Radiation dose escalation or longer androgen suppression for locally advanced prostate cancer? Data from the TROG 03.04 RADAR trial

J.W. Denham, A. Steigler, David Joseph, D.S. Lamb, Nigel Spry, G. Duchesne, C. Atkinson, J. Matthews, S. Turner, L. Kenny, K.H. Tai, N.K. Gogna, S. Gill, H. Tan, R. Kearvell, J. Murray, M. Ebert, A. Haworth, A. Kennedy, B. DelahuntC. Oldmeadow, E.G. Holliday, J. Attia

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    Abstract

    Copyright © 2015 Elsevier Ireland Ltd. All rights reserved. BACKGROUND: The relative effects of radiation dose escalation (RDE) and androgen suppression (AS) duration on local prostatic progression (LP) remain unclear. METHODS: We addressed this in the TROG 03.04 RADAR trial by incorporating a RDE programme by stratification at randomisation. Men were allocated 6 or 18 months AS±18 months zoledronate (Z). The main endpoint was a composite of clinically diagnosed LP or PSA progression with a PSA doubling time ⩾6 months. Fine and Gray competing risk modelling with adjustment for site clustering produced cumulative incidence estimates at 6.5 years for each RDE group. RESULTS: Composite LP declined coherently in the 66, 70 and 74 Gy external beam dosing groups and was lowest in the high dose rate brachytherapy boost (HDRB) group. At 6.5 years, adjusted cumulative incidences were 22%, 15%, 13% and 7% respectively. Compared to 6 months AS, 18 months AS also significantly reduced LP (p
    Original languageEnglish
    Pages (from-to)301-307
    JournalRadiotherapy & Oncology
    Volume115
    Issue number3
    DOIs
    Publication statusPublished - 2015

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