Ten-year outcomes of intensity-modulated radiation therapy combined with neoadjuvant hormonal therapy for intermediate- and high-risk patients with T1c-T2N0M0 prostate cancer.

Abstract

BACKGROUND:

We aimed to analyze the 10-year outcomes of intensity-modulated radiation therapy (IMRT) combined with neoadjuvant hormonal therapy (HT) for patients with intermediate- and high-risk T1c-T2N0M0 prostate cancer.

METHODS:

Fifty patients with T1c-T2N0M0 prostate cancer, who were treated with high-dose IMRT combined with neoadjuvant HT, were evaluated. Of these patients, 19 and 31 were classified into the intermediate- and high-risk groups, respectively. Neoadjuvant HT was administered over a median duration of 6 months; 74 and 78 Gy in 2 Gy per fraction were essentially delivered to the intermediate- and high-risk cases, respectively. Adjuvant HT was not administered to any of the patients after the completion of IMRT.

RESULTS:

Over a median follow-up period of 118 months, the 10-year prostate-specific antigen failure-free survival, prostate-specific antigen failure-free, salvage hormonal therapy-free, prostate cancer-specific survival, and overall survival rates were 70.2 %, 78.7 %, 89.2 %, 100 %, and 88.8 %, respectively. No grade 3 or higher acute or late toxicities were observed. The 10-year likelihoods of developing grade 2 late urinary and rectal toxicities were 13.7 % and 4.2 %, respectively. Compared with the outcomes of a cohort of historical controls who were locally irradiated with 70 Gy by three-dimensional conformal radiotherapy, the prostate-specific antigen failure-free rate was significantly better in the IMRT groups (78.7 % vs. 53.4 % at 10 years; p = 0.027).

CONCLUSIONS:

High-dose IMRT combined with neoadjuvant HT achieved not only high prostate-specific antigen control, but also excellent survival outcomes with acceptable morbidities, for a Japanese cohort of intermediate- and high-risk T1c-T2N0M0 prostate cancer patients, and these results warrant further investigation.

• Authors: Takashi Mizowaki, Yoshiki Norihisa, Kenji Takayama, Itaru Ikeda, Haruo Inokuchi, Kiyonao Nakamura, Tomomi Kamba, Takahiro Inoue, Toshiyuki Kamoto, Osamu Ogawa, Masahiro Hiraoka
• Journal: International journal of clinical oncology (Int J Clin Oncol) Vol. 21 Issue 4 Pg. 783-790 (Aug 2016) ISSN: 1437-7772 [Electronic] Japan
• PMID: 26843024 (Publication Type: Journal Article)

Chemical References

• Androgen Antagonists
• Antineoplastic Agents, Hormonal
• Biomarkers, Tumor
• Prostate-Specific Antigen

Topics

• Aged
• Androgen Antagonists (therapeutic use)
• Antineoplastic Agents, Hormonal (therapeutic use)
• Asian People (statistics & numerical data)
• Biomarkers, Tumor (blood)
• Disease-Free Survival
• Dose Fractionation, Radiation
• Follow-Up Studies
• Humans
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Neoadjuvant Therapy (methods)
• Neoplasm Staging
• Prostate-Specific Antigen (blood)
• Prostatic Neoplasms (blood, drug therapy, radiotherapy, surgery)
• Radiotherapy, Adjuvant
• Radiotherapy, Intensity-Modulated
• Retrospective Studies
• Risk Assessment
• Risk Factors
• Salvage Therapy (methods)
• Sample Size
• Treatment Outcome