Quality of Life Aspects of Treatment Options for Localized and Locally Advanced Prostate Cancer

2001 ◽  
Vol 40 (Suppl. 2) ◽  
pp. 24-30 ◽  
Author(s):  
J. Anderson
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Advanced Prostate Cancer ◽  
Treatment Options ◽  
Locally Advanced ◽  
Locally Advanced Prostate Cancer

Final analysis of intergroup randomized phase III study of androgen deprivation therapy (ADT) plus radiation therapy (RT) in locally advanced prostate cancer (CaP) (NCIC-CTG, SWOG, MRC-UK, INT: T94-0110).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 4509-4509 ◽  
Author(s):  
Malcolm David Mason ◽  
Wendy Parulekar ◽  
Matthew Robert Sydes ◽  
Mahesh Parmar ◽  
John Anderson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Overall Survival ◽  
Advanced Prostate Cancer ◽  
Locally Advanced ◽  
Final Analysis ◽  
Disease Specific Survival ◽  
Locally Advanced Prostate Cancer ◽  
Disease Specific

4509 Background: Data from the SPCG-7 study and interim analysis of this trial have demonstrated an overall survival (OS) benefit for RT when added to ADT. We present the protocol specified final analysis of PR3/PR07. Methods: Patients with locally advanced (T3/T4, N0/NX, n=1057) or organ-confined prostate cancer (T2,N0/NX, with either PSA > 40 μg/l or PSA > 20 μg/l and Gleason > 8, n=144) were randomized to lifelong ADT (bilateral orchiectomy or LHRH agonist) or ADT + RT (65-69 Gy to prostate + seminal vesicles with or without 45Gy to pelvic nodes). The primary outcome measure was OS; secondary outcomes included disease-specific survival (DSS), time to disease progression and quality of life. Final analysis was planned after 421 deaths. Results: 1,205 patients were randomized from 1995-2005, 602 to ADT alone and 603 to ADT+RT (well balanced with respect to baseline characteristics). The median follow-up is 8.0 years and 465 patients have died (260 ADT, 205 ADT+RT). Adding RT to ADT significantly reduced the risk of death (Hazard Ratio 0.70, 95% CI 0.57-0.85, p=0.001). 199 patients died of disease and/or treatment (134 on ADT alone and 65 on ADT+RT). Competing risk analysis demonstrated that patients on the ADT alone arm had a significantly higher chance of dying of disease related causes than those treated with ADT+RT (10 year cumulative disease specific death rates 15% with ADT+ RT, 26% with ADT alone, p<0.0001). The addition of RT to ADT had a small detrimental effect on late gastrointestinal toxicity and health-related quality-of-life (> grade II proctitis, 0.3% ADT alone, 1.0% ADT+RT; mean change EORTC Rectal symptoms -0.3 ADT vs 1.7 ADT + RT, p=0.54). Conclusions: Mature data indicate a sustained and substantial overall survival and disease specific survival benefit for ADT+RT in the management of patients with locally advanced prostate cancer with minimal increase in late treatment toxicity. The benefits of combined modality treatment should be discussed with all patients. Supported by NCI-US Grant CA077202, CCSRI Grants #14469 and # 015469, UK Medical Research Council Grant G9805643, UK National Cancer Research Network.

scholarly journals What is the correct staging and treatment strategy for locally advanced prostate cancer extending to the bladder?

2015 ◽  
Vol 87 (2) ◽  
pp. 130 ◽  
Author(s):  
Özgür Haki Yüksel ◽  
Ayhan Verit ◽  
Ahmet Ürkmez
Keyword(s):  
Quality Of Life ◽  
Prostate Cancer ◽  
Advanced Prostate Cancer ◽  
Prostate Gland ◽  
Locally Advanced ◽  
Local Therapy ◽  
Locally Advanced Prostate Cancer ◽  
Term Survival ◽  
Bladder Invasion

In locally advanced prostate cancer with bladder invasion, frequently encountered problems such as bleeding, urinary retention, hydronephrosis, and pain create distress for the patients. Therefore patients’ quality of life is disrupted and duration of hospitalization is prolonged. Relevant literature about accurate staging and treatment of locally advanced prostate cancer with bladder invasion was investigated. Locally advanced prostate cancer can present as a large-volume aggressive tumor extending beyond boundaries of prostate gland, and involving neighboring structures which can be involved as recurrence(s) following initial local therapy. Survival times of these patients can range between 5 and 8 years. Their common characteristics are adverse and severe local symptoms unfavorably affecting quality of life Control of local symptoms and their effective palliation are independent clinical targets influencing survival outcomes of these patients. The treatment outcomes of locally advanced prostate cancer into the bladder are currently debatable. Although in the current TNM classification, it is defined in T4a, we think that this may be categorized as a subgroup of T3 and thus encourage surgeons for the indication of radical surgeries (radical prostatectomy, radical cystoprostatectomy) in selected patient populations after discussing issues concerning consequences of the treatment alternatives, and expectations with the patients. Cystoprostatectomy followed by immediate androgen deprivation therapy may be a feasible option for selected patients with previously untreated prostate cancer involving the bladder neck because of excellent local control and long term survival.

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