Radical radiotherapy for prostate cancer: patterns of care in Sweden 1998–2016

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskrift

Abstract

Introduction: Radiotherapy is an established treatment option for prostate cancer (PCa), both as primary treatment and secondary treatment after radical prostatectomy (RP). Since 1998, detailed data on radiotherapy delivered to Swedish men with PCa (e.g. treatment modalities, absorbed doses, fractionation) have been collated within PCa data Base Sweden (PCBaSe). This study reports patterns of radical radiotherapy for PCa in Sweden over the past two decades. Materials and methods: All men with non-metastatic PCa (1998–2016) who received external beam radiotherapy (EBRT) or high or low dose-rate brachytherapy (HDR-BT/LDR-BT) were identified in PCBaSe. Analyses included: trends in radiation techniques, fractionation patterns and total doses over time; PCa-specific survival comparing treatment in 2007–2017 with 1998–2006; and regional variation in type of primary radiotherapy. Results: About 20,876 men underwent primary radiotherapy. The main treatment modalities include conventionally fractionated (2.0 Gy/fraction) EBRT (51%), EBRT with HDR-BT boost (27%) and hypofractionated (>2.4 Gy/fraction) EBRT (11%). EBRT with photon or proton boost and HDR-BT and LDR-BT monotherapies were each used minimally. Use of dose-escalated EBRT (>74 Gy) and moderate hypofractionation increased over time, while use of HDR-BT declined. Considerable regional variation in treatment modalities was apparent. Risk of PCa death following primary radiotherapy had declined for intermediate-risk (HR: 0.60; 95%CI 0.47–0.87) and high-risk PCa (HR: 0.72; 95%CI 0.61-0.86). Discussion: Increased use of dose escalation and hypofractionated EBRT has occurred in Sweden over the past two decades, reflecting current evidence and practice guidelines. Disease-specific outcomes have also improved. Data collected in PCBaSe provide an excellent resource for further research into RT use in PCa management.

Detaljer

Författare
  • Kerri Beckmann
  • Hans Garmo
  • Per Nilsson
  • Ingela Franck Lissbrant
  • Anders Widmark
  • Pär Stattin
Enheter & grupper
Externa organisationer
  • King's College London
  • University of South Australia
  • Uppsala University Hospital
  • Skåne University Hospital
  • Sahlgrenska Academy
  • Umeå University
Forskningsområden

Ämnesklassifikation (UKÄ) – OBLIGATORISK

  • Urologi och njurmedicin
Originalspråkengelska
Sidor (från-till)549-557
Antal sidor9
TidskriftActa Oncologica
Volym59
Utgåva nummer5
StatusPublished - 2020 mar 5
PublikationskategoriForskning
Peer review utfördJa