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Short-term androgen deprivation therapy and high-dose radiotherapy in intermediate- and high-risk localized prostate cancer : results from the GETUG 14 randomized phase III trial
Champ libre 1
Few studies compared short-term androgen deprivation (STADT) with high-dose radiotherapy (STADT-RT) versus high dose radiotherapy (RT) alone in localized prostate cancer.
Champ libre 2
The GETUG 14 study randomized 376 patients between RT (n=191) and STADT-RT (n=179). RT dose was 80 Gy in both arms and STADT was 4-month flutamide, starting 2 months before irradiation and 4-month triptorelin, starting with irradiation. Disease-free survival (DFS) was the primary endpoint. Secondary endpoints were overall survival (OS), biochemical failure-free survival (BFFS), metastasis-free survival (MFS), toxicity and quality of life.
Champ libre 3
With a median follow-up of 84 months, five-year DFS was 76% in RT arm versus 84% in STADT-RT arm (hazard radio (HR) = 0.64; (95% CI 0.43 - 0.89); p = 0.02). ADT had a positive impact on BFS (HR = 0.45; p = 0.001) and MFS (HR = 0.5; p = 0.09) but not on OS (HR = 1.22; p = 0.54). No difference was fond in terms of gastro intestinal (26% of grade >1 in both arm, p = 0.97) and genito-urinary toxicity (39% for RT and 42% for STADT-RT, p = 0.55). Siimilarly, no difference was found in quality of life.
Champ libre 4
STADT improves DFS in intermediate and high-risk prostate cancer patients receiving high dose (80 Gy) RT, without any deterioration in the safety profile.
Champ libre 5
Nicolas DEMOGEOT (1) , Paul SARGOS (2), Nassim SAHKI (3), Stéphane GUÉRIF (4), Renaud DE CREVOISIER (5), Gilles CALAIS (6), Jean-Michel HANNOUN LEVI (7), Grégoire BOUCHE (8), Christophe HENNEQUIN (9), Jacques CRETIN (10), Yazid BELKACEMI (11), Jonathan KHALIFA (12), David AZRIA (13), Alain GRANDGIRARD (14), Pascal POMMIER (15), Jean-Marc SIMON (16), Catherine LEGER (17), Véronique BECKENDORF (1), Bernard DUBRAY (18), Stéphane SUPIOT (19) - (1)Crlcc Institut De Cancérologie De Lorraine, France, (2)Crlcc Institut Begonie, France, (3)Crlcc Institut De Cancérologie, France, (4)Chu La Milétrie, France, (5)Crlcc Eugène Marquis, France, (6)Chu Bretonneau, France, (7)Crlcc Antoine Lacassagne, France, (8)Crlcc Jean Godinot, France, (9)Chu Saint-Louis, France, (10)Crlcc Institut De Cancérologie Du Gard, France, (11)Oncologie-Radiothérapie Ghu Henri Mondor. Université Paris Est Créteil (upec). Inserm – Imrb U 955 (i-Biot), France, (12)Institut Claudius Regaud / Universitaire Du Cancer De Toulouse-Oncopole, France, (13)Fédération Universitaire D’oncologie Radiothérapie D’occitanie Méditerranée, Institut Du Cancer Montpellier (icm), Univ Montpellier, Inserm U1194 Icm, France, (14)Hôpital Emile Muller, Ghrmsa, France, (15)Crlcc Léon Bérard / Crlcc Institut Curie, France, (16)Aphp.sorbonne Université Après Hôpitaux Universitaires Pitié Salpêtrière Charles Foix, France, (17)Unicancer, France, (18)Crlcc Institut Henri Becquerel, France, (19)Crlcc Institut De L'ouest, France
Auteurs
Nicolas DEMOGEOT (1) , Paul SARGOS (2), Nassim SAHKI (3), Stéphane GUÉRIF (4), Renaud DE CREVOISIER (5), Gilles CALAIS (6), Jean-Michel HANNOUN LEVI (7), Grégoire BOUCHE (8), Christophe HENNEQUIN (9), Jacques CRETIN (10), Yazid BELKACEMI (11), Jonathan KHALIFA (12), David AZRIA (13), Alain GRANDGIRARD (14), Pascal POMMIER (15), Jean-Marc SIMON (16), Catherine LEGER (17), Véronique BECKENDORF (1), Bernard DUBRAY (18), Stéphane SUPIOT (19) - (1)Crlcc Institut De Cancérologie De Lorraine, France, (2)Crlcc Institut Begonie, France, (3)Crlcc Institut De Cancérologie, France, (4)Chu La Milétrie, France, (5)Crlcc Eugène Marquis, France, (6)Chu Bretonneau, France, (7)Crlcc Antoine Lacassagne, France, (8)Crlcc Jean Godinot, France, (9)Chu Saint-Louis, France, (10)Crlcc Institut De Cancérologie Du Gard, France, (11)Oncologie-Radiothérapie Ghu Henri Mondor. Université Paris Est Créteil (upec). Inserm – Imrb U 955 (i-Biot), France, (12)Institut Claudius Regaud / Universitaire Du Cancer De Toulouse-Oncopole, France, (13)Fédération Universitaire D’oncologie Radiothérapie D’occitanie Méditerranée, Institut Du Cancer Montpellier (icm), Univ Montpellier, Inserm U1194 Icm, France, (14)Hôpital Emile Muller, Ghrmsa, France, (15)Crlcc Léon Bérard / Crlcc Institut Curie, France, (16)Aphp.sorbonne Université Après Hôpitaux Universitaires Pitié Salpêtrière Charles Foix, France, (17)Unicancer, France, (18)Crlcc Institut Henri Becquerel, France, (19)Crlcc Institut De L'ouest, France