Long-term outcomes of three-dimensional conformal radiation therapy combined with neoadjuvant hormonal therapy in Japanese patients with locally advanced prostate cancer
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The outcomes of three-dimensional conformal radiation therapy (3D-CRT) combined with neoadjuvant hormonal therapy (NAHT) in Japanese patients with locally advanced prostate cancer who initiated salvage hormonal therapy (SHT) at a relatively early phase were evaluated.
Between April 1998 and April 2003, 70 Japanese patients with T3N0M0 prostate cancer who received radical 3D-CRT treatment were evaluated. The median age, initial prostate-specific antigen (PSA) level, and duration of NAHT were 73 years old, 26.3 ng/ml, and 4 months, respectively. Seventy grays were given in 35 fractions that were confined to the prostate and seminal vesicles. Adjuvant hormonal therapy was not administered after 3D-CRT in any of the cases.
The median follow-up period was 64.9 months. The median PSA value at the time of initiation of SHT was 5.0 ng/ml (range 0.1–21.6 ng/ml). Overall, disease-specific, PSA failure-free (based on the Phoenix definition) and SHT-free survival rates at 5 years were 90.3% (95% CI 86.5–94.0), 96.5% (94.0–98.9), 60.5% (48.2–72.7), and 63.5% (57.2–69.8), respectively. Therefore, two-thirds of the patients were still hormone-free at 5 years.
PSA control rates in our series of Japanese patients with stage T3N0M0 prostate cancer treated with the standard dose of 3D-CRT combined with NAHT seemed higher than expected. This approach involving 3D-CRT combined with NAHT with the initiation of SHT at PSA values of around 5 ng/ml may be one option for Japanese patients with locally advanced prostate cancer, although further prospective study is required to confirm the validity.
- Long-term outcomes of three-dimensional conformal radiation therapy combined with neoadjuvant hormonal therapy in Japanese patients with locally advanced prostate cancer
International Journal of Clinical Oncology
Volume 15, Issue 6 , pp 571-577
- Cover Date
- Print ISSN
- Online ISSN
- Springer Japan
- Additional Links
- Prostate cancer
- Neoadjuvant hormonal therapy
- Three-dimensional conformal radiation therapy
- PSA failure
- Salvage hormonal therapy
- Industry Sectors
- Author Affiliations
- 1. Department of Radiation Oncology and Image-Applied Therapy, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
- 2. Department of Radiology, Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan
- 3. Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan
- 4. Department of Urology, Kyoto University Graduate School of Medicine, Kyoto, Japan