Survival in Patients With Metastatic Prostate Cancer Undergoing Radiotherapy: The Importance of Prostate-Specific Antigen-Based Stratification

OBJECTIVES: To explore the effectiveness of radiotherapy in mPCa patients with different PSA stratifications based on the cancer database of a large population. BACKGROUND: Screening criteria for patients with metastatic prostate cancer, who are candidates for radiotherapy, are rarely reported. PATI...

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Autores principales: Tian, Zijian, Meng, Lingfeng, Wang, Xin, Wang, Xuan, Ma, Tianming, Wang, Miao, Zhong, Qiuzi, Zhang, Yaqun, Liu, Ming
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8224529/
https://www.ncbi.nlm.nih.gov/pubmed/34178701
http://dx.doi.org/10.3389/fonc.2021.706236
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author Tian, Zijian
Meng, Lingfeng
Wang, Xin
Wang, Xuan
Ma, Tianming
Wang, Miao
Zhong, Qiuzi
Zhang, Yaqun
Liu, Ming
author_facet Tian, Zijian
Meng, Lingfeng
Wang, Xin
Wang, Xuan
Ma, Tianming
Wang, Miao
Zhong, Qiuzi
Zhang, Yaqun
Liu, Ming
author_sort Tian, Zijian
collection PubMed
description OBJECTIVES: To explore the effectiveness of radiotherapy in mPCa patients with different PSA stratifications based on the cancer database of a large population. BACKGROUND: Screening criteria for patients with metastatic prostate cancer, who are candidates for radiotherapy, are rarely reported. PATIENTS AND METHODS: We identified 22,604 patients with metastatic prostate cancer in the Surveillance, Epidemiology, and End Results database and divided them into a radiotherapy group and a control group. Patients with metastatic prostate cancer were divided into subgroups according to their levels of prostate-specific antigen to evaluate the efficacy of radiotherapy. They were also divided into six subgroups according to their prostate-specific antigen levels. We used multivariate Cox analysis to evaluate overall survival and cancer-specific survival. After 1:1 propensity score matching, Kaplan-Meier analysis was used to explore the difference in overall survival and cancer-specific survival in the radiotherapy and control group. RESULTS: In all, 5,505 patients received radiotherapy, compared to 17,099 in the control group. In the multivariate Cox analysis, radiotherapy improved overall survival (hazard ratio [HR]: 0.730, 95% confidence interval [CI]: 0.636–0.838; P<0.001) and cancer-specific survival (HR: 0.764, 95% CI: 0.647–0.903; P=0.002) in patients with a PSA level of 4–10 ng/mL. Similar results were obtained by Kaplan-Meier analysis after 1:1 propensity score matching. In patients with prostate-specific antigen levels between 4–10 ng/mL, the overall survival (P<0.001) and cancer-specific survival (P<0.05) in the radiotherapy group was significantly better than those in the control group. CONCLUSION: The result of this large population-based study shows that rigorous selection of appropriate metastatic prostate cancer patients for radiotherapy can benefit prognosis significantly. This can be the basis for future prospective trials.
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spelling pubmed-82245292021-06-25 Survival in Patients With Metastatic Prostate Cancer Undergoing Radiotherapy: The Importance of Prostate-Specific Antigen-Based Stratification Tian, Zijian Meng, Lingfeng Wang, Xin Wang, Xuan Ma, Tianming Wang, Miao Zhong, Qiuzi Zhang, Yaqun Liu, Ming Front Oncol Oncology OBJECTIVES: To explore the effectiveness of radiotherapy in mPCa patients with different PSA stratifications based on the cancer database of a large population. BACKGROUND: Screening criteria for patients with metastatic prostate cancer, who are candidates for radiotherapy, are rarely reported. PATIENTS AND METHODS: We identified 22,604 patients with metastatic prostate cancer in the Surveillance, Epidemiology, and End Results database and divided them into a radiotherapy group and a control group. Patients with metastatic prostate cancer were divided into subgroups according to their levels of prostate-specific antigen to evaluate the efficacy of radiotherapy. They were also divided into six subgroups according to their prostate-specific antigen levels. We used multivariate Cox analysis to evaluate overall survival and cancer-specific survival. After 1:1 propensity score matching, Kaplan-Meier analysis was used to explore the difference in overall survival and cancer-specific survival in the radiotherapy and control group. RESULTS: In all, 5,505 patients received radiotherapy, compared to 17,099 in the control group. In the multivariate Cox analysis, radiotherapy improved overall survival (hazard ratio [HR]: 0.730, 95% confidence interval [CI]: 0.636–0.838; P<0.001) and cancer-specific survival (HR: 0.764, 95% CI: 0.647–0.903; P=0.002) in patients with a PSA level of 4–10 ng/mL. Similar results were obtained by Kaplan-Meier analysis after 1:1 propensity score matching. In patients with prostate-specific antigen levels between 4–10 ng/mL, the overall survival (P<0.001) and cancer-specific survival (P<0.05) in the radiotherapy group was significantly better than those in the control group. CONCLUSION: The result of this large population-based study shows that rigorous selection of appropriate metastatic prostate cancer patients for radiotherapy can benefit prognosis significantly. This can be the basis for future prospective trials. Frontiers Media S.A. 2021-06-10 /pmc/articles/PMC8224529/ /pubmed/34178701 http://dx.doi.org/10.3389/fonc.2021.706236 Text en Copyright © 2021 Tian, Meng, Wang, Wang, Ma, Wang, Zhong, Zhang and Liu https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Tian, Zijian
Meng, Lingfeng
Wang, Xin
Wang, Xuan
Ma, Tianming
Wang, Miao
Zhong, Qiuzi
Zhang, Yaqun
Liu, Ming
Survival in Patients With Metastatic Prostate Cancer Undergoing Radiotherapy: The Importance of Prostate-Specific Antigen-Based Stratification
title Survival in Patients With Metastatic Prostate Cancer Undergoing Radiotherapy: The Importance of Prostate-Specific Antigen-Based Stratification
title_full Survival in Patients With Metastatic Prostate Cancer Undergoing Radiotherapy: The Importance of Prostate-Specific Antigen-Based Stratification
title_fullStr Survival in Patients With Metastatic Prostate Cancer Undergoing Radiotherapy: The Importance of Prostate-Specific Antigen-Based Stratification
title_full_unstemmed Survival in Patients With Metastatic Prostate Cancer Undergoing Radiotherapy: The Importance of Prostate-Specific Antigen-Based Stratification
title_short Survival in Patients With Metastatic Prostate Cancer Undergoing Radiotherapy: The Importance of Prostate-Specific Antigen-Based Stratification
title_sort survival in patients with metastatic prostate cancer undergoing radiotherapy: the importance of prostate-specific antigen-based stratification
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8224529/
https://www.ncbi.nlm.nih.gov/pubmed/34178701
http://dx.doi.org/10.3389/fonc.2021.706236
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