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Analysis of survival in radical and postoperative radiotherapy for prostate cancer.

Abstract

PURPOSE
To analyze survival and complications in high dose 3D conformal radiotherapy (3DCRT) patients treated with curative and post-operative intent and compare radical surgery + radiotherapy (RT) patients vs. RT only patients.
MATERIAL AND METHOD
103 patients were treated curatively (RAD), 94 postoperatively (POST-OP). The mean age was higher in RAD group (72.6 years, range 56.4-85.1) than in POST-OP group (65.4 years, 43.9-77) (p < 0.0001). According to NCCN prognostic classification 13 (12%) patients was low risk, 48 (47%) intermediate risk and 42 (41%) high risk in RAD group. In POST-OP group 13 (14%) patients were low risk, 37 (40%) intermediate risk and 44 (46%) high risk. Hormone Therapy (HT) was administered in 98 patients (95%) in RAD and in 45 patients (47.8%) in POST-OP. Patients were treated with a three-dimensional conformal radiotherapy (3D-CRT). In RAD 15 (15%) were alive with disease (AWD), 5 (5%) dead of disease (DOD) and 10 (10%) dead of other cause (DOC); in POST-OP 14 (14.8%) were AWD, 2 (2%) DOD and 3 (3%) DOC. The prescription dose was 80 Gy in 2-Gy fractions in the RAD group, and 70 Gy in 2-Gy fractions in the POST-OP, respectively.
RESULTS
No biochemical or clinical relapse was found in low risk patients in RAD group and 1 relapse in POST-OP group. The largest number of relapses occurred and in intermediate-high risk in RAD (39%) and POST-OP group (33%). In the cause-specific survival analysis no significant differences were found in high risk group between RAD and POST-OP (p = 0.9). In the biochemical relapse-free survival (bRFS) at 5 years analysis no significant differences were found in the high risk group between RAD and POST-OP (p = 0.1020).
CONCLUSION
RT in RAD low- risk is very effectiva. RAD and POST-OP RT were well tolerated with a very low toxicity. The cause-specific survival at 5 years was 95% and 97% for the two groups of treatment, RAD and POST-OP respectively (Log-rank test p = 0.2908).

Authors

Tramacere F, Gianicolo EA, Pignatelli A, Portaluri M

Institution

Radiotherapy Dept, ASL BR, Ospedale "A. Perrino", Brindisi, Italy. francescotramacere@libero.it

Source

Archivio italiano di urologia, andrologia : organo ufficiale [di] Società italiana di ecografia urologica e nefrologica / Associazione ricerche in urologia 83:4 2011 Dec pg 188-94

MeSH

Adult
Aged
Aged, 80 and over
Algorithms
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Neoplasm Invasiveness
Neoplasm Staging
Postoperative Care
Prognosis
Prostatectomy
Prostatic Neoplasms
Radiotherapy Dosage
Radiotherapy Planning, Computer-Assisted
Radiotherapy, Adjuvant
Radiotherapy, Conformal
Retrospective Studies
Treatment Outcome

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

22670316