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The impact of increasing dose on overall survival in prostate cancer
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...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4448310/ https://www.ncbi.nlm.nih.gov/pubmed/25990489 http://dx.doi.org/10.1186/s13014-015-0419-3 |
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author | Hall, Matthew D. Schultheiss, Timothy E. Smith, David D. Tseng, Bertrand P. Wong, Jeffrey Y. C. |
author_facet | Hall, Matthew D. Schultheiss, Timothy E. Smith, David D. Tseng, Bertrand P. Wong, Jeffrey Y. C. |
author_sort | Hall, Matthew D. |
collection | PubMed |
description | 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13014-015-0419-3) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-4448310 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-44483102015-05-30 The impact of increasing dose on overall survival in prostate cancer Hall, Matthew D. Schultheiss, Timothy E. Smith, David D. Tseng, Bertrand P. Wong, Jeffrey Y. C. Radiat Oncol Research 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. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s13014-015-0419-3) contains supplementary material, which is available to authorized users. BioMed Central 2015-05-21 /pmc/articles/PMC4448310/ /pubmed/25990489 http://dx.doi.org/10.1186/s13014-015-0419-3 Text en © Hall et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Hall, Matthew D. Schultheiss, Timothy E. Smith, David D. Tseng, Bertrand P. Wong, Jeffrey Y. C. The impact of increasing dose on overall survival in prostate cancer |
title | The impact of increasing dose on overall survival in prostate cancer |
title_full | The impact of increasing dose on overall survival in prostate cancer |
title_fullStr | The impact of increasing dose on overall survival in prostate cancer |
title_full_unstemmed | The impact of increasing dose on overall survival in prostate cancer |
title_short | The impact of increasing dose on overall survival in prostate cancer |
title_sort | impact of increasing dose on overall survival in prostate cancer |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4448310/ https://www.ncbi.nlm.nih.gov/pubmed/25990489 http://dx.doi.org/10.1186/s13014-015-0419-3 |
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