Short-term neoadjuvant androgen deprivation therapy and external-beam radiotherapy for locally advanced prostate cancer: Long-term results of RTOG 8610
Short-term neoadjuvant androgen deprivation therapy and external-beam radiotherapy for locally advanced prostate cancer: Long-term results of RTOG 8610
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DOI：
10.1200/jco.2007.13.9881
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发表时间：
2008-02-01
影响因子：
45.3
通讯作者：
Pilepich, Miljenko V.
中科院分区：
文献类型：
--
作者：
Roach, Mack, III;Bae, Kyounghwa;Pilepich, Miljenko V.
放射治疗肿瘤组（RTOG）8610是第一个评价新辅助雄激素剥夺治疗（ADT）联合外照射放疗（EBRT）治疗局部晚期前列腺癌的III期随机试验。这份报告总结了长期随访结果。材料和MethodsBetween 1987年和1991年，456评估患者（中位年龄，70岁）参加。根据1988年美国癌症联合委员会TNM分期系统，符合条件的患者患有巨大（5 x 5 cm）肿瘤（T2-4），伴或不伴盆腔淋巴结受累。患者在EBRT之前和同时接受联合ADT，包括戈舍瑞林3.6 mg，每4周一次和氟替卡松250 mg，每日3次，持续2个月，或者他们单独接受EBRT。研究终点包括总生存率（OS）、疾病特异性死亡率（DSM）、远处转移（DM）、无病生存率（DFS）和生化失败（BF）。（43%对34%）和中位生存时间（8.7 v7.3年）分别支持ADT和EBRT;然而，这些差异未达到统计学显著性（P = 0.12）。10年DSM（23% v36%; P = 0.01）、DM（35% v47%; P = 0.006）、DFS（11% v3%; P
PurposeRadiation Therapy Oncology Group ( RTOG) 8610 was the first phase III randomized trial to evaluate neoadjuvant androgen deprivation therapy ( ADT) in combination with external-beam radiotherapy ( EBRT) in men with locally advanced prostate cancer. This report summarizes long-term follow-up results.Materials and MethodsBetween 1987 and 1991, 456 assessable patients ( median age, 70 years) were enrolled. Eligible patients had bulky ( 5 x 5 cm) tumors ( T2-4) with or without pelvic lymph node involvement according to the 1988 American Joint Committee on Cancer TNM staging system. Patients received combined ADT that consisted of goserelin 3.6 mg every 4 weeks and flutamide 250 mg tid for 2 months before and concurrent with EBRT, or they received EBRT alone. Study end points included overall survival ( OS), disease-specific mortality ( DSM), distant metastasis ( DM), disease-free survival ( DFS), and biochemical failure ( BF).ResultsTen-year OS estimates ( 43% v 34%) and median survival times ( 8.7 v 7.3 years) favored ADT and EBRT, respectively; however, these differences did not reach statistical significance ( P =.12). There was a statistically significant improvement in 10-year DSM ( 23% v 36%; P =.01), DM ( 35% v 47%; P =.006), DFS ( 11% v 3%; P