dc.contributor.author | Parker, CC | |
dc.contributor.author | James, ND | |
dc.contributor.author | Brawley, CD | |
dc.contributor.author | Clarke, NW | |
dc.contributor.author | Ali, A | |
dc.contributor.author | Amos, CL | |
dc.contributor.author | Attard, G | |
dc.contributor.author | Chowdhury, S | |
dc.contributor.author | Cook, A | |
dc.contributor.author | Cross, W | |
dc.contributor.author | Dearnaley, DP | |
dc.contributor.author | Douis, H | |
dc.contributor.author | Gilbert, DC | |
dc.contributor.author | Gilson, C | |
dc.contributor.author | Gillessen, S | |
dc.contributor.author | Hoyle, A | |
dc.contributor.author | Jones, RJ | |
dc.contributor.author | Langley, RE | |
dc.contributor.author | Malik, ZI | |
dc.contributor.author | Mason, MD | |
dc.contributor.author | Matheson, D | |
dc.contributor.author | Millman, R | |
dc.contributor.author | Rauchenberger, M | |
dc.contributor.author | Rush, H | |
dc.contributor.author | Russell, JM | |
dc.contributor.author | Sweeney, H | |
dc.contributor.author | Bahl, A | |
dc.contributor.author | Birtle, A | |
dc.contributor.author | Capaldi, L | |
dc.contributor.author | Din, O | |
dc.contributor.author | Ford, D | |
dc.contributor.author | Gale, J | |
dc.contributor.author | Henry, A | |
dc.contributor.author | Hoskin, P | |
dc.contributor.author | Kagzi, M | |
dc.contributor.author | Lydon, A | |
dc.contributor.author | O'Sullivan, JM | |
dc.contributor.author | Paisey, SA | |
dc.contributor.author | Parikh, O | |
dc.contributor.author | Pudney, D | |
dc.contributor.author | Ramani, V | |
dc.contributor.author | Robson, P | |
dc.contributor.author | Srihari, NN | |
dc.contributor.author | Tanguay, J | |
dc.contributor.author | Parmar, MKB | |
dc.contributor.author | Sydes, MR | |
dc.contributor.author | STAMPEDE Trial Collaborative Group, | |
dc.contributor.editor | Brenton JD | |
dc.coverage.spatial | United States | |
dc.date.accessioned | 2022-08-23T13:33:49Z | |
dc.date.available | 2022-08-23T13:33:49Z | |
dc.date.issued | 2022-06-01 | |
dc.identifier | ARTN e1003998 | |
dc.identifier | PMEDICINE-D-22-00022 | |
dc.identifier.citation | PLoS Medicine, 2022, 19 (6), pp. e1003998 - | |
dc.identifier.issn | 1549-1277 | |
dc.identifier.uri | https://repository.icr.ac.uk/handle/internal/5315 | |
dc.identifier.eissn | 1549-1676 | |
dc.identifier.eissn | 1549-1676 | |
dc.identifier.doi | 10.1371/journal.pmed.1003998 | |
dc.description.abstract | BACKGROUND: STAMPEDE has previously reported that radiotherapy (RT) to the prostate improved overall survival (OS) for patients with newly diagnosed prostate cancer with low metastatic burden, but not those with high-burden disease. In this final analysis, we report long-term findings on the primary outcome measure of OS and on the secondary outcome measures of symptomatic local events, RT toxicity events, and quality of life (QoL). METHODS AND FINDINGS: Patients were randomised at secondary care sites in the United Kingdom and Switzerland between January 2013 and September 2016, with 1:1 stratified allocation: 1,029 to standard of care (SOC) and 1,032 to SOC+RT. No masking of the treatment allocation was employed. A total of 1,939 had metastatic burden classifiable, with 42% low burden and 58% high burden, balanced by treatment allocation. Intention-to-treat (ITT) analyses used Cox regression and flexible parametric models (FPMs), adjusted for stratification factors age, nodal involvement, the World Health Organization (WHO) performance status, regular aspirin or nonsteroidal anti-inflammatory drug (NSAID) use, and planned docetaxel use. QoL in the first 2 years on trial was assessed using prospectively collected patient responses to QLQ-30 questionnaire. Patients were followed for a median of 61.3 months. Prostate RT improved OS in patients with low, but not high, metastatic burden (respectively: 202 deaths in SOC versus 156 in SOC+RT, hazard ratio (HR) = 0·64, 95% CI 0.52, 0.79, p < 0.001; 375 SOC versus 386 SOC+RT, HR = 1.11, 95% CI 0.96, 1.28, p = 0·164; interaction p < 0.001). No evidence of difference in time to symptomatic local events was found. There was no evidence of difference in Global QoL or QLQ-30 Summary Score. Long-term urinary toxicity of grade 3 or worse was reported for 10 SOC and 10 SOC+RT; long-term bowel toxicity of grade 3 or worse was reported for 15 and 11, respectively. CONCLUSIONS: Prostate RT improves OS, without detriment in QoL, in men with low-burden, newly diagnosed, metastatic prostate cancer, indicating that it should be recommended as a SOC. TRIAL REGISTRATION: ClinicalTrials.gov NCT00268476, ISRCTN.com ISRCTN78818544. | |
dc.format | Electronic-eCollection | |
dc.format.extent | e1003998 - | |
dc.language | eng | |
dc.language.iso | eng | |
dc.publisher | PUBLIC LIBRARY SCIENCE | |
dc.relation.ispartof | PLoS Medicine | |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | |
dc.subject | Docetaxel | |
dc.subject | Humans | |
dc.subject | Male | |
dc.subject | Prostate | |
dc.subject | Prostatic Neoplasms | |
dc.subject | Quality of Life | |
dc.subject | Switzerland | |
dc.title | Radiotherapy to the prostate for men with metastatic prostate cancer in the UK and Switzerland: Long-term results from the STAMPEDE randomised controlled trial. | |
dc.type | Journal Article | |
dcterms.dateAccepted | 2022-04-22 | |
dc.date.updated | 2022-08-23T13:33:13Z | |
rioxxterms.version | VoR | |
rioxxterms.versionofrecord | 10.1371/journal.pmed.1003998 | |
rioxxterms.licenseref.startdate | 2022-06-01 | |
rioxxterms.type | Journal Article/Review | |
pubs.author-url | https://www.ncbi.nlm.nih.gov/pubmed/35671327 | |
pubs.issue | 6 | |
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/Radiotherapy and Imaging | |
pubs.organisational-group | /ICR/Primary Group/Royal Marsden Clinical Units | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Prostate and Bladder Cancer Research | |
pubs.organisational-group | /ICR/Primary Group/ICR Divisions/Closed research teams/Clinical Academic Radiotherapy (Dearnaley) | |
pubs.organisational-group | /ICR/ImmNet | |
pubs.publication-status | Published online | |
pubs.volume | 19 | |
icr.researchteam | Prostate & Bladder Cancer | |
icr.researchteam | Clinic Acad RT Dearnaley | |
dc.contributor.icrauthor | James, Nicholas | |
dc.contributor.icrauthor | Dearnaley, David | |
icr.provenance | Deposited by Mr Arek Surman on 2022-08-23. Deposit type is initial. No. of files: 1. Files: Radiotherapy to the prostate for men with metastatic prostate cancer in the UK and Switzerland Long-term results from the ST.pdf | |