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Effectiveness of Boost Modality in Overall Survival of Prostate Cancer Patients

S Datta1*, T Biswas2,3 , A Dey1 , T Podder2,3 , (1) University of Akron, Akron, OH, (2) University Hospitals Seidman Cancer Center, Cleveland, OH, (3) Case Western Reserve University, Cleveland, OH


(Wednesday, 7/17/2019) 10:30 AM - 11:00 AM

Room: Exhibit Hall | Forum 4

Purpose: IMRT is one of the common modalities for treating low-risk and intermediate-risk prostate cancer (CaP) patients. However, the utilization of IMRT technique and brachytherapy for boost treatment can vary due to a variety of reasons. In this study, efficacy of IMRT boost and BT boost has been evaluated in terms of overall survival (OS).

Methods: Analyzed NCDB for Stage T1-2c prostate cancer patients treated from 2004-2015. Patients were stratified according to NCCN guidelines: low-risk (T1–T2a, GS=6, PSA<10), intermediate-risk (T2b or T2c, GS= 7, or PSA:10-20). Considered two groups of patients: (1) IMRT Boost (IMRT-B) group (n=32,462), who received initial/primary and well as the boost treatment both IMRT, and (2) BT Boost (BT-B) group (n=11,857), who were treated with initial/primary with IMRT and boost with BT (either LDR or HDR). Considered total dose: 70-81Gy for IMRT-B and 45-55Gy for initial IMRT for BT-B group. OS was calculated from the date of diagnosis until the date of death or last follow up. Kaplan-Meier analysis was performed for determining OS. IBM SPSS software (version 24) was used for statistical analysis; p-value < 0.05 was considered statistically significant.

Results: Median age of the patients was 69 years (range: 37-90 years) and median follow-up was 71.9 months (range: 0-156.9 months). Mean OS for low-risk patients was 125.8 months and 133.9 months in IMRT-B and BT-B group, respectively. 10-year survival in BT-B group was 4.4% and 8.9% higher for low-risk and intermediate-risk patients, respectively, as compared to that of in IMRT-B group. All these differences in OS were statistically significant (p<0.05).

Conclusion: This study indicates that for low-risk and intermediate-risk prostate cancers, IMRT boost appeared to be preferable over brachytherapy boost (73.2% vs. 26.8%). However, overall survival in BT-boost group is better as compared to IMRT-boost group. Multivariable risk model analysis is underway.


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