Definitive radiotherapy for prostate cancer in Norway 2006–2015: Temporal trends, performance and survival. (February 2021)

• Record Type: Journal Article
• Authors: Fosså, Sophie D.; Aas, Kirsti; Müller, Christoph.; Jerm, Marianne B.; Tandstad, Torgrim; Lilleby, Wolfgang; Kvåle, Rune; Gulbrandsen, Johanne; Haug, Erik; Myklebust, Tor A.
• Is Part Of: Radiotherapy and oncology. Volume 155(2021)
• Page Start: 33
• Page End: 41
• Publication Date: 2021-02
• Subjects: Prostate cancer -- Curative radiotherapy -- Temporal trends -- National registry -- Survival; Oncology -- Periodicals; Radiotherapy -- Periodicals; Tumors -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiothérapie -- Périodiques; Cancérologie -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9940642
• DOI: 10.1016/j.radonc.2020.10.022
• Languages: English
• ISSNs: 0167-8140

Abstract

Highlights: Radiotherapy remains a curative treatment in prostate cancer. Increased 10-year survival after escalated radiotherapy. Regular monitoring of data from National radiotherapy registries need regulat data monitoring. Abstract: Background: More studies are needed to document nation-wide use and effectiveness of curative definitive radiotherapy (Def-RT) in the treatment of prostate cancer (PCa). Patients and methods: For 38, 960 men diagnosed with PCa without distant metastases from 2006 to 2015 data from the Norwegian Prostate Cancer Registry and a national radiotherapy database (NoRadBase) was analyzed. Overall survival and PCa-specific mortality were described comparing EQD-2 < 74 Gy ("low-dose") with EQD-2 ≥ 74 Gy ("escalated dose"). Results: Use of Def-RT decreased (27–24%) whereas the proportion of radical prostatectomies (RPs) increased (31–38%). In high-risk patients the use of RP doubled (18–36%), while the proportion of Def-RT remained stable (about 35%). Before 2010, almost a quarter of patients received low-dose Def-RT with gradual increase of escalated Def-RT thereafter. Escalated Def-RT was associated with significantly more favorable 10-year PCa-specific mortality (4.4% [95% CI: 2.7–10.7%]) than observed after low-dose Def- RT (8.8% [95% CI: 6.2–9.8%), with the most beneficial effects in high-risk patients. Our analyses indicated the need to expand the NoRadBase by consensus-based quality measures. Conclusion: In this nationwide cohort, the overall use of Def-RT decreased slightly. In high-risk patients the provision of Def-RT remained stable and was accompanied by doubling of patients with RP and reduction of a "no curative treatment" strategy. Escalated dose Def-RT significantly reduced 10-year PCa-specific mortality compared to low-dose Def-RT. Aiming for cancer care equity national radiotherapy registries for PCa should regularly monitor data based on consensus-based quality measures enabling feedback to the responsible hospitals.