Might this now be possible with the POSEIDON dataset @AmarUKishan?
Calculator showing 10yr MFS with RT (+/- HT) based on pre RT PSA & path features would be v useful, pending widely avail biomarker #radonc#pcsm
Would be really helpful to be able to generate individualised estimates of MFS/PCSS/OS for salvage RT alone (beyond the subgroup data from Supp Table 4). Any plans for a nomogram/calculator, or suggestions re how to go about this? #radonc#pcsm
@DrSpratticus Is Figure 4 potentially mislabelled? Top 2 panels being RT +/- HT, middle 2 RT +/- ST HT and bottom 2 RT +/- LT HT?
Another query? Fig 2F shows MFS HR 0.79 (95%CI 0.7-0.89), but then upper bound CI crosses HR 1 for all PSA levels (Fig 4B)? 🙏🙂
@NiuSanford I would have thought the correct statistical interpr here is that there is no clear diff in trtmt effect based on T or N stage ➡️ p value for interaction >>0.05, wide CIs including HR of overall effect.
@alison_tree Similar concerns been expressed for mod hypofrac in past - do we know re any differential effect of IPSS on GU tox from SBRT vs mod hypofrac? #radonc#pcsm@weeloonong
@DrAndrewLoblaw@piet_ost@chrisparker@RTendulkarMD Another approach: Aim ≥5%⬆️MFS @ 10yr with ADT. Trials suggest need pt with MFS≤70-75% (without ADT) to observe this benefit.
FFDM is ~10% > 10yr MFS (e.g per RADICALS-HD) ➡️ if Tendulkar nomogram 10yr DM >15-20% recommend ADT (depending on comorbs/pt prefs) 💡🤓🤔
Would be really helpful to be able to generate individualised estimates of MFS/PCSS/OS for salvage RT alone (beyond the subgroup data from Supp Table 4). Any plans for a nomogram/calculator, or suggestions re how to go about this? #radonc#pcsm
Duration of Androgen Suppression with Postoperative Radiotherapy (DADSPORT) for Nonmetastatic Prostate Cancer: A Collaborative Systematic Review and Meta-analysis of Aggregate Data
https://t.co/WWqOHsaC0P
This systematic review and meta-analysis by the DADSPORT Collaboration evaluated the impact of hormone therapy (HT) added to postoperative radiotherapy (RT) in nonmetastatic #ProstateCancer across five randomized controlled trials involving 4,411 participants. While HT did not significantly improve overall survival (OS) in the general population, it did show meaningful benefits in metastasis-free survival (MFS) and prostate cancer–specific survival (PCSS), each with a 4% absolute improvement at 8 years.
Notably, OS benefits may be limited to patients with higher pre-RT PSA levels or CAPRA-S scores.
These findings support the use of adjuvant HT to improve cancer outcomes, particularly in higher-risk patients.
@DrSpratticus@AmarUKishan@drjefstathiou@PCaParker@_APollack@PaulSargos@felixfengmd@OncoAlert@Silke_Gillessen@AOmlin@nataliagandur@bavilima
@DrewCareyMD@HopkinsMedicine Biological effect relates to both total dose & dose per fraction, cannot exceed CNII tolerance as such based purely on use of 3Gy/#. Also important to distinguish BED and EQD2 (see below). 30Gy/10# is equivalent to <40Gy at 2Gy/# (RION should be exceedingly rare at this dose).
@HKennecke@JCO_ASCO@OncoAlert Agree with overall message, but worth noting that ~half of the n=530 treated with upfront surgery were either clinical stage I or >12cm from verge 👇
OCUM trial n=~1100 but majority not informative re RT omission. Key group n=257, stage II/III <12cm from verge treated with upfront surg (MRF>1mm, no T4 or low T3, vast majority N≤1 & 6-12cm from verge) ➡️ 5yr LR 3.8%. No info re T3 substage/EMVI https://t.co/cR7FXB8PEI #radonc
OCUM trial n=~1100 but majority not informative re RT omission. Key group n=257, stage II/III <12cm from verge treated with upfront surg (MRF>1mm, no T4 or low T3, vast majority N≤1 & 6-12cm from verge) ➡️ 5yr LR 3.8%. No info re T3 substage/EMVI https://t.co/cR7FXB8PEI #radonc