Short-term neoadjuvant androgen deprivation therapy and external-beam radiotherapy for locally advanced prostate cancer

Long-term results of RTOG 8610

Mack Roach, Kyounghwa Bae, Joycelyn Speight, Harvey B. Wolkov, Phillip Rubin, R. Jeffrey Lee, Colleen Lawton, Richard Valicenti, David Grignon, Miljenko V. Pilepich

Research output: Contribution to journalArticle

428 Citations (Scopus)

Abstract

Purpose: Radiation 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 Methods: Between 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). Results: Ten-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 <.0001), and BF (65% v 80%; P <.0001) with the addition of ADT, but no differences were observed in the risk of fatal cardiac events. Conclusion: The addition of 4 months of ADT to EBRT appears to have a dramatic impact on clinically meaningful end points in men with locally advanced disease with no statistically significant impact on the risk of fatal cardiac events.

Original languageEnglish (US)
Pages (from-to)585-591
Number of pages7
JournalJournal of Clinical Oncology
Volume26
Issue number4
DOIs
StatePublished - Feb 1 2008
Externally publishedYes

Fingerprint

Radiation Oncology
Androgens
Prostatic Neoplasms
Radiotherapy
Neoplasm Staging
Disease-Free Survival
Survival
Therapeutics
Goserelin
Neoplasm Metastasis
Flutamide
Mortality
Lymph Nodes
Neoplasms

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

Cite this

Short-term neoadjuvant androgen deprivation therapy and external-beam radiotherapy for locally advanced prostate cancer : Long-term results of RTOG 8610. / Roach, Mack; Bae, Kyounghwa; Speight, Joycelyn; Wolkov, Harvey B.; Rubin, Phillip; Lee, R. Jeffrey; Lawton, Colleen; Valicenti, Richard; Grignon, David; Pilepich, Miljenko V.

In: Journal of Clinical Oncology, Vol. 26, No. 4, 01.02.2008, p. 585-591.

Research output: Contribution to journalArticle

Roach, Mack ; Bae, Kyounghwa ; Speight, Joycelyn ; Wolkov, Harvey B. ; Rubin, Phillip ; Lee, R. Jeffrey ; Lawton, Colleen ; Valicenti, Richard ; Grignon, David ; Pilepich, Miljenko V. / Short-term neoadjuvant androgen deprivation therapy and external-beam radiotherapy for locally advanced prostate cancer : Long-term results of RTOG 8610. In: Journal of Clinical Oncology. 2008 ; Vol. 26, No. 4. pp. 585-591.
@article{0619010672264ecba4907b4ecf6a23ee,
title = "Short-term neoadjuvant androgen deprivation therapy and external-beam radiotherapy for locally advanced prostate cancer: Long-term results of RTOG 8610",
abstract = "Purpose: Radiation 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 Methods: Between 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). Results: Ten-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 <.0001), and BF (65{\%} v 80{\%}; P <.0001) with the addition of ADT, but no differences were observed in the risk of fatal cardiac events. Conclusion: The addition of 4 months of ADT to EBRT appears to have a dramatic impact on clinically meaningful end points in men with locally advanced disease with no statistically significant impact on the risk of fatal cardiac events.",
author = "Mack Roach and Kyounghwa Bae and Joycelyn Speight and Wolkov, {Harvey B.} and Phillip Rubin and Lee, {R. Jeffrey} and Colleen Lawton and Richard Valicenti and David Grignon and Pilepich, {Miljenko V.}",
year = "2008",
month = "2",
day = "1",
doi = "10.1200/JCO.2007.13.9881",
language = "English (US)",
volume = "26",
pages = "585--591",
journal = "Journal of Clinical Oncology",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
number = "4",

}

TY - JOUR

T1 - Short-term neoadjuvant androgen deprivation therapy and external-beam radiotherapy for locally advanced prostate cancer

T2 - Long-term results of RTOG 8610

AU - Roach, Mack

AU - Bae, Kyounghwa

AU - Speight, Joycelyn

AU - Wolkov, Harvey B.

AU - Rubin, Phillip

AU - Lee, R. Jeffrey

AU - Lawton, Colleen

AU - Valicenti, Richard

AU - Grignon, David

AU - Pilepich, Miljenko V.

PY - 2008/2/1

Y1 - 2008/2/1

N2 - Purpose: Radiation 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 Methods: Between 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). Results: Ten-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 <.0001), and BF (65% v 80%; P <.0001) with the addition of ADT, but no differences were observed in the risk of fatal cardiac events. Conclusion: The addition of 4 months of ADT to EBRT appears to have a dramatic impact on clinically meaningful end points in men with locally advanced disease with no statistically significant impact on the risk of fatal cardiac events.

AB - Purpose: Radiation 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 Methods: Between 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). Results: Ten-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 <.0001), and BF (65% v 80%; P <.0001) with the addition of ADT, but no differences were observed in the risk of fatal cardiac events. Conclusion: The addition of 4 months of ADT to EBRT appears to have a dramatic impact on clinically meaningful end points in men with locally advanced disease with no statistically significant impact on the risk of fatal cardiac events.

UR - http://www.scopus.com/inward/record.url?scp=39149085396&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=39149085396&partnerID=8YFLogxK

U2 - 10.1200/JCO.2007.13.9881

DO - 10.1200/JCO.2007.13.9881

M3 - Article

VL - 26

SP - 585

EP - 591

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 4

ER -