Friday, February 13, 2009

EORTC & German trial of Postop RT for Prostate Cancer

In response to a question - here are the two other trials of post op RT for Prostate Cancer referred to in the last post

96-02 (German):
Wiegel ASCO 2005 (abstract only)
385 s/p RP, pT3N0, undetectable PSA
60 Gy post op RT to prostate bed
If PSA detectable, 66Gy postop RT (20%of patients entered)
32 in RT arm did not receive RT (21% of arm)
39 mo follow up
Per protocol: bRFS (4) 81% with RT, 60% NFT (p<0.001)
Intention to treat: bRFS (4) ~75% with RT, 60% NFT (SS)
Grade II rectal toxicity 3%

1,005 Patients underwent RP, node negative with + margins, + ECE, or SVI.
Randomized to
50Gy + 10Gy boost to bed
Close observation (NFT)
Mean f/u 5 years
•90% had PSA <0.2
bPFS (5) 74% RT vs 53% NFT (p<0.001)
Clinical Failure (5) 8.8% RT vs 19.0% NFT (p=0.009)
No difference in OS or Distant Failures
Grade 1-2 toxicity 45%NFT vs 60%RT (SS)
Grade 3 toxicity ~4% for both (NS)

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