Whole-pelvis, "mini-pelvis," or prostate-only external beam radiotherapy after neoadjuvant and concurrent hormonal therapy in patients treated in the Radiation Therapy Oncology Group 9413 trial

Mack Roach, Michelle DeSilvio, Richard Valicenti, David Grignon, Sucha O. Asbell, Colleen Lawton, Charles R. Thomas, William U. Shipley

Research output: Contribution to journalArticle

133 Citations (Scopus)

Abstract

Purpose: The Radiation Therapy Oncology Group (RTOG) 9413 trial demonstrated a better progression-free survival (PFS) with whole-pelvis (WP) radiotherapy (RT) compared with prostate-only (PO) RT. This secondary analysis was undertaken to determine whether "mini-pelvis" (MP; defined as ≥10 × 11 cm but 15%. Neoadjuvant and concurrent hormonal therapy (N&CHT) was administered 2 months before and during RT for 4 months. From April 1, 1995, to June 1, 1999, a group of 325 patients were randomized to WP RT + N&CHT and another group of 324 patients were randomized to receive PO RT + N&CHT. Patients randomized to PO RT were dichotomized by median field size (10 × 11 cm), with the larger field considered an "MP" field and the smaller a PO field. Results: The median PFS was 5.2, 3.7, and 2.9 years for WP, MP, and PO fields, respectively (p = 0.02). The 7-year PFS was 40%, 35%, and 27% for patients treated to WP, MP, and PO fields, respectively. There was no association between field size and late Grade 3+ genitourinary toxicity but late Grade 3+ gastrointestinal RT complications correlated with increasing field size. Conclusions: This subset analysis demonstrates that RT field size has a major impact on PFS, and the findings support comprehensive nodal treatment in patients with a risk of LN involvement of >15%.

Original languageEnglish (US)
Pages (from-to)647-653
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume66
Issue number3
DOIs
StatePublished - Nov 1 2006
Externally publishedYes

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pelvis
Radiation Oncology
Pelvis
Prostate
radiation therapy
therapy
Radiotherapy
progressions
Disease-Free Survival
Therapeutics
grade
toxicity
set theory

Keywords

  • Prostate cancer
  • Radiation field size
  • Randomized trials

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

Cite this

Whole-pelvis, "mini-pelvis," or prostate-only external beam radiotherapy after neoadjuvant and concurrent hormonal therapy in patients treated in the Radiation Therapy Oncology Group 9413 trial. / Roach, Mack; DeSilvio, Michelle; Valicenti, Richard; Grignon, David; Asbell, Sucha O.; Lawton, Colleen; Thomas, Charles R.; Shipley, William U.

In: International Journal of Radiation Oncology Biology Physics, Vol. 66, No. 3, 01.11.2006, p. 647-653.

Research output: Contribution to journalArticle

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abstract = "Purpose: The Radiation Therapy Oncology Group (RTOG) 9413 trial demonstrated a better progression-free survival (PFS) with whole-pelvis (WP) radiotherapy (RT) compared with prostate-only (PO) RT. This secondary analysis was undertaken to determine whether {"}mini-pelvis{"} (MP; defined as ≥10 × 11 cm but 15{\%}. Neoadjuvant and concurrent hormonal therapy (N&CHT) was administered 2 months before and during RT for 4 months. From April 1, 1995, to June 1, 1999, a group of 325 patients were randomized to WP RT + N&CHT and another group of 324 patients were randomized to receive PO RT + N&CHT. Patients randomized to PO RT were dichotomized by median field size (10 × 11 cm), with the larger field considered an {"}MP{"} field and the smaller a PO field. Results: The median PFS was 5.2, 3.7, and 2.9 years for WP, MP, and PO fields, respectively (p = 0.02). The 7-year PFS was 40{\%}, 35{\%}, and 27{\%} for patients treated to WP, MP, and PO fields, respectively. There was no association between field size and late Grade 3+ genitourinary toxicity but late Grade 3+ gastrointestinal RT complications correlated with increasing field size. Conclusions: This subset analysis demonstrates that RT field size has a major impact on PFS, and the findings support comprehensive nodal treatment in patients with a risk of LN involvement of >15{\%}.",
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AU - Grignon, David

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