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Cytoreductive radiotherapy combined with abiraterone in metastatic castration-resistance prostate cancer: a single center experience
Liru He
Sun Yat-sen University Cancer Center
Corresponding Author
ORCiD: https://orcid.org/0000-0002-7192-0205
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at Radiation Oncology.
Background: To investigate the potential benefit of cytoreductive radiotherapy (cRT) in metastatic castration-resistant prostate cancer (mCRPC) patients receiving abiraterone.
Methods: From February 2014 to February 2019, 149 mCRPC patients treated with abiraterone were identified. Patients receiving cRT before abiraterone failure (AbiRT group) were matched by one-to-two propensity score to patients without cRT before abiraterone failure (non-AbiRT group).
Results: The median follow-up was 23.5 months. Thirty patients (20.1%) were in the AbiRT group, whereas 119 patients (79.9%) were in the non-AbiRT group. The 2-year OS of patients managed by AbiRT and non-AbiRT were 89.5% and 73.5%, respectively (P = 0.0003). On multivariate analysis, only AbiRT (HR, 0.17; 95%CI, 0.05–0.58; P = 0.004) and prognostic index (HR, 2.71; 95% CI, 1.37–5.35; P = 0.004) were significant factors. After matching, AbiRT continued to be associated with improved OS (median OS not reached vs. 44.0 months, P = 0.009). Subgroup analysis revealed that patients aged ≤65 years (HR, 0.09; 95%CI, 0.01–0.65; P = 0.018), PSA ≤20 ng/mL (HR, 0.29; 95% CI, 0.09–0.99; P = 0.048), chemotherapy-naïve upon abiraterone treatment (HR, 0.20; 95% CI, 0.06–0.66; P = 0.008) and in intermediate prognosis groups by COU-AA-301 prognostic index (HR, 0.13; 95% CI, 0.03-0.57; P = 0.007) had improved OS with AbiRT.
Conclusions: cRT before resistance to abiraterone may improve survival in selected mCRPC patients: age ≤65 years old, chemotherapy-naïve, with a relatively low PSA level at the diagnosis of mCRPC and intermediate prognosis.
Keywords
metastatic castration-resistant prostate cancer, cytoreduction, radiotherapy, abiraterone
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CURRENT STATUS: Published
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Posted 15 Dec, 2020
Published
On 06 Jan, 2021
No community comments so far
Editorial decision: Accept
On 04 Dec, 2020
Editor assigned
On 01 Dec, 2020
Submission checks complete
On 01 Dec, 2020
Editor invited
On 01 Dec, 2020
No comments provided
Editor assigned
On 29 Oct, 2020
Submission checks complete
On 28 Oct, 2020
Editor invited
On 28 Oct, 2020
No comments provided
Editorial decision: Major revision
On 07 Oct, 2020
Review #2 received
Received 30 Sep, 2020
Reviewer #2 agreed
On 22 Sep, 2020
Review #1 received
Received 30 Jul, 2020
Reviewer #1 agreed
On 16 Jul, 2020
Reviewers invited
Invitations sent on 13 Jul, 2020
Editor assigned
On 03 Jul, 2020
First submitted
On 02 Jul, 2020
Submission checks complete
On 02 Jul, 2020
Editor invited
On 02 Jul, 2020
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Subject Areas
Oncology
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This preprint is under consideration at Radiation Oncology. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research
Cytoreductive radiotherapy combined with abiraterone in metastatic castration-resistance prostate cancer: a single center experience
Liru He
Sun Yat-sen University Cancer Center
Corresponding Author
ORCiD: https://orcid.org/0000-0002-7192-0205
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
Version 3
Posted 15 Dec, 2020
Published
On 06 Jan, 2021
No community comments so far
Editorial decision: Accept
On 04 Dec, 2020
Editor assigned
On 01 Dec, 2020
Submission checks complete
On 01 Dec, 2020
Editor invited
On 01 Dec, 2020
No comments provided
Editor assigned
On 29 Oct, 2020
Submission checks complete
On 28 Oct, 2020
Editor invited
On 28 Oct, 2020
No comments provided
Editorial decision: Major revision
On 07 Oct, 2020
Review #2 received
Received 30 Sep, 2020
Reviewer #2 agreed
On 22 Sep, 2020
Review #1 received
Received 30 Jul, 2020
Reviewer #1 agreed
On 16 Jul, 2020
Reviewers invited
Invitations sent on 13 Jul, 2020
Editor assigned
On 03 Jul, 2020
First submitted
On 02 Jul, 2020
Submission checks complete
On 02 Jul, 2020
Editor invited
On 02 Jul, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Oncology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published version at Radiation Oncology.
Background: To investigate the potential benefit of cytoreductive radiotherapy (cRT) in metastatic castration-resistant prostate cancer (mCRPC) patients receiving abiraterone.
Methods: From February 2014 to February 2019, 149 mCRPC patients treated with abiraterone were identified. Patients receiving cRT before abiraterone failure (AbiRT group) were matched by one-to-two propensity score to patients without cRT before abiraterone failure (non-AbiRT group).
Results: The median follow-up was 23.5 months. Thirty patients (20.1%) were in the AbiRT group, whereas 119 patients (79.9%) were in the non-AbiRT group. The 2-year OS of patients managed by AbiRT and non-AbiRT were 89.5% and 73.5%, respectively (P = 0.0003). On multivariate analysis, only AbiRT (HR, 0.17; 95%CI, 0.05–0.58; P = 0.004) and prognostic index (HR, 2.71; 95% CI, 1.37–5.35; P = 0.004) were significant factors. After matching, AbiRT continued to be associated with improved OS (median OS not reached vs. 44.0 months, P = 0.009). Subgroup analysis revealed that patients aged ≤65 years (HR, 0.09; 95%CI, 0.01–0.65; P = 0.018), PSA ≤20 ng/mL (HR, 0.29; 95% CI, 0.09–0.99; P = 0.048), chemotherapy-naïve upon abiraterone treatment (HR, 0.20; 95% CI, 0.06–0.66; P = 0.008) and in intermediate prognosis groups by COU-AA-301 prognostic index (HR, 0.13; 95% CI, 0.03-0.57; P = 0.007) had improved OS with AbiRT.
Conclusions: cRT before resistance to abiraterone may improve survival in selected mCRPC patients: age ≤65 years old, chemotherapy-naïve, with a relatively low PSA level at the diagnosis of mCRPC and intermediate prognosis.
Figure 1
Figure 2
Figure 3
Figure 4