The impact of increasing dose on overall survival in prostate cancer

Radiation Oncology

Jeffrey Y. C. Wong²  Bertrand P. Tseng³  David D. Smith¹  Timothy E. Schultheiss²  Matthew D. Hall² 

[1] Division of Biostatistics, City of Hope National Medical Center, 1500 East Duarte Road, Duarte 91010, CA, USA;Department of Radiation Oncology, City of Hope National Medical Center, 1500 East Duarte Road, Duarte 91010, CA, USA;Duke University Medical Center, Durham 27710, NC, USA

关键词: Overall survival;    Dose response;    Dose;    Prostate cancer;    Radiation therapy;   

Others  :  1228530
DOI  :  10.1186/s13014-015-0419-3

 received in 2015-02-03, accepted in 2015-05-11,  发布年份 2015

【 摘 要 】

Purpose

To assess the impact of increasing dose on overall survival (OS) for prostate cancer patients.

Methods

Treatment data were obtained on more than 20,000 patients in the National Oncology Data Alliance®, a proprietary database of merged tumor registries, who were treated for prostate cancer with definitive radiotherapy between 1995 and 2006. Eligible patients had complete data on total dose, T stage, use and timing of androgen deprivation therapy (ADT), and treatment start date (n = 20,028). Patients with prior malignancies were excluded.

Results

On multivariate analysis, dose, T stage, grade, marital status, age, and neoadjuvant ADT were significant predictors of OS. Hazard ratios for OS declined monotonically with increasing dose, reaching 0.63 (95 % Confidence Interval 0.53–0.76) at ≥80 Gy. On subset analysis, neoadjuvant ADT significantly improved OS in high risk patients but was not significant in lower risk patients. The dose response was maintained across all risk groups. Medical comorbidities were balanced across all dose strata and sensitivity analysis demonstrated that other prognostic factors were unlikely to explain the observed dose response.

Conclusions

This study suggests that increasing dose significantly improves OS in prostate cancer patients treated with radiotherapy.

【 授权许可】

   
2015 Hall et al.; licensee BioMed Central.

【 图 表 】

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