Older age predicts decreased @entity3 and prostate XXXX for @entity1 treated with radiation therapy: meta-analysis of radiation therapy oncology group trials.

@entity1 @entity263 @entity5 @entity16178 @entity342 @entity3 @entity1349
PURPOSE: The impact of age on @entity263 ( @entity263 ) outcome has been controversial; therefore, we analyzed the effect of age on @entity1349 ( @entity1349 ), distant @entity3 , prostate @entity5 (PCSD), and nonprostate @entity5 (NPCD) on @entity1 with locally advanced @entity263 . METHODS AND MATERIALS: @entity1 who participated in four Radiation Therapy Oncology Group (RTOG) phase III trials, 8531, 8610, 9202, and 9413, were studied. Cox proportional hazards regression was used for @entity1349 analysis, and cumulative events analysis with Fine and Gray's regression was used for analyses of @entity3 , PCSD, and NPCD. RESULTS: Median follow-up of 4,128 @entity1 with median age of 70 (range, 43-88 years) was 7.3 years. Most @entity1 had high-risk disease: @entity16178 to cT4 (54%) and Gleason scores (GS) of 7 (45%) and 8 to 10 (27%). Older age ( <=70 vs. >70 years) predicted for decreased @entity1349 (10-year rate, 55% vs. 41%, respectively; p<0.0001) and increased NPCD (10-year rate, 28% vs. 46%, respectively; p<0.0001) but decreased @entity3 (10-year rate, 27% vs. 20%, respectively; p<0.0001) and PCSD (10-year rate, 18% vs. 14%, respectively; p<0.0001). To account for competing risks, outcomes were analyzed in 2-year intervals, and age-dependent differences in @entity3 and PCSD persisted, even in the earliest time periods. When adjusted for other covariates, an age of >70 years remained associated with decreased @entity1349 (hazard ratio [HR], 1.56 [95% confidence interval [CI], 1.43-1.70] p<0.0001) but with decreased @entity3 (HR, 0.72 [95% CI, 0.63-0.83] p<0.0001) and PCSD (HR, 0.78 [95% CI, 0.66-0.92] p<0.0001). Finally, the impact of the duration of @entity342 deprivation therapy as a function of age was evaluated. CONCLUSIONS: These data support less aggressive @entity263 in older @entity1 , independent of other clinical features. While the biological underpinning of this finding remains unknown, stratification by age in future trials appears to be warranted.
