Long-term Results of External Beam Radiotherapy for Prostate Cancer with Prostate-specific Antigen of More Than 50 ng/ml and Without Evidence of Lymph Node or Distant Metastasis

Anticancer Res. 2018 Apr;38(4):2303-2309. doi: 10.21873/anticanres.12475.

Abstract

Background/aim: To evaluate long-term treatment outcomes of external beam radiotherapy for prostate cancer with a pretreatment prostate-specific antigen (PSA) level of more than 50 ng/ml and without evidence of lymph node or distant metastasis.

Patients and methods: Definitive radiotherapy of 66 Gy or 72 Gy in combination with androgen deprivation therapy (ADT) was performed. PSA relapse-free survival (PRFS), distant metastasis-free survival (DMFS), cause-specific survival (CSS), and overall survival (OS) were evaluated. The impact of prognostic factors on PRFS, DMFS, CSS, and OS was analyzed in univariate and multivariate analyses.

Results: One hundred twenty patients with a median follow-up period of 92.6 months were analyzed in this study. The median duration of ADT was 11.0 months. The 5- and 8-year PRFS rates in all patients were 65.1% and 48.5%, respectively. The 8-year DMFS, CSS, and OS rates in all patients were 84.0%, 93.4%, and 81.6%, respectively. Both in univariate and multivariate analyses, Gleason score (GS) and radiotherapy dose were significant prognostic factors (p=0.015 and 0.001). There was no significant difference between each prognostic factor in DMFS, CSS, and OS.

Conclusion: We might have indicated the significance of definitive radiotherapy even for prostate cancer with PSA of more than 50 ng/ml and without evidence of metastasis.

Keywords: Prostate cancer; androgen deprivation therapy; biochemical control; external beam radiotherapy; prostate-specific antigen.

MeSH terms

  • Adult
  • Aged
  • Disease-Free Survival
  • Follow-Up Studies
  • Humans
  • Lymph Nodes / pathology
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Prostate-Specific Antigen / blood*
  • Prostatic Neoplasms / blood*
  • Prostatic Neoplasms / pathology
  • Prostatic Neoplasms / radiotherapy*
  • Radiotherapy Dosage
  • Radiotherapy, Intensity-Modulated
  • Treatment Outcome

Substances

  • Prostate-Specific Antigen