Evidence Based Medicine on FHIR Implementation Guide
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This page is part of the Evidence Based Medicine on FHIR Implementation Guide (v1.0.0-ballot: STU1 Ballot 1) based on FHIR (HL7® FHIR® Standard) v5.0.0. . For a full list of available versions, see the Directory of published versions

: 22056152 Combined androgen deprivation therapy and radiation therapy for locally advanced prostate cancer: a randomised, phase 3 trial. - XML Representation

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    <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: Citation</b><a name="179626"> </a></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource Citation &quot;179626&quot; Version &quot;1&quot; Updated &quot;2023-11-26 22:35:23+0000&quot; </p></div><p><b>StructureDefinition Work Group</b>: cds</p><p><b>url</b>: <code>https://fevir.net/resources/Citation/179626</code></p><p><b>identifier</b>: FEvIR Object Identifier: 179626, id: 22056152</p><p><b>version</b>: 1.0.0-ballot</p><p><b>title</b>: 22056152 Combined androgen deprivation therapy and radiation therapy for locally advanced prostate cancer: a randomised, phase 3 trial.</p><p><b>status</b>: active</p><p><b>date</b>: 2023-12-17 16:55:23+0000</p><p><b>publisher</b>: HL7 International / Clinical Decision Support</p><p><b>contact</b>: HL7 International / Clinical Decision Support: <a href="http://www.hl7.org/Special/committees/dss">http://www.hl7.org/Special/committees/dss</a></p><p><b>description</b>: This Citation Resource is referenced in an example for the EBMonFHIR Implementation Guide.</p><h3>UseContexts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Code</b></td><td><b>Value[x]</b></td></tr><tr><td style="display: none">*</td><td>FEvIR Platform Use (Details: http://hl7.org/fhir/citation-classification-type code fevir-platform-use = 'FEvIR Platform Use', stated as 'FEvIR Platform Use')</td><td>Medline Base <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-citation-artifact-classifier.html">Citation Artifact Classifier</a>#medline-base)</span></td></tr></table><p><b>jurisdiction</b>: World <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (m49.htm#001)</span></p><p><b>copyright</b>: https://creativecommons.org/licenses/by-nc-sa/4.0/</p><p><b>approvalDate</b>: 2012-01-03</p><p><b>lastReviewDate</b>: 2022-03-21</p><p><b>author</b>: Computable Publishing®: MEDLINE-to-FEvIR Converter: </p><blockquote><p><b>classification</b></p><p><b>type</b>: Citation Source <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-citation-classification-type.html">Citation Classification Type</a>#citation-source)</span></p><p><b>classifier</b>: MEDLINE <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: MEDLINE Citation Owner <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-citation-classification-type.html">Citation Classification Type</a>#medline-owner)</span></p><p><b>classifier</b>: National Library of Medicine, Index Section <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (elements_descriptions.html#owner_value#NLM)</span></p></blockquote><p><b>currentState</b>: Medline Citation Status of Medline <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-citation-status-type.html">Citation Status Type</a>#medline-medline)</span>, PubMed PublicationStatus of ppublish <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-citation-status-type.html">Citation Status Type</a>#pubmed-publication-status-ppublish)</span></p><blockquote><p><b>statusDate</b></p><p><b>activity</b>: PubMed Pubstatus of Entrez <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-citation-status-type.html">Citation Status Type</a>#pubmed-pubstatus-entrez)</span></p><p><b>period</b>: ?? --&gt; 2011-11-08 06:00:00+0000</p></blockquote><blockquote><p><b>statusDate</b></p><p><b>activity</b>: PubMed Pubstatus of Pubmed <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-citation-status-type.html">Citation Status Type</a>#pubmed-pubstatus-pubmed)</span></p><p><b>period</b>: ?? --&gt; 2011-11-08 06:00:00+0000</p></blockquote><blockquote><p><b>statusDate</b></p><p><b>activity</b>: PubMed Pubstatus of Medline <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-citation-status-type.html">Citation Status Type</a>#pubmed-pubstatus-medline)</span></p><p><b>period</b>: ?? --&gt; 2012-01-04 06:00:00+0000</p></blockquote><blockquote><p><b>citedArtifact</b></p><p><b>identifier</b>: id: 22056152, id: PMC3243932, id: 10.1016/S0140-6736(11)61095-7, pii: S0140-6736(11)61095-7</p><p><b>relatedIdentifier</b>: id: ISRCTN24991896, id: NCT00002633</p><h3>Titles</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Language</b></td><td><b>Text</b></td></tr><tr><td style="display: none">*</td><td>Primary title <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-title-type.html">Title Type</a>#primary)</span></td><td>English <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-v3-ietf3066.html">Tags for the Identification of Languages</a>#en)</span></td><td>Combined androgen deprivation therapy and radiation therapy for locally advanced prostate cancer: a randomised, phase 3 trial.</td></tr></table><h3>Abstracts</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Text</b></td><td><b>Copyright</b></td></tr><tr><td style="display: none">*</td><td>**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 &amp;gt;3, three patients (0·5%) in the ADT only group, two (0·3%) in the ADT and RT group; diarrhoea grade &amp;gt;3, four patients (0·7%) vs eight (1·3%); urinary toxicity grade &amp;gt;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.</td><td>Copyright © 2011 Elsevier Ltd. All rights reserved.</td></tr></table><blockquote><p><b>relatesTo</b></p><p><b>type</b>: cites</p><p><b>classifier</b>: Journal Article <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-citation-artifact-classifier.html">Citation Artifact Classifier</a>#D016428)</span></p><p><b>citation</b>: Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. 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J Clin Oncol. 2010;28:1117–1123.</p><h3>Documents</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Url</b></td></tr><tr><td style="display: none">*</td><td><a href="https://pubmed.ncbi.nlm.nih.gov/20124165/">https://pubmed.ncbi.nlm.nih.gov/20124165/</a></td></tr></table><p><b>resourceReference</b>: <span>id: 20124165</span></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: comment-in</p><p><b>classifier</b>: Comment <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D016420)</span></p><p><b>citation</b>: Lancet. 2011 Dec 17;378(9809):2056-7</p><h3>Documents</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Url</b></td></tr><tr><td style="display: none">*</td><td><a href="https://pubmed.ncbi.nlm.nih.gov/22056154/">https://pubmed.ncbi.nlm.nih.gov/22056154/</a></td></tr></table><p><b>resourceReference</b>: <span>id: 22056154</span></p></blockquote><blockquote><p><b>relatesTo</b></p><p><b>type</b>: 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style="display: none">*</td><td>Periodical <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-published-in-type.html">Published In Type</a>#D020492)</span></td><td>Electronic ISSN Type: 1474-547X, ISOAbbreviation: Lancet, ISSN Linking: 0140-6736, Medline Title Abbreviation: Lancet, NLM Unique ID: 2985213R</td><td>Lancet (London, England)</td><td>England</td></tr></table><p><b>citedMedium</b>: Internet <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-medium.html">Cited Medium</a>#internet)</span></p><p><b>volume</b>: 378</p><p><b>issue</b>: 9809</p><p><b>articleDate</b>: 2011-12-17</p><p><b>publicationDateText</b>: 2011-Dec-17</p><p><b>language</b>: English <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.3.0/CodeSystem-v3-ietf3066.html">Tags for the Identification of Languages</a>#en)</span></p><p><b>pageString</b>: 2104-11</p></blockquote><blockquote><p><b>publicationForm</b></p><p><b>citedMedium</b>: Internet without issue <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-medium.html">Cited Medium</a>#internet-without-issue)</span></p><p><b>articleDate</b>: 2011-11-02</p></blockquote><blockquote><p><b>webLocation</b></p><p><b>classifier</b>: Abstract <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-artifact-url-classifier.html">Artifact Url Classifier</a>#abstract)</span></p><p><b>url</b>: <a href="https://pubmed.ncbi.nlm.nih.gov/22056152/">https://pubmed.ncbi.nlm.nih.gov/22056152/</a></p></blockquote><blockquote><p><b>webLocation</b></p><p><b>classifier</b>: DOI Based <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-artifact-url-classifier.html">Artifact Url Classifier</a>#doi-based)</span></p><p><b>url</b>: <a href="https://doi.org/10.1016/S0140-6736(11)61095-7">https://doi.org/10.1016/S0140-6736(11)61095-7</a></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: Publishing Model <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#publishing-model)</span></p><p><b>classifier</b>: Print Electronic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-citation-artifact-classifier.html">Citation Artifact Classifier</a>#Print-Electronic)</span></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: Chemical <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#chemical)</span></p><p><b>classifier</b>: Androgen Antagonists <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D000726)</span>, Gonadotropin-Releasing Hormone <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (chemical-substances#33515-09-2; #D007987)</span></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: MeSH Heading <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading)</span></p><p><b>artifactAssessment</b>: <a name="meshHeading0"> </a></p><blockquote><p/><p><a name="meshHeading0"> </a></p><p><b>artifact</b>: <a href="#">#</a></p><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Adenocarcinoma <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D000230)</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: mortality <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#Q000401)</span></p><blockquote><p><b>component</b></p></blockquote></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: radiotherapy <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#Q000532)</span></p><blockquote><p><b>component</b></p></blockquote></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: therapy <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#Q000628)</span></p><blockquote><p><b>component</b></p></blockquote></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Aged, 80 and over <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D000369)</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td>qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td><td>is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Androgen Antagonists <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D000726)</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: adverse effects <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#Q000009)</span></p><blockquote><p><b>component</b></p></blockquote></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: therapeutic use <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#Q000627)</span></p><blockquote><p><b>component</b></p></blockquote></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Combined Modality Therapy <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D003131)</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td>qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td><td>is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Gonadotropin-Releasing Hormone <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D007987)</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: agonists <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#Q000819)</span></p><blockquote><p><b>component</b></p></blockquote></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Humans <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D006801)</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td>qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td><td>is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Male <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D008297)</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td>qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td><td>is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Orchiectomy <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D009919)</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td>qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td><td>is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Prostatic Neoplasms <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D011471)</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: mortality <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#Q000401)</span></p><blockquote><p><b>component</b></p></blockquote></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: radiotherapy <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#Q000532)</span></p><blockquote><p><b>component</b></p></blockquote></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: therapy <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#Q000628)</span></p><blockquote><p><b>component</b></p></blockquote></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Quality of Life <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D011788)</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td>qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td><td>is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Radiotherapy <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D011878)</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: adverse effects <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#Q000009)</span></p><blockquote><p><b>component</b></p></blockquote></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Survival Rate <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D015996)</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td>qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td><td>is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td></tr></table></blockquote></blockquote></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: Publication Type <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#publication-type)</span></p><p><b>classifier</b>: Clinical Trial, Phase III <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D017428)</span>, Journal Article <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D016428)</span>, Multicenter Study <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D016448)</span>, Randomized Controlled Trial <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D016449)</span>, Research Support, N.I.H., Extramural <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D052061)</span>, Research Support, Non-U.S. Gov't <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D013485)</span></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: Knowledge Artifact Type <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#knowledge-artifact-type)</span></p><p><b>classifier</b>: Journal Article <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-citation-artifact-classifier.html">Citation Artifact Classifier</a>#D016428)</span></p><p><b>artifactAssessment</b>: <span>: Classifier added by Computable Publishing LLC</span></p></blockquote><blockquote><p><b>classification</b></p><p><b>type</b>: Citation Subset <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#citation-subset)</span></p><p><b>classifier</b>: IM <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (elements_descriptions.html#citationsubset#IM)</span></p></blockquote><blockquote><p><b>contributorship</b></p><p><b>complete</b>: true</p><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a name="author0"> </a></p><blockquote><p/><p><a name="author0"> </a></p><p><b>name</b>: Padraig Warde </p></blockquote><p><b>forenameInitials</b>: P</p><p><b>affiliation</b>: <span>: Princess Margaret Hospital, Toronto, Canada. padraig.warde@rmp.uhn.on.ca</span></p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a name="author1"> </a></p><blockquote><p/><p><a name="author1"> </a></p><p><b>name</b>: Malcolm Mason </p></blockquote><p><b>forenameInitials</b>: M</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a name="author2"> </a></p><blockquote><p/><p><a name="author2"> </a></p><p><b>name</b>: Keyue Ding </p></blockquote><p><b>forenameInitials</b>: K</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a name="author3"> </a></p><blockquote><p/><p><a name="author3"> </a></p><p><b>name</b>: Peter Kirkbride </p></blockquote><p><b>forenameInitials</b>: P</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a name="author4"> </a></p><blockquote><p/><p><a name="author4"> </a></p><p><b>name</b>: Michael Brundage </p></blockquote><p><b>forenameInitials</b>: M</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a name="author5"> </a></p><blockquote><p/><p><a name="author5"> </a></p><p><b>name</b>: Richard Cowan </p></blockquote><p><b>forenameInitials</b>: R</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a name="author6"> </a></p><blockquote><p/><p><a name="author6"> </a></p><p><b>name</b>: Mary Gospodarowicz </p></blockquote><p><b>forenameInitials</b>: M</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a name="author7"> </a></p><blockquote><p/><p><a name="author7"> </a></p><p><b>name</b>: Karen Sanders </p></blockquote><p><b>forenameInitials</b>: K</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a name="author8"> </a></p><blockquote><p/><p><a name="author8"> </a></p><p><b>name</b>: Edmund Kostashuk </p></blockquote><p><b>forenameInitials</b>: E</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a name="author9"> </a></p><blockquote><p/><p><a name="author9"> </a></p><p><b>name</b>: Greg Swanson </p></blockquote><p><b>forenameInitials</b>: G</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a name="author10"> </a></p><blockquote><p/><p><a name="author10"> </a></p><p><b>name</b>: Jim Barber </p></blockquote><p><b>forenameInitials</b>: J</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a name="author11"> </a></p><blockquote><p/><p><a name="author11"> </a></p><p><b>name</b>: Andrea Hiltz </p></blockquote><p><b>forenameInitials</b>: A</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a name="author12"> </a></p><blockquote><p/><p><a name="author12"> </a></p><p><b>name</b>: Mahesh K B Parmar </p></blockquote><p><b>forenameInitials</b>: MK</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a name="author13"> </a></p><blockquote><p/><p><a name="author13"> </a></p><p><b>name</b>: Jinka Sathya </p></blockquote><p><b>forenameInitials</b>: J</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a name="author14"> </a></p><blockquote><p/><p><a name="author14"> </a></p><p><b>name</b>: John Anderson </p></blockquote><p><b>forenameInitials</b>: J</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a name="author15"> </a></p><blockquote><p/><p><a name="author15"> </a></p><p><b>name</b>: Charles Hayter </p></blockquote><p><b>forenameInitials</b>: C</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a name="author16"> </a></p><blockquote><p/><p><a name="author16"> </a></p><p><b>name</b>: John Hetherington </p></blockquote><p><b>forenameInitials</b>: J</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a name="author17"> </a></p><blockquote><p/><p><a name="author17"> </a></p><p><b>name</b>: Matthew R Sydes </p></blockquote><p><b>forenameInitials</b>: MR</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a name="author18"> </a></p><blockquote><p/><p><a name="author18"> </a></p><p><b>name</b>: Wendy Parulekar </p></blockquote><p><b>forenameInitials</b>: W</p></blockquote><blockquote><p><b>entry</b></p><p><b>contributor</b>: <a name="author19"> </a></p><blockquote><p/><p><a name="author19"> </a></p><p><b>name</b>: NCIC CTG PR.3/MRC UK PR07 investigators</p></blockquote></blockquote></blockquote></blockquote><hr/><blockquote><p><b>Generated Narrative: Practitioner #author0</b><a name="author0"> </a></p><p><b>name</b>: Padraig Warde </p></blockquote><hr/><blockquote><p><b>Generated Narrative: Practitioner #author1</b><a name="author1"> </a></p><p><b>name</b>: Malcolm Mason </p></blockquote><hr/><blockquote><p><b>Generated Narrative: Practitioner #author2</b><a name="author2"> </a></p><p><b>name</b>: Keyue Ding </p></blockquote><hr/><blockquote><p><b>Generated Narrative: Practitioner #author3</b><a name="author3"> </a></p><p><b>name</b>: Peter Kirkbride </p></blockquote><hr/><blockquote><p><b>Generated Narrative: Practitioner #author4</b><a name="author4"> </a></p><p><b>name</b>: Michael Brundage </p></blockquote><hr/><blockquote><p><b>Generated Narrative: Practitioner #author5</b><a name="author5"> </a></p><p><b>name</b>: Richard Cowan </p></blockquote><hr/><blockquote><p><b>Generated Narrative: Practitioner #author6</b><a name="author6"> </a></p><p><b>name</b>: Mary Gospodarowicz </p></blockquote><hr/><blockquote><p><b>Generated Narrative: Practitioner #author7</b><a name="author7"> </a></p><p><b>name</b>: Karen Sanders </p></blockquote><hr/><blockquote><p><b>Generated Narrative: Practitioner #author8</b><a name="author8"> </a></p><p><b>name</b>: Edmund Kostashuk </p></blockquote><hr/><blockquote><p><b>Generated Narrative: Practitioner #author9</b><a name="author9"> </a></p><p><b>name</b>: Greg Swanson </p></blockquote><hr/><blockquote><p><b>Generated Narrative: Practitioner #author10</b><a name="author10"> </a></p><p><b>name</b>: Jim Barber </p></blockquote><hr/><blockquote><p><b>Generated Narrative: Practitioner #author11</b><a name="author11"> </a></p><p><b>name</b>: Andrea Hiltz </p></blockquote><hr/><blockquote><p><b>Generated Narrative: Practitioner #author12</b><a name="author12"> </a></p><p><b>name</b>: Mahesh K B Parmar </p></blockquote><hr/><blockquote><p><b>Generated Narrative: Practitioner #author13</b><a name="author13"> </a></p><p><b>name</b>: Jinka Sathya </p></blockquote><hr/><blockquote><p><b>Generated Narrative: Practitioner #author14</b><a name="author14"> </a></p><p><b>name</b>: John Anderson </p></blockquote><hr/><blockquote><p><b>Generated Narrative: Practitioner #author15</b><a name="author15"> </a></p><p><b>name</b>: Charles Hayter </p></blockquote><hr/><blockquote><p><b>Generated Narrative: Practitioner #author16</b><a name="author16"> </a></p><p><b>name</b>: John Hetherington </p></blockquote><hr/><blockquote><p><b>Generated Narrative: Practitioner #author17</b><a name="author17"> </a></p><p><b>name</b>: Matthew R Sydes </p></blockquote><hr/><blockquote><p><b>Generated Narrative: Practitioner #author18</b><a name="author18"> </a></p><p><b>name</b>: Wendy Parulekar </p></blockquote><hr/><blockquote><p><b>Generated Narrative: Organization #author19</b><a name="author19"> </a></p><p><b>name</b>: NCIC CTG PR.3/MRC UK PR07 investigators</p></blockquote><hr/><blockquote><p><b>Generated Narrative: ArtifactAssessment #meshHeading0</b><a name="meshHeading0"> </a></p><p><b>artifact</b>: <a href="#">#</a></p><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Adenocarcinoma <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D000230)</span></p><p><b>freeToShare</b>: true</p><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: mortality <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#Q000401)</span></p><blockquote><p><b>component</b></p></blockquote></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: radiotherapy <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#Q000532)</span></p><blockquote><p><b>component</b></p></blockquote></blockquote><blockquote><p><b>component</b></p><p><b>type</b>: qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></p><p><b>classifier</b>: therapy <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#Q000628)</span></p><blockquote><p><b>component</b></p></blockquote></blockquote></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact Classification Type</a>#mesh-heading &quot;MeSH heading&quot;)</span></p><p><b>classifier</b>: Aged, 80 and over <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (#D000369)</span></p><p><b>freeToShare</b>: true</p><h3>Components</h3><table class="grid"><tr><td style="display: none">-</td><td><b>Type</b></td><td><b>Classifier</b></td></tr><tr><td style="display: none">*</td><td>qualifier <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td><td>is not a major topic <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> ()</span></td></tr></table></blockquote><blockquote><p><b>content</b></p><p><b>informationType</b>: classifier</p><p><b>type</b>: components (if present) include qualifier codings <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R5/codesystem-cited-artifact-classification-type.html">Cited Artifact 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            value="**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 &amp;gt;3, three patients (0·5%) in the ADT only group, two (0·3%) in the ADT and RT group; diarrhoea grade &amp;gt;3, four patients (0·7%) vs eight (1·3%); urinary toxicity grade &amp;gt;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 value="Copyright © 2011 Elsevier Ltd. All rights reserved."/>
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