title: Does family history of prostate cancer affect outcomes following radiotherapy?
abstract: OBJECTIVE
  To examine family history (FH) as a prognostic factor following radiotherapy (RT).
  
  
  METHODS
  Between 1989 and 2007, 1711 men with clinically localized prostate cancer and complete family history who had received RT (median RT dose=74Gy) without androgen deprivation therapy were analyzed. FH was defined as any prostate cancer in a first degree relative. For the biochemical failure (BF) outcome, this sample size has 85% power to detect a hazard ratio of 1.56 for positive versus negative FH.
  
  
  RESULTS
  With a median follow-up of 71 months, there was no significant difference in the distribution of Gleason score (GS) or prostate specific antigen (PSA) based on FH. A positive FH was not an independent predictor of BF, distant metastasis (DM), prostate cancer specific mortality (PCSM), or overall mortality (OM) in Cox proportional multivariable analysis. On further analysis in a Cox proportional multivariable analysis, men with two or more first degree relatives with prostate cancer had a significantly higher likelihood of BF and DM than those with no FH, although there was no difference in PCSM or OM. Men with a positive FH (23%) were more likely to be younger, have a lower PSA, and non-palpable disease. There was no interaction between a positive FH and neither race nor treatment era (pre-PSA vs. PSA era).
  
  
  CONCLUSIONS
  A positive FH is not a prognostic factor following RT and should not alter standard treatment recommendations. Patients with two or more first degree relatives with prostate cancer had a higher likelihood of BF and DM, but there was no effect on survival. There was no interaction between a positive FH and African American race or treatment era. A positive FH was however, associated with more favorable PSA values and T-stage that may be the result of earlier screening.
authors.affiliation: Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, United States.
authors.forename: Hilary
authors.initials: H
authors.lastname: Bagshaw
authors.affiliation: Department of Biostatistics, Fox Chase Cancer Center, Philadelphia, United States.
authors.forename: Karen
authors.initials: K
authors.lastname: Ruth
authors.affiliation: Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, United States.
authors.forename: Eric M
authors.initials: EM
authors.lastname: Horwitz
authors.affiliation: Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, United States.
authors.forename: David Y T
authors.initials: DY
authors.lastname: Chen
authors.affiliation: Department of Radiation Oncology, Stanford University, Stanford, United States. Electronic address: mark.buyyounouski@stanford.edu.
authors.forename: Mark K
authors.initials: MK
authors.lastname: Buyyounouski
mesh_terms: D000368:Aged; D018572:Disease-Free Survival; D005192:Family Health; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D010414:Pennsylvania / Q000453:epidemiology; D011379:Prognosis; D016016:Proportional Hazards Models; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000235:genetics / Q000473:pathology / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D016896:Treatment Outcome
keywords: Family history; Prostate cancer; Radiotherapy