Generated Narrative: Citation 179626 version: 20; Last updated: 2025-10-13 12:34:35+0000; Language: en Profile: JournalArticleCitation ArtifactPublicationStatus: Active url: https://fevir.net/resources/Citation/179626 identifier: FEvIR Object Identifier/179626, https://pubmed.ncbi.nlm.nih.gov/22056152 title: 22056152 Combined androgen deprivation therapy and radiation therapy for locally advanced prostate cancer: a randomised, phase 3 trial. status: Active author: Computable Publishing®: MEDLINE-to-FEvIR Converter: publisher: Computable Publishing LLC contact: support@computablepublishing.com description: This Citation Resource is referenced in an example for the EBMonFHIR Implementation Guide. UseContexts - Code Value[x] * Citation Classification Type: fevir-platform-use (FEvIR Platform Use) Medline Base copyright: https://creativecommons.org/licenses/by-nc-sa/4.0/ approvalDate: 2012-01-03 lastReviewDate: 2022-03-21 classification type: Citation Source classifier: MEDLINE classification type: MEDLINE Citation Owner classifier: National Library of Medicine, Index Section currentState: Medline Citation Status of Medline, PubMed PublicationStatus of ppublish statusDate activity: PubMed Pubstatus of Entrez period: ?? --> 2011-11-08 06:00:00+0000 statusDate activity: PubMed Pubstatus of Pubmed period: ?? --> 2011-11-08 06:00:00+0000 statusDate activity: PubMed Pubstatus of Medline period: ?? --> 2012-01-04 06:00:00+0000 statusDate activity: PubMed Pubstatus of PMC release period: ?? --> 2011-12-17 citedArtifact identifier: https://pubmed.ncbi.nlm.nih.gov/22056152, https://www.ncbi.nlm.nih.gov/pmc//PMC3243932, https://doi.org/10.1016/S0140-6736(11)61095-7, pii/S0140-6736(11)61095-7 relatedIdentifier: ISRCTN24991896, https://clinicaltrials.gov/NCT00002633 Titles - Type Text * Primary title Combined androgen deprivation therapy and radiation therapy for locally advanced prostate cancer: a randomised, phase 3 trial. Abstracts - Type Text Copyright * Primary human use BACKGROUND: Whether the addition of radiation therapy (RT) improves overall survival in men with locally advanced prostate cancer managed with androgen deprivation therapy (ADT) is unclear. Our aim was to compare outcomes in such patients with locally advanced prostate cancer. METHODS: Patients with: locally advanced (T3 or T4) prostate cancer (n=1057); or organ-confined disease (T2) with either a prostate-specific antigen (PSA) concentration more than 40 ng/mL (n=119) or PSA concentration more than 20 ng/mL and a Gleason score of 8 or higher (n=25), were randomly assigned (done centrally with stratification and dynamic minimisation, not masked) to receive lifelong ADT and RT (65-69 Gy to the prostate and seminal vesicles, 45 Gy to the pelvic nodes). The primary endpoint was overall survival. The results presented here are of an interim analysis planned for when two-thirds of the events for the final analysis were recorded. All efficacy analyses were done by intention to treat and were based on data from all patients. This trial is registered at controlledtrials.com as ISRCTN24991896 and Clinicaltrials.gov as NCT00002633. RESULTS: Between 1995 and 2005, 1205 patients were randomly assigned (602 in the ADT only group and 603 in the ADT and RT group); median follow-up was 6·0 years (IQR 4·4-8·0). At the time of analysis, a total of 320 patients had died, 175 in the ADT only group and 145 in the ADT and RT group. The addition of RT to ADT improved overall survival at 7 years (74%, 95% CI 70-78 vs 66%, 60-70; hazard ratio [HR] 0·77, 95% CI 0·61-0·98, p=0·033). Both toxicity and health-related quality-of-life results showed a small effect of RT on late gastrointestinal toxicity (rectal bleeding grade >3, three patients (0·5%) in the ADT only group, two (0·3%) in the ADT and RT group; diarrhoea grade >3, four patients (0·7%) vs eight (1·3%); urinary toxicity grade >3, 14 patients (2·3%) in both groups). INTERPRETATION: The benefits of combined modality treatment--ADT and RT--should be discussed with all patients with locally advanced prostate cancer. FUNDING: Canadian Cancer Society Research Institute, US National Cancer Institute, and UK Medical Research Council. Copyright © 2011 Elsevier Ltd. All rights reserved. relatesTo type: Cites classifier: Journal Article citation: Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2008;127:2893–2917. target: https://pubmed.ncbi.nlm.nih.gov/21351269/ relatesTo type: Cites classifier: Journal Article citation: Jemal A, Siegel R, Xu J, Ward E. Cancer statistics, 2010. CA Cancer J Clin. 2010;60:277–300. target: https://pubmed.ncbi.nlm.nih.gov/20610543/ relatesTo type: Cites classifier: Journal Article citation: Cooperberg MR, Moul JW, Carroll PR. The changing face of prostate cancer. J Clin Oncol. 2005;23:8146–8151. target: https://pubmed.ncbi.nlm.nih.gov/16278465/ relatesTo type: Cites classifier: Journal Article citation: Eastham JA, Evans CP, Zietman A. What is the optimal management of high risk, clinically localized prostate cancer? Urol Oncol. 2010;28:557–567. target: https://pubmed.ncbi.nlm.nih.gov/20816616/ relatesTo type: Cites classifier: Journal Article citation: Fellows GJ, Clark PB, Beynon LL. Treatment of advanced localised prostatic cancer by orchiectomy, radiotherapy, or combined treatment. A Medical Research Council Study. Urological Cancer Working Party—Subgroup on Prostatic Cancer. Br J Urol. 1992;70:304–309. target: https://pubmed.ncbi.nlm.nih.gov/1422689/ relatesTo type: Cites classifier: Journal Article citation: Pocock SJ, Simon R. Sequential treatment assignment with balancing for prognostic factors in the controlled clinical trial. Biometrics. 1975;31:103–115. target: https://pubmed.ncbi.nlm.nih.gov/1100130/ relatesTo type: Cites classifier: Journal Article citation: Aaronson NK, Ahmedzai S, Bergman B. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993;85:365–376. target: https://pubmed.ncbi.nlm.nih.gov/8433390/ relatesTo type: Cites classifier: Journal Article citation: Esper P, Mo F, Chodak G, Sinner M, Cella D, Pienta KJ. Measuring quality of life in men with prostate cancer using the functional assessment of cancer therapy-prostate instrument. Urology. 1997;50:920–928. target: https://pubmed.ncbi.nlm.nih.gov/9426724/ relatesTo type: Cites classifier: Journal Article citation: Monti AF, Ostinelli A, Frigerio M. An ICRU 50 radiotherapy treatment chart. Radiother Oncol. 1995;35:145–150. target: https://pubmed.ncbi.nlm.nih.gov/7569023/ relatesTo type: Cites classifier: Journal Article citation: Bolla M, van Tienhoven G, Warde P. External irradiation with or without long-term androgen suppression for prostate cancer with high metastatic risk: 10-year results of an EORTC randomised study. Lancet Oncol. 2010;11:1066–1073. target: https://pubmed.ncbi.nlm.nih.gov/20933466/ relatesTo type: Cites classifier: Journal Article citation: Bolla M, Gonzalez D, Warde P. Improved survival in patients with locally advanced prostate cancer treated with radiotherapy and goserelin. N Engl J Med. 1997;337:295–300. target: https://pubmed.ncbi.nlm.nih.gov/9233866/ relatesTo type: Cites citation: Gray R. A class of K-sample tests for comparing the cumulative incidence of a competing risk. Ann Stat. 1988;16:1141–1154. relatesTo type: Cites citation: Lan G, DeMets D. Discrete sequential boundaries for clinical trials. Biometrika. 1983;70:659–663. relatesTo type: Cites classifier: Journal Article citation: Widmark A, Klepp O, Solberg A. Endocrine treatment, with or without radiotherapy, in locally advanced prostate cancer (SPCG-7/SFUO-3): an open randomised phase III trial. Lancet. 2009;373:301–308. target: https://pubmed.ncbi.nlm.nih.gov/19091394/ relatesTo type: Cites classifier: Journal Article citation: Cella D, Nichol MB, Eton D, Nelson JB, Mulani P. Estimating clinically meaningful changes for the Functional Assessment of Cancer Therapy—prostate: results from a clinical trial of patients with metastatic hormone-refractory prostate cancer. Value Health. 2009;12:124–129. target: https://pubmed.ncbi.nlm.nih.gov/18647260/ relatesTo type: Cites classifier: Journal Article citation: Osoba D, Bezjak A, Brundage M, Zee B, Tu D, Pater J. Analysis and interpretation of health-related quality-of-life data from clinical trials: basic approach of The National Cancer Institute of Canada Clinical Trials Group. Eur J Cancer. 2005;41:280–287. target: https://pubmed.ncbi.nlm.nih.gov/15661554/ relatesTo type: Cites classifier: Journal Article citation: Bolla M, de Reijke TM, van Tienhoven G. Duration of androgen suppression in the treatment of prostate cancer. N Engl J Med. 2009;360:2516–2527. target: https://pubmed.ncbi.nlm.nih.gov/19516032/ relatesTo type: Cites classifier: Journal Article citation: Horwitz EM, Bae K, Hanks GE. Ten-year follow-up of radiation therapy oncology group protocol 92-02: a phase III trial of the duration of elective androgen deprivation in locally advanced prostate cancer. J Clin Oncol. 2008;26:2497–2504. target: https://pubmed.ncbi.nlm.nih.gov/18413638/ relatesTo type: Cites classifier: Journal Article citation: Alibhai SM, Duong-Hua M, Cheung AM. Fracture types and risk factors in men with prostate cancer on androgen deprivation therapy: a matched cohort study of 19,079 men. J Urol. 2010;184:918–923. target: https://pubmed.ncbi.nlm.nih.gov/20643458/ relatesTo type: Cites classifier: Journal Article citation: Alibhai SM, Mohamedali HZ. Cardiac and cognitive effects of androgen deprivation therapy: are they real? Curr Oncol. 2010;17(suppl 2):S55–S64. target: https://pubmed.ncbi.nlm.nih.gov/20882135/ relatesTo type: Cites classifier: Journal Article citation: Keating NL, O'Malley AJ, Smith MR. Diabetes and cardiovascular disease during androgen deprivation therapy for prostate cancer. J Clin Oncol. 2006;24:4448–4456. target: https://pubmed.ncbi.nlm.nih.gov/16983113/ relatesTo type: Cites classifier: Journal Article citation: Shahinian VB, Kuo YF, Freeman JL, Goodwin JS. Risk of fracture after androgen deprivation for prostate cancer. N Engl J Med. 2005;352:154–164. target: https://pubmed.ncbi.nlm.nih.gov/15647578/ relatesTo type: Cites classifier: Journal Article citation: McMullen KP, Lee WR. A structured literature review to determine the use of the American Society for Therapeutic Radiology and Oncology consensus definition of biochemical failure. Urology. 2003;61:391–396. target: https://pubmed.ncbi.nlm.nih.gov/12597954/ relatesTo type: Cites classifier: Journal Article citation: Kuban DA, Tucker SL, Dong L. Long-term results of the M D Anderson randomized dose-escalation trial for prostate cancer. Int J Radiat Oncol Biol Phys. 2008;70:67–74. target: https://pubmed.ncbi.nlm.nih.gov/17765406/ relatesTo type: Cites classifier: Journal Article citation: Zietman AL, DeSilvio ML, Slater JD. Comparison of conventional-dose vs high-dose conformal radiation therapy in clinically localized adenocarcinoma of the prostate: a randomized controlled trial. JAMA. 2005;294:1233–1239. target: https://pubmed.ncbi.nlm.nih.gov/16160131/ relatesTo type: Cites classifier: Journal Article citation: Rosenthal SA, Sandler HM. Treatment strategies for high-risk locally advanced prostate cancer. Nat Rev Urol. 2010;7:31–38. target: https://pubmed.ncbi.nlm.nih.gov/20062072/ relatesTo type: Cites classifier: Journal Article citation: Cooperberg MR, Broering JM, Carroll PR. Time trends and local variation in primary treatment of localized prostate cancer. J Clin Oncol. 2010;28:1117–1123. target: https://pubmed.ncbi.nlm.nih.gov/20124165/ relatesTo type: Has Comment In classifier: Comment citation: Lancet. 2011 Dec 17;378(9809):2056-7. doi: 10.1016/S0140-6736(11)61254-3. target: https://pubmed.ncbi.nlm.nih.gov/22056154/ relatesTo type: Has Comment In classifier: Comment citation: Ann Intern Med. 2012 Apr 17;156(8):JC4-05, JC4-04. doi: 10.7326/0003-4819-156-8-201204170-02005. target: https://pubmed.ncbi.nlm.nih.gov/22508745/ relatesTo type: Has Comment In classifier: Comment citation: J Urol. 2012 Sep;188(3):810. doi: 10.1016/j.juro.2012.05.065. target: https://pubmed.ncbi.nlm.nih.gov/22883758/ relatesTo type: Has Comment In classifier: Comment citation: Eur Urol. 2012 Nov;62(5):932-3. doi: 10.1016/j.eururo.2012.08.041. target: https://pubmed.ncbi.nlm.nih.gov/23036346/ publicationForm publishedIn type: Periodical identifier: Electronic ISSN Type/1474-547X, ISOAbbreviation/Lancet, ISSN Linking/0140-6736, Medline Title Abbreviation/Lancet, NLM Unique ID/2985213R title: Lancet (London, England) publisherLocation: England citedMedium: Internet volume: 378 issue: 9809 articleDate: 2011-12-17 pageString: 2104-11 publicationForm citedMedium: Internet without issue articleDate: 2011-11-02 webLocation classifier: Abstract url: https://pubmed.ncbi.nlm.nih.gov/22056152/ webLocation classifier: DOI Based url: https://doi.org/10.1016/S0140-6736(11)61095-7 classification type: Publishing Model classifier: Print Electronic classification type: Chemical classifier: Androgen Antagonists, Gonadotropin-Releasing Hormone classification type: MeSH heading artifactAssessment: ArtifactAssessment: artifact[x] = this resource classification type: Publication type classifier: Clinical Trial, Phase III, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't classification type: Knowledge Artifact Type classifier: Journal Article artifactAssessment: Classifier added by Computable Publishing LLC classification type: Citation subset classifier: IM contributorship complete: true entry contributor: Warde P forenameInitials: P affiliation: Princess Margaret Hospital, Toronto, Canada. padraig.warde@rmp.uhn.on.ca entry contributor: Mason M forenameInitials: M entry contributor: Ding K forenameInitials: K entry contributor: Kirkbride P forenameInitials: P entry contributor: Brundage M forenameInitials: M entry contributor: Cowan R forenameInitials: R entry contributor: Gospodarowicz M forenameInitials: M entry contributor: Sanders K forenameInitials: K entry contributor: Kostashuk E forenameInitials: E entry contributor: Swanson G forenameInitials: G entry contributor: Barber J forenameInitials: J entry contributor: Hiltz A forenameInitials: A entry contributor: Parmar MK forenameInitials: MK entry contributor: Sathya J forenameInitials: J entry contributor: Anderson J forenameInitials: J entry contributor: Hayter C forenameInitials: C entry contributor: Hetherington J forenameInitials: J entry contributor: Sydes MR forenameInitials: MR entry contributor: Parulekar W forenameInitials: W entry contributor: NCIC CTG PR.3/MRC UK PR07 investigators Generated Narrative: Practitioner #contributor0 name: Padraig Warde Generated Narrative: Practitioner #contributor1 name: Malcolm Mason Generated Narrative: Practitioner #contributor2 name: Keyue Ding Generated Narrative: Practitioner #contributor3 name: Peter Kirkbride Generated Narrative: Practitioner #contributor4 name: Michael Brundage Generated Narrative: Practitioner #contributor5 name: Richard Cowan Generated Narrative: Practitioner #contributor6 name: Mary Gospodarowicz Generated Narrative: Practitioner #contributor7 name: Karen Sanders Generated Narrative: Practitioner #contributor8 name: Edmund Kostashuk Generated Narrative: Practitioner #contributor9 name: Greg Swanson Generated Narrative: Practitioner #contributor10 name: Jim Barber Generated Narrative: Practitioner #contributor11 name: Andrea Hiltz Generated Narrative: Practitioner #contributor12 name: Mahesh K B Parmar Generated Narrative: Practitioner #contributor13 name: Jinka Sathya Generated Narrative: Practitioner #contributor14 name: John Anderson Generated Narrative: Practitioner #contributor15 name: Charles Hayter Generated Narrative: Practitioner #contributor16 name: John Hetherington Generated Narrative: Practitioner #contributor17 name: Matthew R Sydes Generated Narrative: Practitioner #contributor18 name: Wendy Parulekar Generated Narrative: Organization #contributor19 name: NCIC CTG PR.3/MRC UK PR07 investigators Generated Narrative: ArtifactAssessment #meshHeading0 artifact: Citation 22056152 Combined androgen deprivation therapy and radiation therapy for locally advanced prostate cancer: a randomised, phase 3 trial. content type: components (if present) include qualifier codings classifier: Adenocarcinoma freeToShare: true component type: qualifier classifier: is not a major topic component 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22056152 Combined androgen deprivation therapy and radiation therapy for locally advanced prostate cancer: a randomised, phase 3 trial.
Computable Publishing®: MEDLINE-to-FEvIR Converter
This Citation Resource is referenced in an example for the EBMonFHIR Implementation Guide.
National Library of Medicine, Index Section
Combined androgen deprivation therapy and radiation therapy for locally advanced prostate cancer: a randomised, phase 3 trial.
**BACKGROUND:** Whether the addition of radiation therapy (RT) improves overall survival in men with locally advanced prostate cancer managed with androgen deprivation therapy (ADT) is unclear. Our aim was to compare outcomes in such patients with locally advanced prostate cancer. **METHODS:** Patients with: locally advanced (T3 or T4) prostate cancer (n=1057); or organ-confined disease (T2) with either a prostate-specific antigen (PSA) concentration more than 40 ng/mL (n=119) or PSA concentration more than 20 ng/mL and a Gleason score of 8 or higher (n=25), were randomly assigned (done centrally with stratification and dynamic minimisation, not masked) to receive lifelong ADT and RT (65-69 Gy to the prostate and seminal vesicles, 45 Gy to the pelvic nodes). The primary endpoint was overall survival. The results presented here are of an interim analysis planned for when two-thirds of the events for the final analysis were recorded. All efficacy analyses were done by intention to treat and were based on data from all patients. This trial is registered at controlledtrials.com as ISRCTN24991896 and Clinicaltrials.gov as NCT00002633. **RESULTS:** Between 1995 and 2005, 1205 patients were randomly assigned (602 in the ADT only group and 603 in the ADT and RT group); median follow-up was 6·0 years (IQR 4·4-8·0). At the time of analysis, a total of 320 patients had died, 175 in the ADT only group and 145 in the ADT and RT group. The addition of RT to ADT improved overall survival at 7 years (74%, 95% CI 70-78 vs 66%, 60-70; hazard ratio [HR] 0·77, 95% CI 0·61-0·98, p=0·033). Both toxicity and health-related quality-of-life results showed a small effect of RT on late gastrointestinal toxicity (rectal bleeding grade >3, three patients (0·5%) in the ADT only group, two (0·3%) in the ADT and RT group; diarrhoea grade >3, four patients (0·7%) vs eight (1·3%); urinary toxicity grade >3, 14 patients (2·3%) in both groups). **INTERPRETATION:** The benefits of combined modality treatment--ADT and RT--should be discussed with all patients with locally advanced prostate cancer. **FUNDING:** Canadian Cancer Society Research Institute, US National Cancer Institute, and UK Medical Research Council.
Copyright © 2011 Elsevier Ltd. All rights reserved.
Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2008;127:2893–2917.
Jemal A, Siegel R, Xu J, Ward E. Cancer statistics, 2010. CA Cancer J Clin. 2010;60:277–300.
Cooperberg MR, Moul JW, Carroll PR. The changing face of prostate cancer. J Clin Oncol. 2005;23:8146–8151.
Eastham JA, Evans CP, Zietman A. What is the optimal management of high risk, clinically localized prostate cancer? Urol Oncol. 2010;28:557–567.
Fellows GJ, Clark PB, Beynon LL. Treatment of advanced localised prostatic cancer by orchiectomy, radiotherapy, or combined treatment. A Medical Research Council Study. Urological Cancer Working Party—Subgroup on Prostatic Cancer. Br J Urol. 1992;70:304–309.
Pocock SJ, Simon R. Sequential treatment assignment with balancing for prognostic factors in the controlled clinical trial. Biometrics. 1975;31:103–115.
Aaronson NK, Ahmedzai S, Bergman B. The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993;85:365–376.
Esper P, Mo F, Chodak G, Sinner M, Cella D, Pienta KJ. Measuring quality of life in men with prostate cancer using the functional assessment of cancer therapy-prostate instrument. Urology. 1997;50:920–928.
Monti AF, Ostinelli A, Frigerio M. An ICRU 50 radiotherapy treatment chart. Radiother Oncol. 1995;35:145–150.
Bolla M, van Tienhoven G, Warde P. External irradiation with or without long-term androgen suppression for prostate cancer with high metastatic risk: 10-year results of an EORTC randomised study. Lancet Oncol. 2010;11:1066–1073.
Bolla M, Gonzalez D, Warde P. Improved survival in patients with locally advanced prostate cancer treated with radiotherapy and goserelin. N Engl J Med. 1997;337:295–300.
Gray R. A class of K-sample tests for comparing the cumulative incidence of a competing risk. Ann Stat. 1988;16:1141–1154.
Lan G, DeMets D. Discrete sequential boundaries for clinical trials. Biometrika. 1983;70:659–663.
Widmark A, Klepp O, Solberg A. Endocrine treatment, with or without radiotherapy, in locally advanced prostate cancer (SPCG-7/SFUO-3): an open randomised phase III trial. Lancet. 2009;373:301–308.
Cella D, Nichol MB, Eton D, Nelson JB, Mulani P. Estimating clinically meaningful changes for the Functional Assessment of Cancer Therapy—prostate: results from a clinical trial of patients with metastatic hormone-refractory prostate cancer. Value Health. 2009;12:124–129.
Osoba D, Bezjak A, Brundage M, Zee B, Tu D, Pater J. Analysis and interpretation of health-related quality-of-life data from clinical trials: basic approach of The National Cancer Institute of Canada Clinical Trials Group. Eur J Cancer. 2005;41:280–287.
Bolla M, de Reijke TM, van Tienhoven G. Duration of androgen suppression in the treatment of prostate cancer. N Engl J Med. 2009;360:2516–2527.
Horwitz EM, Bae K, Hanks GE. Ten-year follow-up of radiation therapy oncology group protocol 92-02: a phase III trial of the duration of elective androgen deprivation in locally advanced prostate cancer. J Clin Oncol. 2008;26:2497–2504.
Alibhai SM, Duong-Hua M, Cheung AM. Fracture types and risk factors in men with prostate cancer on androgen deprivation therapy: a matched cohort study of 19,079 men. J Urol. 2010;184:918–923.
Alibhai SM, Mohamedali HZ. Cardiac and cognitive effects of androgen deprivation therapy: are they real? Curr Oncol. 2010;17(suppl 2):S55–S64.
Keating NL, O'Malley AJ, Smith MR. Diabetes and cardiovascular disease during androgen deprivation therapy for prostate cancer. J Clin Oncol. 2006;24:4448–4456.
Shahinian VB, Kuo YF, Freeman JL, Goodwin JS. Risk of fracture after androgen deprivation for prostate cancer. N Engl J Med. 2005;352:154–164.
McMullen KP, Lee WR. A structured literature review to determine the use of the American Society for Therapeutic Radiology and Oncology consensus definition of biochemical failure. Urology. 2003;61:391–396.
Kuban DA, Tucker SL, Dong L. Long-term results of the M D Anderson randomized dose-escalation trial for prostate cancer. Int J Radiat Oncol Biol Phys. 2008;70:67–74.
Zietman AL, DeSilvio ML, Slater JD. Comparison of conventional-dose vs high-dose conformal radiation therapy in clinically localized adenocarcinoma of the prostate: a randomized controlled trial. JAMA. 2005;294:1233–1239.
Rosenthal SA, Sandler HM. Treatment strategies for high-risk locally advanced prostate cancer. Nat Rev Urol. 2010;7:31–38.
Cooperberg MR, Broering JM, Carroll PR. Time trends and local variation in primary treatment of localized prostate cancer. J Clin Oncol. 2010;28:1117–1123.
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Princess Margaret Hospital, Toronto, Canada. padraig.warde@rmp.uhn.on.ca