FLAME TRIAL prostate boost - ?lymph nodes?

[evilbooyaa]

POP-RT inclusion was >20% LN risk per Roach formula (median est. risk was 37.8%).

Median PSA 28.

Gleason Group 4-5 = 49%.

DFS benefit not seen for those >66YO and LN risk <40%.

DMFS benefit (unplanned subgroup analysis) not seen in >66YO.

Thanks for the article. Lots of ideas in there. I'm digging through it now. Do you have the supplement? I love supplements. A lot of good stuff is often hidden in the supplements. Maybe I missed it at the link you gave.

We each can have different take homes from that study.

Totally agree, no wrong answer. For me, I suspect the differences seen in regards to bDFS and MFS is more likely due to this: "the use of adjuvant ADT was not standardized for these patients, with a substantial difference in use of adjuvant ADT between both treatment groups (SBRT: 23% vs. ENRT: 60%)."

Relevant: acute GU/GI toxicity appear to be similar from early results of PEACE V STORM

https://www.sciencedirect.com/science/article/pii/S2588931123001992

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[sirspamalot]

Bowel prep is gasX and watching that diet. And showing up for treatment.

 

[SneakyBooger]

Relevant: acute GU/GI toxicity appear to be similar from early results of PEACE V STORM

https://www.sciencedirect.com/science/article/pii/S2588931123001992

Thanks for the timely link regarding acute toxicities.

I would have thought there would more than 196 pts in this trial. Only 7 pts had grade 2+ toxicity.

It's paywalled, but here is part of the abstract. As always, looking forward to digesting this. (But that will have to wait as I am on a different mission this morning.)

Results and limitations​

Between June 2018 and April 2021, 196 patients were assigned randomly to MDT or ENRT. Ninety-seven of 99 patients allocated to MDT and 93 of 97 allocated to ENRT received per-protocol treatment. Worst acute GI toxicity proportions were as follows: grade ≥2 events in three (3%) in the MDT group versus four (4%) in the ENRT group (p = 0.11). Worst acute GU toxicity proportions were as follows: grade ≥2 events in eight (8%) in the MDT group versus 12 (13%) in the ENRT group (p = 0.95). We observed no significant difference between the study groups in the proportion of patients with a clinically significant QoL reduction from baseline for any subdomain score area.

 

[evilbooyaa]

Randomised Ph II, not ph III, hence low pt numbers.

 

[Chartreuse Wombat]

Thanks for the timely link regarding acute toxicities.

I would have thought there would more than 196 pts in this trial. Only 7 pts had grade 2+ toxicity.

It's paywalled, but here is part of the abstract. As always, looking forward to digesting this. (But that will have to wait as I am on a different mission this morning.)

Results and limitations​

Between June 2018 and April 2021, 196 patients were assigned randomly to MDT or ENRT. Ninety-seven of 99 patients allocated to MDT and 93 of 97 allocated to ENRT received per-protocol treatment. Worst acute GI toxicity proportions were as follows: grade ≥2 events in three (3%) in the MDT group versus four (4%) in the ENRT group (p = 0.11). Worst acute GU toxicity proportions were as follows: grade ≥2 events in eight (8%) in the MDT group versus 12 (13%) in the ENRT group (p = 0.95). We observed no significant difference between the study groups in the proportion of patients with a clinically significant QoL reduction from baseline for any subdomain score area.

Another example of overutilization of p-values. In small studies like this the authors should emphasize CI of HR. I expect they are very wide and probably cannot conclude much of anything. If p>0.05 please provide CI of HR

 

[evilbooyaa]

?? It's 3 vs 4%. What are CI or HR going to add for you here?

 

[Chartreuse Wombat]

?? It's 3 vs 4%. What are CI or HR going to add for you here?

Confidence in your inference or not.

 

[SneakyBooger]

I keep thinkin bout those low numbers...

They must have used SpaceOAR!