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Ten-year outcomes of intensity-modulated radiation therapy combined with neoadjuvant hormonal therapy for intermediate- and high-risk patients with T1c-T2N0M0 prostate cancer

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Abstract

Background

We aimed to analyze the 10-year outcomes of intensity-modulated radiation therapy (IMRT) combined with neoadjuvant hormonal therapy (HT) for patients with intermediate- and high-risk T1c-T2N0M0 prostate cancer.

Methods

Fifty patients with T1c-T2N0M0 prostate cancer, who were treated with high-dose IMRT combined with neoadjuvant HT, were evaluated. Of these patients, 19 and 31 were classified into the intermediate- and high-risk groups, respectively. Neoadjuvant HT was administered over a median duration of 6 months; 74 and 78 Gy in 2 Gy per fraction were essentially delivered to the intermediate- and high-risk cases, respectively. Adjuvant HT was not administered to any of the patients after the completion of IMRT.

Results

Over a median follow-up period of 118 months, the 10-year prostate-specific antigen failure-free survival, prostate-specific antigen failure-free, salvage hormonal therapy-free, prostate cancer-specific survival, and overall survival rates were 70.2 %, 78.7 %, 89.2 %, 100 %, and 88.8 %, respectively. No grade 3 or higher acute or late toxicities were observed. The 10-year likelihoods of developing grade 2 late urinary and rectal toxicities were 13.7 % and 4.2 %, respectively. Compared with the outcomes of a cohort of historical controls who were locally irradiated with 70 Gy by three-dimensional conformal radiotherapy, the prostate-specific antigen failure-free rate was significantly better in the IMRT groups (78.7 % vs. 53.4 % at 10 years; p = 0.027).

Conclusions

High-dose IMRT combined with neoadjuvant HT achieved not only high prostate-specific antigen control, but also excellent survival outcomes with acceptable morbidities, for a Japanese cohort of intermediate- and high-risk T1c-T2N0M0 prostate cancer patients, and these results warrant further investigation.

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Acknowledgments

This work was supported, in part, by Grants-in-Aid for scientific research from the Ministry of Education, Culture, Sports, Science, and Technology (24591838) Japan and New Energy and Industrial Technology Development Organization (NEDO). The funding programs had no effects on the study design or interpretation of data.

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Authors and Affiliations

  1. Department of Radiation Oncology and Image-applied Therapy, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan

    Takashi Mizowaki, Yoshiki Norihisa, Kenji Takayama, Itaru Ikeda, Haruo Inokuchi, Kiyonao Nakamura & Masahiro Hiraoka

  2. Department of Urology, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-Ku, Kyoto, 606-8507, Japan

    Tomomi Kamba, Takahiro Inoue, Toshiyuki Kamoto & Osamu Ogawa

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  1. Takashi Mizowaki
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  2. Yoshiki Norihisa
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  3. Kenji Takayama
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  4. Itaru Ikeda
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Correspondence to Takashi Mizowaki.

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Mizowaki, T., Norihisa, Y., Takayama, K. et al. Ten-year outcomes of intensity-modulated radiation therapy combined with neoadjuvant hormonal therapy for intermediate- and high-risk patients with T1c-T2N0M0 prostate cancer. Int J Clin Oncol 21, 783–790 (2016). https://doi.org/10.1007/s10147-016-0954-4

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