dc.contributor.author | Kass-Iliyya, A | |
dc.contributor.author | Jovic, G | |
dc.contributor.author | Murphy, C | |
dc.contributor.author | Fisher, C | |
dc.contributor.author | Syndikus, I | |
dc.contributor.author | Jose, C | |
dc.contributor.author | Scrase, CD | |
dc.contributor.author | Graham, JD | |
dc.contributor.author | Nicol, D | |
dc.contributor.author | Sydes, MR | |
dc.contributor.author | Dearnaley, D | |
dc.date.accessioned | 2018-03-01T14:43:53Z | |
dc.date.issued | 2018-06-01 | |
dc.identifier.citation | European urology, 2018, 73 (6), pp. 968 - 976 | |
dc.identifier.issn | 0302-2838 | |
dc.identifier.uri | https://repository.icr.ac.uk/handle/internal/1470 | |
dc.identifier.eissn | 1873-7560 | |
dc.identifier.doi | 10.1016/j.eururo.2017.12.017 | |
dc.description.abstract | BACKGROUND: The importance of 2-yr postradiotherapy prostate biopsy status remains uncertain. OBJECTIVE: To assess the value of 2 year post treatment biopsies in a randomised trial of radiotherapy dose escalation. DESIGN, SETTING, AND PARTICIPANTS: Between 1998 and 2001, 843 men with localised prostate cancer were randomised to receive either control-64Gy or escalated-74Gy conformal radiotherapy (CFRT) in the MRC RT01 trial in combination with 3-6-mo neoadjuvant androgen deprivation therapy. Prostate biopsies were planned at 2 yr from start of CFRT in suitable men. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Prostate biopsy results and prostate-specific antigen (PSA) levels performed at 2 yr post-CFRT were evaluated with long-term biochemical progression free survival (bPFS) and overall survival. Outcome measures were timed from the 2-yr biopsy using a landmark approach. RESULTS AND LIMITATIONS: A 2-yr biopsy was performed in 312/843 patients. One hundred and seventy-seven patients were included in the per-protocol group with median follow-up of 7.8 yr from biopsy. Median PSA at biopsy was 0.5ng/ml. Sixty-four bPFS events were reported: 46/145 (32%) in patients with negative, 6/18 (33%) suspicious, and 12/14 (86%) positive biopsies. A positive biopsy was prognostic of worse bPFS, going forward, compared with negative and suspicious biopsies, hazard ratio (HR)=4.81 (95% confidence interval [CI]: 2.50-9.26, p<0.001). The estimate for survival was HR=1.58 (95% CI: 0.52-4.78, p=0.42). PSA values at 2 yr between 1.01ng/ml and 2.09ng/ml were also associated with subsequent PSA failures (HR=2.71, 95% CI: 1.98-3.71), bPFS events (HR=2.45, 95% CI: 1.81-3.32), and prostate cancer-specific survival (HR=2.87, 95% CI: 1.08-7.64) compared with PSA ≤1.0ng/ml. CONCLUSIONS: Two-year postradiotherapy prostate biopsies have limited value in patients with PSA control but both positive biopsy and higher PSA status are strongly associated with future bPFS events. A policy of selected biopsy may provide an opportunity for early salvage interventions. PATIENT SUMMARY: Routine 2-yr postradiotherapy biopsy is not recommended but can be considered in selected patients with unfavourable post-treatment prostate-specific antigen levels who are suitable for early salvage treatments. | |
dc.format | Print-Electronic | |
dc.format.extent | 968 - 976 | |
dc.language | eng | |
dc.language.iso | eng | |
dc.publisher | ELSEVIER SCIENCE BV | |
dc.rights.uri | https://creativecommons.org/licenses/by/4.0 | |
dc.subject | Prostate | |
dc.subject | Humans | |
dc.subject | Prostatic Neoplasms | |
dc.subject | Androgen Antagonists | |
dc.subject | Prostate-Specific Antigen | |
dc.subject | Biopsy | |
dc.subject | Neoadjuvant Therapy | |
dc.subject | Radiotherapy Dosage | |
dc.subject | Survival Rate | |
dc.subject | Follow-Up Studies | |
dc.subject | Aged | |
dc.subject | Middle Aged | |
dc.subject | Male | |
dc.subject | Randomized Controlled Trials as Topic | |
dc.subject | Progression-Free Survival | |
dc.title | Two-years Postradiotherapy Biopsies: Lessons from MRC RT01 Trial. | |
dc.type | Journal Article | |
dcterms.dateAccepted | 2017-12-14 | |
rioxxterms.versionofrecord | 10.1016/j.eururo.2017.12.017 | |
rioxxterms.licenseref.uri | https://creativecommons.org/licenses/by/4.0 | |
rioxxterms.licenseref.startdate | 2018-06 | |
rioxxterms.type | Journal Article/Review | |
dc.relation.isPartOf | European urology | |
pubs.issue | 6 | |
pubs.notes | Not known | |
pubs.organisational-group | /ICR | |
pubs.organisational-group | /ICR/Primary Group | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Closed research teams | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Closed research teams/Clinical Academic Radiotherapy (Dearnaley) | |
pubs.organisational-group | /ICR | |
pubs.organisational-group | /ICR/Primary Group | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Closed research teams | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Closed research teams/Clinical Academic Radiotherapy (Dearnaley) | |
pubs.publication-status | Published | |
pubs.volume | 73 | |
pubs.embargo.terms | Not known | |
icr.researchteam | Clinical Academic Radiotherapy (Dearnaley) | |
dc.contributor.icrauthor | Dearnaley, David | |