Type of Proposal
Oral presentation
Faculty
Schulich School of Medicine Windsor
Faculty Sponsor
SROP- Schulich School of Medicine and Dentistry
Start Date
24-3-2015 10:00 AM
End Date
24-3-2015 10:50 AM
Importance of the Project
Through my research, it is hoped to establish a new standard of care at Windsor Regional Hospital for high risk localized prostate cancer. We have shown a benefit to treating this disease with high dose rate brachytherapy in addition to external beam radiation treatment as opposed to the current standard of care which is external beam radiation treatment only.
Existing State of Knowledge
There has been one prior randomized control trial published recently that compared the two types of radiation therapy being studied in our study. This groups research demonstrated an increase relapse-free survival in patients treated with HDR-brachytherapy in conjunction with EBRT compared with those treated with EBRT alone. We planned to demonstrate these same findings in our patient population.
Research Question
We aimed to demonstrate there is a significant increase in relapse-free survival in high risk localized prostate cancer patients treated with HDR-brachytherapy in conjunction with EBRT compared with EBRT alone.
Methodology
A retrospective chart review was completed on a sample of 324 patients who were treated at a regional cancer centre in southwestern Ontario between 2001 and 2014. These patients were classified as high-risk according to the American Urological Association and European Association of Urology of having clinical or pathological staging T2c/T3a or Gleason score of 8-10 or Prostate Specific Antigen (PSA) ≥ 20 ng/mL. Of the 324 patients, 53 received HDR-BT with EBRT and 271 received EBRT only. Relapse was defined using the Phoenix definition of PSA rise 2 ng/mL above the nadir. The primary and secondary endpoints of the study were relapse free survival (RFS) and overall survival (OS).
Your Findings
The mean age of the study sample was 78 years (SD ± 8.1) with a mean pre-treament PSA of 17.98 (SD ± 15.79). While relapse occurred in 43 of the 271 patients who received EBRT, only 3 of the 53 patients who received HDR relapsed. Kaplan Meier survival analysis suggested that by the end of the 5 year follow up, more than 50% of patients in each of the study groups were relapse free; and thus median survival was not calculable. The mean time to relapse between the EBRT and HDR groups was (53.7 and 58.5 months, respectively; Log rank = 3.82, p = 0.05).
A RETROSPECTIVE COMPARISON OF HIGH DOSE RATE BRACHYTHERAPY AND EXTERNAL BEAM RADIOTHERAPY IN THE TREATMENT OF HIGH RISK CLINICALLY LOCALIZED PROSTATE CANCER AT THE WINDSOR REGIONAL HOSPITAL DURING 2001-2014.