Bibliographic Details
| Title: |
Outcomes after definitive radiation therapy for localized prostate cancer in a national health care delivery system. |
| Authors: |
Herr, Daniel J., Elliott, David A., Duchesne, Gillian, Stensland, Kristian D., Caram, Megan E. V., Chapman, Christina, Burns, Jennifer A., Hollenbeck, Brent K., Sparks, Jordan B., Shin, Chris, Zaslavsky, Alexander, Tsodikov, Alexander, Skolarus, Ted A. |
| Source: |
Cancer (0008543X); Oct2023, Vol. 129 Issue 20, p3326-3333, 8p |
| Subject Terms: |
MEDICAL care, NATIONAL health services, PROSTATE cancer, RADIOTHERAPY, NATURAL language processing, ANDROGEN deprivation therapy |
| Company/Entity: |
UNITED States. Veterans Health Administration |
| Abstract: |
Purpose: Accurate 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. Methods: National 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. Results: Among 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). Conclusions: These 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. This retrospective, population‐based study of 41,735 men undergoing definitive radiation therapy for localized prostate cancer in a national health care delivery system examined survival outcomes with contemporary treatment. In this cohort, survival outcomes, including metastasis‐free survival as determined by a novel natural language processing algorithm, are improved compared with historical studies and are comparable to those reported on contemporary clinical trials. [ABSTRACT FROM AUTHOR] |
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| Database: |
Complementary Index |
