Optimal ADT for high risk 24m plus

[JimmyToowong]

Urol Int. 2011 Jun 23. [Epub ahead of print]

Optimal Duration of Androgen Deprivation in Combination with Radiation Therapy for Japanese Men with High-Risk Prostate Cancer.

Takaha N, Okihara K, Kamoi K, Kimura Y, Yamada T, Kawauchi A, Kobayashi K, Yamazaki H, Nishimura T, Miki T.

Source

Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Abstract

Objectives: To evaluate the efficacy and toxicity of external beam radiation therapy (EBRT) combined with androgen deprivation therapy (ADT) for Japanese high-risk prostate cancer (PCa) patients in a single institution. Methods: Seventy-five high-risk PCa patients were treated by three-dimensional conformal radiotherapy of 70 Gy combined with neoadjuvant, concurrent and adjuvant ADT.

RESULTS: Median age was 72 (59-82) years. Median initial serum prostate-specific antigen (PSA) was 19.0 (4.7-200) ng/ml. Median duration of the entire ADT was 27 (8-63) months. Median follow-up after initiating ADT and after completing EBRT was 66 (41-105) and 59 (36-94) months, respectively. Five-year overall, clinical progression-free, and biochemical progression-free survival rates were 98.3, 97.2, and 87.4%; 2 (2.7%) cancer deaths, 3 (4.0%) clinical progressions, and 11 (14.7%) biochemical progressions. Multivariate analysis suggested a total duration of ADT shorter than 24 months as an independent risk factor of biochemical progression (p = 0.01). Grade 3 toxicities related to EBRT were observed: 1 patient with proctitis and rectal bleeding and 1 patient with rectal bleeding.

CONCLUSIONS: It is suggested that 70 Gy EBRT combined with ADT confers disease-free survival benefit with tolerable adverse events for Japanese high-risk PCa patients. ADT of 24 months or longer might be recommended to minimize biochemical progression.

Copyright © 2011 S. Karger AG, Basel.

PMID: 21701133 Forum: Primary hormone therapy Title: Optimal ADT for high risk 24m plus

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