Is there a detrimental effect of waiting for radiotherapy for patients with localized prostate cancer?
OBJECTIVE
To evaluate a possible deleterious effect of waiting time to radiotherapy on the biochemical relapse (BR) of patients with localized prostate cancer.


METHODS
Patients included in this retrospective study had localized prostate adenocarcinoma treated with external-beam irradiation alone. Waiting time was defined as the interval between the first consultation and the first radiation treatment. BR was defined as 3 consecutive rises of prostatic specific antigen (PSA). Patients were split into 3 groups of waiting time: group A were treated within 40 days; group B waited 41 to 80 days; group C waited >80 days to receive radiotherapy. The effect of waiting on BR was estimated by the Kaplan-Meier method. Multivariate Cox proportional hazards modeling was adjusted for known prognostic factors.


RESULTS
There were 289 patients who participated in the analysis. Median follow-up time was 6.1 year. Overall BR rate was 44% at 5 years. The median waiting time increased over the study period from 26 days in 1992 to 123 days in 2000. In adjusted multivariate analysis there was a nonsignificant higher risk of BR with waiting for 41 to 80 days (hazard ratio [HR] = 0.8; 95% confidence interval [CI] = 0.3-1.6) and for >80 days (HR = 0.6; 95% CI = 0.2-1.5) when compared with patients treated within 40 days after consultation.


CONCLUSIONS
Delaying the start of radiotherapy showed little effect on the rate of BR in the group of 288 prostate cancer patients analyzed in this study.
Faria
Sergio L
SL
Department of Oncology, Division of Radiation Oncology, McGill University Montreal, QC, Canada. sergio.faria@muhc.mcgill.ca
Mahmud
Salaheddin
S
Wakil
Georges
G
Negrete
Sebastian
S
Souhami
Luis
L
David
Marc
M
Duclos
Marie
M
Shenouda
George
G
Freeman
Carolyn R
CR
D000230:Adenocarcinoma / Q000097:blood / Q000532:radiotherapy; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D016016:Proportional Hazards Models; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000532:radiotherapy*; D011882:Radiotherapy, High-Energy; D012189:Retrospective Studies; D016019:Survival Analysis; D013997:Time Factors
D017430:Prostate-Specific Antigen