Radical radiotherapy in high-risk prostate cancer patients with high or ultra-high initial PSA levels: a single institution analysis

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• 作者：Alessia Guarneri (1)
  Angela Botticella (1)
  Andrea Riccardo Filippi (1)
  Andrea Ruggieri (1)
  Cristina Piva (1)
  Fernando Munoz (1)
  Riccardo Ragona (1)
  Paolo Gontero (2)
  Umberto Ricardi (1)
  
• 关键词：High ; risk prostate cancer ; External beam radiotherapy ; Prostate ; specific antigen ; Gleason Score
• 刊名：Journal of Cancer Research and Clinical Oncology
• 出版年：2013
• 出版时间：July 2013
• 年：2013
• 卷：139
• 期：7
• 页码：1141-1147
• 全文大小：270KB
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• 作者单位：Alessia Guarneri (1)
  Angela Botticella (1)
  Andrea Riccardo Filippi (1)
  Andrea Ruggieri (1)
  Cristina Piva (1)
  Fernando Munoz (1)
  Riccardo Ragona (1)
  Paolo Gontero (2)
  Umberto Ricardi (1)
  
  1. Radiation Oncology, San Giovanni Battista Hospital, University of Torino, 10126, Turin, Italy
  2. Urology, San Giovanni Battista Hospital, University of Torino, 10126, Turin, Italy
  
• ISSN：1432-1335

文摘

Purpose Purpose of this study is to analyze outcomes and pre-treatment prognostic factors in high-risk prostate cancer patients with initial PSA??0?ng/mL, treated with high-dose external beam radiotherapy (EBRT) and androgen deprivation therapy (ADT) in a single institution. Methods Between March 2003 and December 2011, 155 consecutive high-risk prostate cancer patients (a) presenting with pre-treatment PSA level??0?ng/mL, (b) treated with definitive EBRT, and (c) with a minimum follow-up of 24?months were included in this retrospective analysis. Phoenix definition was used to define biochemical control. Primary endpoints were as follows: biochemical disease-free survival (bDFS), distant metastasis-free survival (DMFS), cancer-specific survival (CSS) and overall survival (OS). Multivariate analysis was performed to determine the independent prognostic impact of pre-treatment clinical factors [T stage, PSA, and Gleason score (GS)]. Results At a median follow-up time of 62?months, actuarial bDFS, DMFS, CSS, and OS at 5?years were 64.8, 85.2, 95.8, and 94.4?%, respectively. On multivariate analysis, only GS was significantly associated with three clinical endpoints (bDFS: HR 1.6; p?=?0.022, CSS: HR 4.27, p?=?0.044, OS: HR 2.6; p?=?0.038). Pre-treatment zenith PSA was associated only with bDFS (HR 1.87; p?=?0.027). Conclusions Patients with “high-PSA levels (?0?ng/mL) showed favorable clinical outcomes, supporting the role of local radiotherapy as primary therapy in combination with long-term ADT in patients with high PSA levels at diagnosis. A GS of 8-0 is the strongest predictor of outcome.