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Favorable Biochemical Freedom From Recurrence With Stereotactic Body Radiation Therapy for Intermediate and High-Risk Prostate Cancer: A Single Institutional Experience With Long-Term Follow-Up

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dc.contributor.authorRicco, Anthonyen
dc.contributor.authorBarbera, Gabrielleen
dc.contributor.authorLanciano, Rachelleen
dc.contributor.authorFeng, Jingen
dc.contributor.authorHanlon, Alexandra L.en
dc.contributor.authorLozano, Alicia J.en
dc.contributor.authorGood, Michaelen
dc.contributor.authorArrigo, Stephenen
dc.contributor.authorLamond, Johnen
dc.contributor.authorYang, Junen
dc.date.accessioned2021-10-04T14:42:51Zen
dc.date.available2021-10-04T14:42:51Zen
dc.date.issued2020-09-25en
dc.date.updated2021-10-04T14:42:45Zen
dc.description.abstractPurpose/Objective(s): The current study reports long-term overall survival (OS) and biochemical freedom from recurrence (BFFR) after stereotactic body radiation therapy (SBRT) for men with intermediate and high-risk prostate cancer in a single community hospital setting with early adoption. Materials/Methods: Ninety-seven consecutive men with intermediate and high-risk prostate cancer treated with SBRT between 2007 and 2015 were retrospectively studied. Categorical variables for analysis included National Comprehensive Cancer Network risk group, race, Gleason grade group, T stage, use of androgen deprivation therapy, and planning target volume dose. Continuous variables for analysis included pretreatment prostate-specific antigen (PSA), percent cores positive, age at diagnosis, PSA nadir, prostate volume, percent prostate that received 40 Gy, and minimum dose to 0.03 cc of prostate (Dmin). BFFR was assessed using the Phoenix nadir +2 definition. OS and BFFR were estimated using Kaplan–Meier (KM) methodology with comparisons accomplished using log-rank statistics. Multivariable analysis (MVA) was accomplished with a backwards selection Cox proportional-hazards model with statistical significance taken at the p < 0.05 level. Results: Median FU is 78.4 months. Five- and ten-year OS KM estimates are 90.9 and 73.2%, respectively, with 19 deaths recorded. MVA reveals pretreatment PSA (p = 0.032), percent prostate 40 Gy (p = 0.003), and race (p = 0.031) were predictive of OS. Five- and nine-year BFFR KM estimates are 92.1 and 87.5%, respectively, with 10 biochemical failures recorded. MVA revealed PSA nadir (p < 0.001) was the only factor predictive of BFFR. Specifically, for every one-unit increase in PSA nadir, there was a 4.2-fold increased odds of biochemical failure (HR = 4.248). No significant differences in BFFR were found between favorable intermediate, unfavorable intermediate, and high-risk prostate cancer (p = 0.054) with 7-year KM estimates of 96.6, 81.0, and 85.7%, respectively. Conclusions: Favorable OS and BFFR can be expected after SBRT for intermediate and high-risk prostate cancer with non-significant differences seen for BFFR between favorable intermediate, unfavorable intermediate, and high-risk groups. Our 5-year BFFR compares favorably with the HYPO-RT-PC trial of 84%. PSA nadir was predictive of biochemical failure. This study is ultimately limited by the small absolute number of high-risk patients included.en
dc.description.versionPublished versionen
dc.format.extent10 page(s)en
dc.format.mimetypeapplication/pdfen
dc.identifierARTN 1505 (Article number)en
dc.identifier.doihttps://doi.org/10.3389/fonc.2020.01505en
dc.identifier.eissn2234-943Xen
dc.identifier.issn2234-943Xen
dc.identifier.orcidHanlon, Alexandra L. [0000-0002-9612-2197]en
dc.identifier.pmid33102201en
dc.identifier.urihttp://hdl.handle.net/10919/105153en
dc.identifier.volume10en
dc.language.isoenen
dc.publisherFrontiersen
dc.relation.urihttp://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000576235100001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=930d57c9ac61a043676db62af60056c1en
dc.rightsCreative Commons Attribution 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en
dc.subjectLife Sciences & Biomedicineen
dc.subjectOncologyen
dc.subjectprostate canceren
dc.subjectSBRT (stereotactic body radiation therapy)en
dc.subjecthigh risk prostate canceren
dc.subjectprostate SBRT treatmenten
dc.subjectintermediate risk prostate canceren
dc.subjectQUALITY-OF-LIFEen
dc.subjectNADIR LEVELen
dc.subjectRADIOTHERAPYen
dc.subjectTOXICITYen
dc.subjectTRIALen
dc.subjectSURVIVALen
dc.subjectOUTCOMESen
dc.subjectPATTERNSen
dc.subjectPHASE-2en
dc.subject1112 Oncology and Carcinogenesisen
dc.titleFavorable Biochemical Freedom From Recurrence With Stereotactic Body Radiation Therapy for Intermediate and High-Risk Prostate Cancer: A Single Institutional Experience With Long-Term Follow-Upen
dc.title.serialFrontiers in Oncologyen
dc.typeArticle - Refereeden
dc.type.dcmitypeTexten
dc.type.otherArticleen
dc.type.otherJournalen
dcterms.dateAccepted2020-07-14en
pubs.organisational-group/Virginia Techen
pubs.organisational-group/Virginia Tech/Scienceen
pubs.organisational-group/Virginia Tech/Science/Statisticsen
pubs.organisational-group/Virginia Tech/Faculty of Health Sciencesen

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