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Urologia internationalis · Jan 2011
Optimal duration of androgen deprivation in combination with radiation therapy for Japanese men with high-risk prostate cancer.
- Natsuki Takaha, Koji Okihara, Kazumi Kamoi, Yasunori Kimura, Takeshi Yamada, Akihiro Kawauchi, Kana Kobayashi, Hideya Yamazaki, Tsunehiko Nishimura, and Tsuneharu Miki.
- Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan. ntakaha @ koto.kpu-m.ac.jp
- Urol. Int. 2011 Jan 1;87(1):28-34.
ObjectivesTo evaluate the efficacy and toxicity of external beam radiation therapy (EBRT) combined with androgen deprivation therapy (ADT) for Japanese high-risk prostate cancer (PCa) patients in a single institution.MethodsSeventy-five high-risk PCa patients were treated by three-dimensional conformal radiotherapy of 70 Gy combined with neoadjuvant, concurrent and adjuvant ADT.ResultsMedian age was 72 (59-82) years. Median initial serum prostate-specific antigen (PSA) was 19.0 (4.7-200) ng/ml. Median duration of the entire ADT was 27 (8-63) months. Median follow-up after initiating ADT and after completing EBRT was 66 (41-105) and 59 (36-94) months, respectively. Five-year overall, clinical progression-free, and biochemical progression-free survival rates were 98.3, 97.2, and 87.4%; 2 (2.7%) cancer deaths, 3 (4.0%) clinical progressions, and 11 (14.7%) biochemical progressions. Multivariate analysis suggested a total duration of ADT shorter than 24 months as an independent risk factor of biochemical progression (p = 0.01). Grade 3 toxicities related to EBRT were observed: 1 patient with proctitis and rectal bleeding and 1 patient with rectal bleeding.ConclusionsIt is suggested that 70 Gy EBRT combined with ADT confers disease-free survival benefit with tolerable adverse events for Japanese high-risk PCa patients. ADT of 24 months or longer might be recommended to minimize biochemical progression.Copyright © 2011 S. Karger AG, Basel.
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