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International Journal of Clinical Oncology

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01-08-2016 | Original Article

Ten-year outcomes of intensity-modulated radiation therapy combined with neoadjuvant hormonal therapy for intermediate- and high-risk patients with T1c-T2N0M0 prostate cancer

Authors: Takashi Mizowaki, Yoshiki Norihisa, Kenji Takayama, Itaru Ikeda, Haruo Inokuchi, Kiyonao Nakamura, Tomomi Kamba, Takahiro Inoue, Toshiyuki Kamoto, Osamu Ogawa, Masahiro Hiraoka

Published in: International Journal of Clinical Oncology | Issue 4/2016

Abstract

Background

We aimed to analyze the 10-year outcomes of intensity-modulated radiation therapy (IMRT) combined with neoadjuvant hormonal therapy (HT) for patients with intermediate- and high-risk T1c-T2N0M0 prostate cancer.

Methods

Fifty patients with T1c-T2N0M0 prostate cancer, who were treated with high-dose IMRT combined with neoadjuvant HT, were evaluated. Of these patients, 19 and 31 were classified into the intermediate- and high-risk groups, respectively. Neoadjuvant HT was administered over a median duration of 6 months; 74 and 78 Gy in 2 Gy per fraction were essentially delivered to the intermediate- and high-risk cases, respectively. Adjuvant HT was not administered to any of the patients after the completion of IMRT.

Results

Over a median follow-up period of 118 months, the 10-year prostate-specific antigen failure-free survival, prostate-specific antigen failure-free, salvage hormonal therapy-free, prostate cancer-specific survival, and overall survival rates were 70.2 %, 78.7 %, 89.2 %, 100 %, and 88.8 %, respectively. No grade 3 or higher acute or late toxicities were observed. The 10-year likelihoods of developing grade 2 late urinary and rectal toxicities were 13.7 % and 4.2 %, respectively. Compared with the outcomes of a cohort of historical controls who were locally irradiated with 70 Gy by three-dimensional conformal radiotherapy, the prostate-specific antigen failure-free rate was significantly better in the IMRT groups (78.7 % vs. 53.4 % at 10 years; p = 0.027).

Conclusions

High-dose IMRT combined with neoadjuvant HT achieved not only high prostate-specific antigen control, but also excellent survival outcomes with acceptable morbidities, for a Japanese cohort of intermediate- and high-risk T1c-T2N0M0 prostate cancer patients, and these results warrant further investigation.

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Title: Ten-year outcomes of intensity-modulated radiation therapy combined with neoadjuvant hormonal therapy for intermediate- and high-risk patients with T1c-T2N0M0 prostate cancer
Authors: Takashi Mizowaki
Yoshiki Norihisa
Kenji Takayama
Itaru Ikeda
Haruo Inokuchi
Kiyonao Nakamura
Tomomi Kamba
Takahiro Inoue
Toshiyuki Kamoto
Osamu Ogawa
Masahiro Hiraoka
Publication date: 01-08-2016
Publisher: Springer Japan
Published in: International Journal of Clinical Oncology / Issue 4/2016
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-016-0954-4

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Abstract

Background

Methods

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Conclusions

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