology and Palliative Medicine Humans Male Middle Aged NCDB Neoplasm Grading Propensity Score Proportional Hazards Models Prostate cancer Prostate-Specific Antigen - blood Prostatic Neoplasms - drug therapy Prostatic Neoplasms - mortality Prostatic Neoplasms - pathology Prostatic Neoplasms - radiotherapy Radiation therapy Radiology Survival Rate United States |
| title | Survival outcomes of combined external beam radiotherapy and brachytherapy vs. brachytherapy alone for intermediate-risk prostate cancer patients using the National Cancer Data Base |
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