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Outcomes after adjuvant radiation therapy for prostate cancer at a comprehensive cancer center

  • Original Research
  • Published:
Journal of Radiation Oncology

Abstract

Objectives

Randomized trials have shown that adjuvant radiation therapy improves prostate cancer control for men with adverse surgical pathology. We report cancer control outcomes for men who received adjuvant radiation at The University of Texas MD Anderson Cancer Center (MDACC).

Methods

We identified men who received adjuvant radiation within 12 months of prostatectomy from 1987 through 2010. All men had PSA <0.2 ng/mL at time of RT. Failure was defined as either a rising post-radiation PSA of at least 0.2 ng/mL; or local, nodal, or distant recurrence; or the initiation of salvage treatment.

Results

A total of 137 men received adjuvant radiation. Most men had positive margins (N = 127, 92.7 %) and extraprostatic extension (N = 98, 71.5 %). Thirty-eight percent had Gleason 8–9 disease (N = 52) at prostatectomy. Median radiation dose was 60 Gy (IQR 60–66 Gy). Few men (N = 24, 17.5 %) received concurrent hormone therapy with radiation. Five-year failure for the entire cohort was 11.9 % and 10-year failure was 16 %. Gleason score was the only factor significantly associated with failure. Five- and 10-year failure for men with Gleason 8–9 disease were 18.4 and 20.8 %, while 5- and 10-year failure for men with Gleason <8 disease were 6.7 and 11.9 % (p = 0.013). Radiation dose (<66 Gy versus ≥66 Gy), margin status, and receiving hormone therapy were not associated with failure.

Conclusions

At MDACC, men referred for adjuvant radiation often have margin involvement and/or extraprostatic extension. Patients did well overall, with high 5- and 10-year freedom from failure. Gleason 8–9 disease was associated with increased failure after adjuvant radiation.

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Acknowledgments

This work was presented, in abstract form, at the 97th Annual Meeting of the American Radium Society May 4, 2015 in Kauai, HI.

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Authors and Affiliations

  1. Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1202, Houston, TX, 77030, USA

    Emma B. Holliday, Deborah A. Kuban, Lawrence Levy, Priya Master, Seungtaek Choi, Steven J. Frank, Sean E. McGuire, Usama Mahmood, Thomas J. Pugh & Karen E. Hoffman

  2. Department of Radiation Oncology, Ege University School of Medicine, Izmir, Turkey

    Yasemin Bolukbasi

Authors
  1. Emma B. Holliday
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  2. Deborah A. Kuban
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Corresponding author

Correspondence to Karen E. Hoffman.

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Funding source(s)

There were no funding sources for this work.

Conflict of interest

Emma B. Holliday, Deborah A. Kuban, Yasemin Bolukbasi, Lawrence Levy, Priya Master, Seungtaek Choi, Steve J. Frank, Sean E. McGuire, Usama Mahmood, Thomas J. Pugh, and Karen E. Hoffman declare that they have no conflict of interest.

Ethical approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008.

Informed consent

Due to the retrospective nature of this research, informed consent was not deemed necessary by the institutional review board.

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Holliday, E.B., Kuban, D.A., Bolukbasi, Y. et al. Outcomes after adjuvant radiation therapy for prostate cancer at a comprehensive cancer center. J Radiat Oncol 5, 287–292 (2016). https://doi.org/10.1007/s13566-016-0248-5

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  • DOI: https://doi.org/10.1007/s13566-016-0248-5

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