Improved survival in patients with locally advanced prostate cancer treated with radiotherapy and goserelin

Details

Serval ID
serval:BIB_3AC13DEF88BA
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Improved survival in patients with locally advanced prostate cancer treated with radiotherapy and goserelin
Journal
New England Journal of Medicine
Author(s)
Bolla  M., Gonzalez  D., Warde  P., Dubois  J. B., Mirimanoff  R. O., Storme  G., Bernier  J., Kuten  A., Sternberg  C., Gil  T., Collette  L., Pierart  M.
ISSN
0028-4793 (Print)
Publication state
Published
Issued date
07/1997
Volume
337
Number
5
Pages
295-300
Notes
Clinical Trial
Journal Article
Randomized Controlled Trial --- Old month value: Jul 31
Abstract
BACKGROUND: We conducted a randomized, prospective trial comparing external irradiation with external irradiation plus goserelin (an agonist analogue of gonadotropin-releasing hormone that reduces testosterone secretion) in patients with locally advanced prostate cancer. METHODS: From 1987 to 1995, 415 patients with locally advanced prostate cancer were randomly assigned to receive radiotherapy alone or radiotherapy plus immediate treatment with goserelin. The patients had a median age of 71 years (range, 51 to 80). Patients in both groups received 50 Gy of radiation to the pelvis over a period of five weeks and an additional 20 Gy over an additional two weeks as a prostatic boost. Patients in the combined-treatment group received 3.6 mg of goserelin (Zoladex) subcutaneously every four weeks starting on the first day of irradiation and continuing for three years; those patients also received cyproterone acetate (150 mg orally per day) during the first month of treatment to inhibit the transient rise in testosterone associated with the administration of goserelin. RESULTS: Data were available for analysis on 401 patients. The median follow-up was 45 months. Kaplan-Meier estimates of overall survival at five years were 79 percent (95 percent confidence interval, 72 to 86 percent) in the combined-treatment group and 62 percent (95 percent confidence interval, 52 to 72 percent) in the radiotherapy group (P=0.001). The proportion of surviving patients who were free of disease at five years was 85 percent (95 percent confidence interval, 78 to 92 percent) in the combined-treatment group and 48 percent (95 percent confidence interval, 38 to 58 percent) in the radiotherapy group (P<0.001). CONCLUSIONS: Adjuvant treatment with goserelin, when started simultaneously with external irradiation, improves local control and survival in patients with locally advanced prostate cancer.
Keywords
Adenocarcinoma/*drug therapy/mortality/*radiotherapy Aged Androgen Antagonists/therapeutic use Antineoplastic Agents, Hormonal/adverse effects/*therapeutic use Chemotherapy, Adjuvant Cyproterone Acetate/therapeutic use Goserelin/adverse effects/*therapeutic use Humans Male Middle Aged Neoplasm Staging Prostatic Neoplasms/*drug therapy/mortality/*radiotherapy Survival Analysis Treatment Outcome
Pubmed
Web of science
Create date
24/01/2008 17:12
Last modification date
20/08/2019 13:30
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