TY - JOUR
T1 - Dose escalation of external beam radiotherapy for high-risk prostate cancer—Impact of multiple high-risk factor
AU - Umezawa, Rei
AU - Inaba, Koji
AU - Nakamura, Satoshi
AU - Wakita, Akihisa
AU - Okamoto, Hiroyuki
AU - Tsuchida, Keisuke
AU - Kashihara, Tairo
AU - Kobayashi, Kazuma
AU - Harada, Ken
AU - Takahashi, Kana
AU - Murakami, Naoya
AU - Ito, Yoshinori
AU - Igaki, Hiroshi
AU - Jingu, Keiichi
AU - Itami, Jun
N1 - Funding Information:
This work was supported in part by the Research and Development Fund of the National Cancer Center and by the Practical Research for Innovative Cancer Control from the Japan Agency for Medical Research and Development ( AMED ) (26-A-18 and 26-A-28).
Publisher Copyright:
© 2019 Editorial Office of Asian Journal of Urology
PY - 2019/4
Y1 - 2019/4
N2 - Objective: To retrospectively investigate the treatment outcomes of external beam radiotherapy with androgen deprivation therapy (ADT) in high-risk prostate cancer in three radiotherapy dose groups. Methods: Between 1998 and 2013, patients with high-risk prostate cancer underwent three-dimensional conformal radiotherapy or intensity-modulated radiotherapy of 66 Gy, 72 Gy, or 78 Gy with ADT. Prostate-specific antigen (PSA) relapse was defined using the Phoenix definition. PSA relapse-free survival (PRFS) was evaluated in each radiotherapy dose group. Moreover, high-risk patients were divided into H-1 (patients with multiple high-risk factors) and H-2 (patients with a single high-risk factor) as risk subgroups. Results: Two hundred and eighty-nine patients with a median follow-up period of 77.3 months were analyzed in this study. The median duration of ADT was 10.1 months. Age, Gleason score, T stage, and radiotherapy dose influenced PRFS with statistical significance both in univariate and multivariate analyses. The 4-year PRFS rates in Group-66 Gy, Group-72 Gy and Group-78 Gy were 72.7%, 81.6% and 90.3%, respectively. PRFS rates in the H-1 subgroup differed with statistical significance with an increasing radiotherapy dose having a more favorable PRFS, while PRFS rates in H-2 subgroup did not differ with increase in radiotherapy dose. Conclusion: Dose escalation for high-risk prostate cancer in combination with ADT improved PRFS. PRFS for patients in the H-1 subgroup was poor, but dose escalation in those patients was beneficial, while dose escalation in the H-2 subgroup was not proven to be effective for improving PRFS.
AB - Objective: To retrospectively investigate the treatment outcomes of external beam radiotherapy with androgen deprivation therapy (ADT) in high-risk prostate cancer in three radiotherapy dose groups. Methods: Between 1998 and 2013, patients with high-risk prostate cancer underwent three-dimensional conformal radiotherapy or intensity-modulated radiotherapy of 66 Gy, 72 Gy, or 78 Gy with ADT. Prostate-specific antigen (PSA) relapse was defined using the Phoenix definition. PSA relapse-free survival (PRFS) was evaluated in each radiotherapy dose group. Moreover, high-risk patients were divided into H-1 (patients with multiple high-risk factors) and H-2 (patients with a single high-risk factor) as risk subgroups. Results: Two hundred and eighty-nine patients with a median follow-up period of 77.3 months were analyzed in this study. The median duration of ADT was 10.1 months. Age, Gleason score, T stage, and radiotherapy dose influenced PRFS with statistical significance both in univariate and multivariate analyses. The 4-year PRFS rates in Group-66 Gy, Group-72 Gy and Group-78 Gy were 72.7%, 81.6% and 90.3%, respectively. PRFS rates in the H-1 subgroup differed with statistical significance with an increasing radiotherapy dose having a more favorable PRFS, while PRFS rates in H-2 subgroup did not differ with increase in radiotherapy dose. Conclusion: Dose escalation for high-risk prostate cancer in combination with ADT improved PRFS. PRFS for patients in the H-1 subgroup was poor, but dose escalation in those patients was beneficial, while dose escalation in the H-2 subgroup was not proven to be effective for improving PRFS.
KW - Biochemical control
KW - Dose escalation
KW - External beam radiotherapy
KW - Prostate cancer
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U2 - 10.1016/j.ajur.2017.07.002
DO - 10.1016/j.ajur.2017.07.002
M3 - Article
AN - SCOPUS:85040124013
SN - 2214-3882
VL - 6
SP - 192
EP - 199
JO - Asian Journal of Urology
JF - Asian Journal of Urology
IS - 2
ER -
