Format

Send to

Choose Destination
Int J Radiat Oncol Biol Phys. 2019 Nov 28. pii: S0360-3016(19)34066-0. doi: 10.1016/j.ijrobp.2019.11.027. [Epub ahead of print]

Second cancers in patients with locally advanced prostate cancer randomized to lifelong endocrine treatment with or without radical radiotherapy. Long term follow- up of the Scandinavian Prostate Cancer Group-7 trial.

Author information

1
Department of Oncology, Ålesund Hospital, Møre and Romsdal Hospital Trust, Norway; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology Trondheim, Norway. Electronic address: bjorg.y.aksnessether@helse-mr.no.
2
Department of Research and Innovation, Møre and Romsdal Hospital Trust, Norway; Department of Registration, Cancer Registry of Norway, Oslo, Norway.
3
Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology Trondheim, Norway; Cancer Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
4
Department of Oncology, Ålesund Hospital, Møre and Romsdal Hospital Trust, Norway.
5
Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.
6
Department of Radiology, Ålesund Hospital, Møre and Romsdal Hospital Trust, Ålesund, Norway; Department of circulation and medical imaging, Faculty of Medicine and Health Sciences, NTNU, Trondheim, Norway.
7
Department of Oncology, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
8
Department of Radiation Sciences, Oncology, Umeå University, Umeå, Sweden.
9
Department of Oncology, Ålesund Hospital, Møre and Romsdal Hospital Trust, Norway; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology Trondheim, Norway.

Abstract

BACKGROUND:

Curative radiotherapy (RT) constitute a cornerstone in prostate cancer (PC) treatment. We present long-term follow-up estimates for second cancer (SC) risk and overall survival (OS) in patients randomized to endocrine therapy (ET) alone or combined with 70Gy prostatic radiotherapy (RT) in the Scandinavian Prostate Cancer Group -7 study (SPCG-7). We explored the effect of salvage RT (≥60Gy to ET-group) and report causes of death.

METHODS:

The SPCG-7 study (1996-2002) was a randomized controlled trial that included 875 men with locally advanced non-metastatic PC. In this analysis including data from the Norwegian and Swedish Cancer- and Cause of Death registries for 651 Norwegian and 209 Swedish study patients, we estimated hazard ratios (HRs) for SC and death, and cumulative incidences of SC.

FINDINGS:

Median follow-up of the 860 (431 ET and 429) ET+RT patients was 12.2 years for SC risk analysis and 12.6 years for the OS analysis. Eighty-three of the Norwegian ET patients received salvage RT, median time to salvage RT was 5.9 years We found 125 and 168 SCs in the ET and ET+RT patients, respectively. With ET alone as reference, ET+RT patients had a HR of 1.19 (95%CI 0.92-1.54) for all SCs and 2.54 (95 % CI 1.14-5.69) for urinary bladder cancer (UBC). The total number of UBC was 31 (23 in ET+RT/ 8 in ET), and the vast majority (85 %) were superficial. The HR for SC in salvage RT patients was 0.48 (95% CI 0.24-0.94). Median OS was 12.8 (95 % CI 11.8-13.8) and 15.3 (95% CI 14.3-16.4) years in the ET and ET+RT groups, respectively. Compared to ET alone, the risk of death was reduced in ET+RT patients (HR 0.73, 95% CI 0.62-0.86), and in ET patients receiving salvage RT (HR 0.44, 95% CI 0.30-0.65).

Supplemental Content

Full text links

Icon for Elsevier Science Icon for Norwegian BIBSYS system
Loading ...
Support Center