{"id":612366,"date":"2026-09-02T15:26:09","date_gmt":"2026-09-02T15:26:09","guid":{"rendered":"https:\/\/www.newsbeep.com\/ie\/612366\/"},"modified":"2026-09-02T15:26:09","modified_gmt":"2026-09-02T15:26:09","slug":"high-risk-prostate-cancer-getug-afu-18-suggests-a-role-for-dose-escalated-radiotherapy-with-long-term-adt","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/ie\/612366\/","title":{"rendered":"High-Risk Prostate Cancer GETUG-AFU 18 Suggests a Role for Dose-Escalated Radiotherapy With Long-Term ADT"},"content":{"rendered":"

\t \tIn patients with high-risk prostate cancer receiving long-term androgen-deprivation therapy (ADT), pelvic and prostate external-beam radiation therapy (EBRT) at 80\u00a0Gy\u00a0improved progression-free survival compared with conventional 70-Gy radiotherapy, according to findings from the\u00a0multicenter\u00a0phase III\u00a0GETUG-AFU\u00a018 study published in\u00a0The Lancet Oncology<\/a>.\u00a0However,\u00a0Hennequin\u00a0et al\u00a0noted that these data should be interpreted with caution because of the low number of events observed.<\/p>\n

Radiotherapy at a total dose of 80\u00a0Gy\u00a0\u201ccould be a potential option in this situation,\u201d the investigators wrote, but \u201cfurther research is needed to consolidate and confirm the benefit [of] dose-escalation in prostate cancer\u2013specific survival and overall survival.\u201d<\/p>\n

Study Details<\/p>\n

The study enrolled 505 men with high-risk prostate cancer treated at 25 centers in France. High-risk disease was defined as a prostate-specific antigen (PSA) level of 20\u00a0ng\/mL or higher, a Gleason score of at least 8, or clinical stage T3 to T4. Patients were randomly assigned 1:1 by\u00a0minimization and stratified by center and previous pelvic lymph node dissection\u00a0to dose-escalated\u00a0EBRT\u00a0(80\u00a0Gy\u00a0in 2-Gy fractions over 8 weeks) or standard-dose\u00a0EBRT\u00a0(70\u00a0Gy\u00a0in 2-Gy fractions over 7 weeks), both combined with long-term ADT.<\/p>\n

The primary endpoint was 5-year progression-free survival, defined as the time from randomization to the first evidence of biochemical disease progression\u2014defined as PSA progression of 2\u00a0ng\/mL above the nadir\u2014or clinical progression, including local, regional, or metastatic disease. The analysis was conducted in the intention-to-treat population and required 197 events. Because 92 progression events had occurred by 5 years, the investigators also reported 10-year progression-free survival as a post-hoc analysis.<\/p>\n

Key Findings<\/p>\n

At a median follow-up of 9.5 years, the 5-year progression-free survival rate was 91.4% (95% confidence interval [CI] = 87.0%\u201394.4%) with dose-escalated radiotherapy vs 88.1% (95% CI = 83.2%\u201391.6%) with conventional-dose radiotherapy, and the 10-year rates were 83.6% (95% CI = 77.8%\u201388.0%) vs 72.2% (95% CI = 65.3%\u201378.0%), respectively (post hoc analysis; hazard ratio = 0.56, 95% CI = 0.40\u20130.78;\u00a0P\u00a0< .0001).<\/p>\n

Grade 3 or higher adverse events at 6 months, reflecting acute toxicity, occurred in 60 (24%) patients in the dose-escalation group and 62 (25%) in the conventional-dose group. Sexual disorders (28 [11%] in the dose-escalation group vs 20 [8%] in the conventional-dose group) and bladder or urethra disorders (12 [5%] vs 19 [8%]) were the most frequently reported adverse events of grade 3 or higher.<\/p>\n

At 5 years, late adverse events occurred in 118 (70%) of 168 patients treated with dose-escalated radiotherapy compared with 122 (73%) of 168 who received conventional-dose radiotherapy. Grade 3 or higher late toxicities were reported in 19 (8%) and 17 (7%) patients, respectively. The most common late grade 3 adverse\u00a0event\u00a0was bladder or urethral disorders, seen in seven (4%) patients in the dose-escalation group vs three (2%) in the conventional-dose group.<\/p>\n

Serious adverse events occurred in nine (4%) patients in each group, with none considered related to treatment. No treatment-related deaths were reported.<\/p>\n

\u201cA dose of 80\u00a0Gy\u00a0might be offered to patients with prostate cancer with a poor prognosis; however, additional research is needed to confirm this dose effect,\u201d the investigators concluded.<\/p>\n

Disclosure:\u00a0The study was funded by the French National Cancer Institute and AstraZeneca. For full disclosures of the study authors, visit\u00a0thelancet.com<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"In patients with high-risk prostate cancer receiving long-term androgen-deprivation therapy (ADT), pelvic and prostate external-beam radiation therapy (EBRT)…\n","protected":false},"author":2,"featured_media":612367,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10],"tags":[103,61,60],"class_list":["post-612366","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health","tag-health","tag-ie","tag-ireland"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/posts\/612366","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/comments?post=612366"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/posts\/612366\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/media\/612367"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/media?parent=612366"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/categories?post=612366"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/ie\/wp-json\/wp\/v2\/tags?post=612366"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}