Affiliation:
1. Department of Radiation Oncology University of Michigan Ann Arbor Michigan USA
2. Department of Radiation Oncology Veterans Affairs Ann Arbor Healthcare System Ann Arbor Michigan USA
3. Sir Peter MacCallum Department of Oncology University of Melbourne Melbourne Australia
4. Department of Urology University of Michigan Ann Arbor Michigan USA
5. HSR&D Center for Clinical Management Research Veterans Affairs Ann Arbor Healthcare System Ann Arbor Michigan USA
6. Department of Internal Medicine University of Michigan Ann Arbor Michigan USA
7. Department of Radiation Oncology Baylor University Houston Texas USA
8. Department of Biostatistics University of Michigan Ann Arbor Michigan USA
9. Section of Urology Department of Surgery University of Chicago Chicago Illinois USA
Abstract
AbstractPurposeAccurate information regarding real‐world outcomes after contemporary radiation therapy for localized prostate cancer is important for shared decision‐making. Clinically relevant end points at 10 years among men treated within a national health care delivery system were examined.MethodsNational administrative, cancer registry, and electronic health record data were used for patients undergoing definitive radiation therapy with or without concurrent androgen deprivation therapy within the Veterans Health Administration from 2005 to 2015. National Death Index data were used through 2019 for overall and prostate cancer–specific survival and identified date of incident metastatic prostate cancer using a validated natural language processing algorithm. Metastasis‐free, prostate cancer–specific, and overall survival using Kaplan–Meier methods were estimated.ResultsAmong 41,735 men treated with definitive radiation therapy, the median age at diagnosis was 65 years and median follow‐up was 8.7 years. Most had intermediate (42%) and high‐risk (33%) disease, with 40% receiving androgen deprivation therapy as part of initial therapy. Unadjusted 10‐year metastasis‐free survival was 96%, 92%, and 80% for low‐, intermediate‐, and high‐risk disease. Similarly, unadjusted 10‐year prostate cancer–specific survival was 98%, 97%, and 90% for low‐, intermediate‐, and high‐risk disease. The unadjusted overall survival was lower across increasing disease risk categories at 77%, 71%, and 62% for low‐, intermediate‐, and high‐risk disease (p < .001).ConclusionsThese data provide population‐based 10‐year benchmarks for clinically relevant end points, including metastasis‐free survival, among patients with localized prostate cancer undergoing radiation therapy using contemporary techniques. The survival rates for high‐risk disease in particular suggest that outcomes have recently improved.
Funder
National Cancer Institute
Cited by
1 articles.
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