Long-Term Outcomes of a Phase I Trial of Weekly Docetaxel, Total Androgen Blockade, and Image Guided Intensity Modulated Radiation Therapy for Localized High-Risk Prostate Adenocarcinoma

Shauna McVorran; Thomas Keane; David T Marshall

doi:10.1016/j.adro.2022.100935

Long-Term Outcomes of a Phase I Trial of Weekly Docetaxel, Total Androgen Blockade, and Image Guided Intensity Modulated Radiation Therapy for Localized High-Risk Prostate Adenocarcinoma

Adv Radiat Oncol. 2022 Mar 10;7(6):100935. doi: 10.1016/j.adro.2022.100935. eCollection 2022 Nov-Dec.

Authors

Shauna McVorran¹, Thomas Keane², David T Marshall³

Affiliations

¹ Department of Radiation Oncology, Moffitt Cancer Center, Tampa, Florida.
² Department of Urology, Medical University of South Carolina, Charleston, South Carolina.
³ Department of Radiation Oncology, Medical University of South Carolina, Charleston, South Carolina.

Abstract

Purpose: Our purpose was to describe the long-term outcomes seen with the addition of concurrent weekly docetaxel to high-dose intensity modulated radiation (IMRT) to the prostate and androgen deprivation therapy in patients with high-risk nonmetastatic adenocarcinoma of the prostate.

Methods and materials: Nineteen patients with high-risk, localized prostate cancer were treated in a phase I trial with concurrent docetaxel at doses of 10 to 30 mg/m², in a dose-escalated scheme, in addition to IMRT (77.4 Gy/43 fx) and neoadjuvant and concurrent combined androgen blockade (gonadotropin-releasing hormone agonist and antiandrogen). A gonadotropin-releasing hormone agonist was continued for an additional 24 months post radiation. Kaplan-Meier analysis was used to estimate the survival probabilities.

Results: At a median follow-up of 10.5 years, 5-year and 10-year overall survival were found to be 89.5% and 68.4%, respectively. The median metastasis-free survival and progression-free survival were determined to be 11.3 years and 9.0 years, respectively.

Conclusions: This regimen produced a 10-year overall survival of 68% with a 10-year metastasis-free survival of 58%. Grade >2 toxicity was minimal. These limited data suggest that the addition of concurrent weekly docetaxel to high-dose IMRT for high-risk prostate cancer warrants further investigation.