© 2004 Foundation for Promotion of Cancer Research
Efficacy of Modest Dose Irradiation in Combination with Long-term Endocrinal Treatment for High-risk Prostate Cancer: A Preliminary Report
1 Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 2 Department of Radiation Technology, School of Health Sciences, Faculty of Medicine, Kyushu University, 3 Department of Urology, Graduate School of Medical Sciences, Kyushu University and 4 Department of Urology, Harasanshin Hospital, Fukuoka, Japan
Background: Although radiotherapy in combination with endocrinal manipulation has been identified as an effective treatment for patients with high-risk prostate cancer, the optimal dose for locoregional control of prostate cancer in combination with hormonal therapy has not yet been determined.
Methods: The efficacy of modest doses of irradiation (60–62 Gy) combined with long-term endocrinal treatment for patients with high-risk prostate cancer (defined as a pretreatment prostate-specific antigen (PSA) level greater than 20 ng/ml or a Gleason’s score of 8–10 or T3-T4 disease) was analyzed in 60 Japanese patients. The patients included in this study had received radical radiotherapy with long-term endocrinal manipulation in the period between 1993 and 2000. The median age of the patients was 70 years (range, 56–83). Neoadjuvant hormonal therapy with a median duration of 3.9 months was performed prior to radiotherapy, and hormonal therapy was continued until recurrence. A median dose of 61.4 Gy (range, 44–71.4) was delivered to the prostate. Pelvic node irradiation was performed in 49 patients (81.6%).
Results: After a median follow-up period of 28.5 months, the overall survival, cause-specific survival and biochemical relapse-free survival at 3 years were 94.4%, 96% and 89.8%, respectively. Local failure was observed in one patient, distant metastases were observed in three patients and a late toxic effect greater than Grade 2 was not observed in any patients.
Conclusions: This study, though preliminary due to a short-term follow-up period, reveals the possibility that modest doses of irradiation combined with long-term endocrinal treatment could be an effective means of achieving excellent local control of high-risk prostate cancer.
+ For reprints and all correspondence: Tomonari Sasaki, Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3–1–1, Higashi-ku, Fukuoka 812-8582, Japan. E-mail: tomonari{at}radiol.med.kyushu-u.ac.jp
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