International Journal of Clinical Oncology

, Volume 15, Issue 6, pp 571–577

Long-term outcomes of three-dimensional conformal radiation therapy combined with neoadjuvant hormonal therapy in Japanese patients with locally advanced prostate cancer

  • Masato Sakamoto
  • Takashi Mizowaki
  • Michihide Mitsumori
  • Kenji Takayama
  • Keisuke Sasai
  • Yoshiki Norihisa
  • Toshiyuki Kamoto
  • Eijiro Nakamura
  • Osamu Ogawa
  • Masahiro Hiraoka
Original Article

DOI: 10.1007/s10147-010-0109-y

Cite this article as:
Sakamoto, M., Mizowaki, T., Mitsumori, M. et al. Int J Clin Oncol (2010) 15: 571. doi:10.1007/s10147-010-0109-y

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

Keywords

Prostate cancerNeoadjuvant hormonal therapyThree-dimensional conformal radiation therapyPSA failureSalvage hormonal therapy

Copyright information

© Japan Society of Clinical Oncology 2010

Authors and Affiliations

  • Masato Sakamoto
    • 1
    • 2
  • Takashi Mizowaki
    • 1
  • Michihide Mitsumori
    • 1
  • Kenji Takayama
    • 1
  • Keisuke Sasai
    • 3
  • Yoshiki Norihisa
    • 1
  • Toshiyuki Kamoto
    • 4
  • Eijiro Nakamura
    • 4
  • Osamu Ogawa
    • 4
  • Masahiro Hiraoka
    • 1
  1. 1.Department of Radiation Oncology and Image-Applied TherapyKyoto University Graduate School of MedicineKyotoJapan
  2. 2.Department of RadiologyJapanese Red Cross Society Wakayama Medical CenterWakayamaJapan
  3. 3.Department of RadiologyJuntendo University School of MedicineTokyoJapan
  4. 4.Department of UrologyKyoto University Graduate School of MedicineKyotoJapan