• Int. J. Radiat. Oncol. Biol. Phys. · Jun 2004

    External beam radiotherapy for clinically node-negative, localized hormone-refractory prostate cancer: impact of pretreatment PSA value on radiotherapeutic outcomes.

    • Tetsuo Akimoto, Yoshizumi Kitamoto, Jun-Ichi Saito, Koichi Harashima, Takashi Nakano, Kazuto Ito, Takumi Yamamoto, Kouhei Kurokawa, Hidetoshi Yamanaka, Mitsuhiro Takahashi, Norio Mitsuhashi, and Hideo Niibe.
    • Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Japan. takimoto@showa.gunma-u.ac.jp
    • Int. J. Radiat. Oncol. Biol. Phys. 2004 Jun 1; 59 (2): 372-9.

    PurposeTo analyze the results of clinically node-negative, localized hormone-refractory prostate cancer treated with external beam radiotherapy (EBRT) and to investigate the potential prognostic factors that influenced the therapeutic outcome.Methods And MaterialsFifty-three patients who had developed localized hormone-refractory prostate cancer were treated with EBRT between 1994 and 2001. According to the 1992 American Joint Committee on Cancer clinical stage, 4 patients had T2 and 49 had T3 at the start of RT, and 14 patients had a Gleason score <7, 14 had a Gleason score of 7, and 23 had a Gleason score of 8-10. All patients were treated with EBRT using the unblocked oblique four-field technique, with a total dose of 69 Gy. The fraction dose was 3 Gy three times weekly. The median follow-up after RT was 35 months (range, 8-96 months) and after androgen ablation was 73 months (range, 42-156 months).ResultsOf 53 patients, 15 patients subsequently developed clinical relapse, including locoregional and/or distant metastases. The site of first relapse was bone metastasis in 10, lymph nodes in 3, and local failure in 2 patients; 3 patients died of prostate cancer during the analysis period. The 3-year and 5-year cause-specific survival rate was 94% and 87%, respectively, and the 3-year and 5-year clinical relapse-free survival rate was 78% and 56%, respectively. The univariate analysis revealed that a short prostate-specific antigen (PSA) doubling time and high PSA value at the start of RT and a high Gleason score were statistically significant factors for the risk of clinical relapse. Multivariate analysis demonstrated that the PSA value (PSA or=15 ng/mL) at the start of RT was an independent prognostic factor.ConclusionEBRT could be a treatment of choice for clinically node-negative, localized, hormone-refractory prostate cancer.

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