Evidence map›Paper›PMID 35050303›Full record

Trial reportJAMA oncology2022

Interplay Between Duration of Androgen Deprivation Therapy and External Beam Radiotherapy With or Without a Brachytherapy Boost for Optimal Treatment of High-risk Prostate Cancer: A Patient-Level Data Analysis of 3 Cohorts.

Amar U Kishan, Alison Steigler, James W Denham, Almudena Zapatero, Araceli Guerrero, David Joseph, Xavier Maldonado, Jessica K Wong, Bradley J Stish, Robert T Dess and 49 more

Open access · hybridAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in JAMA oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 1 pooled it
5.9field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 1 synthesis or guideline pooled it, 41 citations in OpenAlex.

  1. Pooled it
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  4. Article
  5. Review
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  8. Article
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  12. Article
  13. Review
  14. The contemporary management of prostate cancer.CA: a cancer journal for clinicians
    Review
  15. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

59 authors at 20 institutions in 6 countries.

Amar U KishanDepartment of Radiation Oncology, University of California, Los Angeles.
Alison SteiglerSchool of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.
James W DenhamSchool of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.
Almudena ZapateroHospital Universitario de la Princesa, Madrid, Spain.
Araceli GuerreroHospital Son Espases, Palma de Mallorca, Spain.
David JosephSir Charles Gairdner Hospital, Perth, West Australia, Australia.
Xavier MaldonadoHospital Universitari Vall d'Hebron, Barcelona, Spain.
Jessica K WongDepartment of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania.
Bradley J StishDepartment of Radiation Oncology, Mayo Clinic, Rochester, Minnesota.
Robert T DessDepartment of Radiation Oncology, University of Michigan, Ann Arbor.
Avinash PilarRadiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
Chandana ReddyDepartment of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio.
Trude B WeddeOslo University Hospital, Oslo, Norway.
Wolfgang A LillebyOslo University Hospital, Oslo, Norway.
Ryan FianoSchiffler Cancer Center, Wheeling Hospital, Wheeling Jesuit University, Wheeling, West Virginia.
Gregory S MerrickSchiffler Cancer Center, Wheeling Hospital, Wheeling Jesuit University, Wheeling, West Virginia.
Richard G StockDepartment of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York.
D Jeffrey DemanesDepartment of Radiation Oncology, University of California, Los Angeles.
Brian J MoranChicago Prostate Cancer Center, Westmont, Illinois.
Phuoc T TranDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Santiago MartinDepartment of Radiation Oncology, Program in Solid Tumors, Clínica Universidad de Navarra, Pamplona, Spain.
Rafael Martinez-MongeDepartment of Radiation Oncology, Program in Solid Tumors, Clínica Universidad de Navarra, Pamplona, Spain.
Daniel J KraussWilliam Beaumont School of Medicine, Oakland University, Royal Oak, Michigan.
Eyad I Abu-IsaDepartment of Radiation Oncology, University of Michigan, Ann Arbor.
Thomas M PisanskyDepartment of Radiation Oncology, Mayo Clinic, Rochester, Minnesota.
C Richard ChooDepartment of Radiation Oncology, Mayo Clinic, Rochester, Minnesota.
Daniel Y SongDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Stephen GrecoDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Curtiland DevilleDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Todd McNuttDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Theodore L DeWeeseDepartment of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Ashley E RossDepartment of Urology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
Jay P CiezkiDepartment of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio.
Derya TilkiDepartment of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
R Jeffrey KarnesDepartment of Urology, Mayo Clinic, Rochester, Minnesota.
Jeffrey J TosoianDepartment of Urology, The James Buchanan Brady Urological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Nicholas G NickolsDepartment of Radiation Oncology, University of California, Los Angeles.
Prashant BhatDavid Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California.
David ShabsovichDavid Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California.
Jesus E JuarezDavid Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California.
Tommy JiangDepartment of Radiation Oncology, University of California, Los Angeles.
T Martin MaDepartment of Radiation Oncology, University of California, Los Angeles.
Michael XiangDepartment of Radiation Oncology, University of California, Los Angeles.
Rebecca PhilipsonDepartment of Radiation Oncology, University of California, Los Angeles.
Albert ChangDepartment of Radiation Oncology, University of California, Los Angeles.
Patrick A KupelianDepartment of Radiation Oncology, University of California, Los Angeles.
Matthew B RettigDivision of Medical Oncology, Ronald Reagan UCLA Medical Center, University of California, Los Angeles.
Felix Y FengHelen Diller Family Comprehensive Cancer Center, University of California, San Francisco.
Alejandro BerlinRadiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
Jonathan D TwardDepartment of Radiotherapy Oncology, Huntsman Cancer Institute at the University of Utah, Salt Lake City.
Brian J DavisDepartment of Radiation Oncology, Mayo Clinic, Rochester, Minnesota.
Robert E ReiterDepartment of Urology, University of California, Los Angeles.
Michael L SteinbergDepartment of Radiation Oncology, University of California, Los Angeles.
David ElashoffDivision of General Internal Medicine and Health Services Research, University of California, Los Angeles.
Paul C BoutrosDepartment of Urology, University of California, Los Angeles.
Eric M HorwitzDepartment of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania.
Rahul D TendulkarDepartment of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio.
Daniel E SprattSeidman Cancer Center, Case Western Reserve University, Cleveland, Ohio.
Tahmineh RomeroDivision of General Internal Medicine and Health Services Research, University of California, Los Angeles.
University of California, Los Angeles · USMayo Clinic · USJohns Hopkins Medicine · USCleveland Clinic · USJohns Hopkins University · USClinica Universidad de Navarra · ESFox Chase Cancer Center · USOslo University Hospital · NOPrincess Margaret Cancer Centre · CAUniversity of Michigan–Ann Arbor · USUniversity of Newcastle Australia · AUWest Los Angeles College · USWheeling Jesuit University · USCase Western Reserve University · USHospital Universitario de La Princesa · ESHospital Universitario Son Espases · ESHuntsman Cancer Institute · USIcahn School of Medicine at Mount Sinai · USNorthwestern University · USOakland University · US

Funding

Women's CancersP30CA016042 · NCI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI Samuel Wheeler French · 1985 to 2026
$134.5M
UCLA SPORE IN PROSTATE CANCERP50CA092131 · NCI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI REITER, ROBERT E · 2002 to 2023
$42.6M
NCI NIH HHS P30 CA016042NCI NIH HHS P50 CA092131
6 · The paper itself

Abstract

importanceRadiotherapy combined with androgen deprivation therapy (ADT) is a standard of care for high-risk prostate cancer. However, the interplay between radiotherapy dose and the required minimum duration of ADT is uncertain.

objectiveTo determine the specific ADT duration threshold that provides a distant metastasis-free survival (DMFS) benefit in patients with high-risk prostate cancer receiving external beam radiotherapy (EBRT) or EBRT with a brachytherapy boost (EBRT+BT). DESIGN, SETTINGS, AND

participantsThis was a cohort study of 3 cohorts assembled from a multicenter retrospective study (2000-2013); a post hoc analysis of the Randomized Androgen Deprivation and Radiotherapy 03/04 (RADAR; 2003-2007) randomized clinical trial (RCT); and a cross-trial comparison of the RADAR vs the Deprivación Androgénica y Radio Terapía (Androgen Deprivation and Radiation Therapy; DART) 01/05 RCT (2005-2010). In all, the study analyzed 1827 patients treated with EBRT and 1108 patients treated with EBRT+BT from the retrospective cohort; 181 treated with EBRT and 203 with EBRT+BT from RADAR; and 91 patients treated with EBRT from DART. The study was conducted from October 15, 2020, to July 1, 2021, and the data analyses, from January 5 to June 15, 2021. EXPOSURES: High-dose EBRT or EBRT+BT for an ADT duration determined by patient-physician choice (retrospective) or by randomization (RCTs). MAIN OUTCOMES AND MEASURES: The primary outcome was DMFS; secondary outcome was overall survival (OS). Natural cubic spline analysis identified minimum thresholds (months).

resultsThis cohort study of 3 studies totaling 3410 men (mean age [SD], 68 [62-74] years; race and ethnicity not collected) with high-risk prostate cancer found a significant interaction between the treatment type (EBRT vs EBRT+BT) and ADT duration (binned to <6, 6 to <18, and ≥18 months). Natural cubic spline analysis identified minimum duration thresholds of 26.3 months (95% CI, 25.4-36.0 months) for EBRT and 12 months (95% CI, 4.9-36.0 months) for EBRT+BT for optimal effect on DMFS. In RADAR, the prolongation of ADT for patients receiving only EBRT was not associated with significant improvements in DMFS (hazard ratio [HR], 1.01; 95% CI, 0.65-1.57); however, for patients receiving EBRT+BT, a longer duration was associated with improved DMFS (DMFS HR, 0.56; 95% CI, 0.36-0.87; P = .01). For patients receiving EBRT alone (DART), 28 months of ADT was associated with improved DMFS compared with 18 months (RADAR HR, 0.37; 95% CI, 0.17-0.80; P = .01). CONCLUSIONS AND RELEVANCE: These cohort study findings suggest that the optimal minimum ADT duration for treatment with high-dose EBRT alone is more than 18 months; and for EBRT+BT, it is 18 months or possibly less. Additional studies are needed to determine more precise minimum durations.

Indexed as

BrachytherapyProstatic NeoplasmsAndrogen AntagonistsAndrogensData AnalysisHumansMaleMiddle AgedRetrospective StudiesAndrogen AntagonistsAndrogens

Identifiers

PMID35050303
PMCPMC8778608
OpenAlexW4205452388

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.