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Strahlentherapie und Onkologie
Published in: Strahlentherapie und Onkologie 10/2019

01-10-2019 | Prostate Cancer | Original Article

Treatment outcomes of prostate cancer patients with Gleason score 8–10 treated with definitive radiotherapy

TROD 09-001 multi-institutional study

Authors: Chair&Professor Gokhan Ozyigit, M.D., Cem Onal, M.D., Sefik Igdem, M.D., Zumre Arican Alicikus, M.D., Ayca Iribas, M.D., Mustafa Akin, M.D., Deniz Yalman, M.D., Ilknur Cetin, M.D., Melek Gamze Aksu, M.D., Banu Atalar, M.D., Fazilet Dincbas, M.D., Pervin Hurmuz, M.D., Ozan Cem Guler, M.D., Barbaros Aydin, M.D., Fatma Sert, M.D., Cumhur Yildirim, M.D., Ilknur Birkay Gorken, M.D., Fulya Yaman Agaoglu, M.D., Aylin Fidan Korcum, M.D., Deniz Yuce, M.D., Ph.D., Serdar Ozkok, M.D., Emin Darendeliler, M.D., Fadil Akyol, M.D.

Published in: Strahlentherapie und Onkologie | Issue 10/2019

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Abstract

Purpose

To validate the clinical outcomes and prognostic factors in prostate cancer (PCa) patients with Gleason score (GS) 8–10 disease treated with external beam radiotherapy (EBRT) + androgen deprivation therapy (ADT) in the modern era.

Methods

Institutional databases of biopsy proven 641 patients with GS 8–10 PCa treated between 2000 and 2015 were collected from 11 institutions. In this multi-institutional Turkish Radiation Oncology Group study, a standard database sheet was sent to each institution for patient enrollment. The inclusion criteria were, T1–T3N0M0 disease according to AJCC (American Joint Committee on Cancer) 2010 Staging System, no prior diagnosis of malignancy, at least 70 Gy total irradiation dose to prostate ± seminal vesicles delivered with either three-dimensional conformal RT or intensity-modulated RT and patients receiving ADT.

Results

The median follow-up time was 5.9 years (range 0.4–18.2 years); 5‑year overall survival (OS), biochemical relapse-free survival (BRFS) and distant metastases-free survival (DMFS) rates were 88%, 78%, and 79%, respectively. Higher RT doses (≥78 Gy) and longer ADT duration (≥2 years) were significant predictors for improved DMFS, whereas advanced stage was a negative prognosticator for DMFS in patients with GS 9–10.

Conclusions

Our results validated the fact that oncologic outcomes after radical EBRT significantly differ in men with GS 8 versus those with GS 9–10 prostate cancer. We found that EBRT dose was important predictive factor regardless of ADT period. Patients receiving ‘non-optimal treatment’ (RT doses <78 Gy and ADT period <2 years) had the worst treatment outcomes.
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Metadata
Title
Treatment outcomes of prostate cancer patients with Gleason score 8–10 treated with definitive radiotherapy
TROD 09-001 multi-institutional study
Authors
Chair&Professor Gokhan Ozyigit, M.D.
Cem Onal, M.D.
Sefik Igdem, M.D.
Zumre Arican Alicikus, M.D.
Ayca Iribas, M.D.
Mustafa Akin, M.D.
Deniz Yalman, M.D.
Ilknur Cetin, M.D.
Melek Gamze Aksu, M.D.
Banu Atalar, M.D.
Fazilet Dincbas, M.D.
Pervin Hurmuz, M.D.
Ozan Cem Guler, M.D.
Barbaros Aydin, M.D.
Fatma Sert, M.D.
Cumhur Yildirim, M.D.
Ilknur Birkay Gorken, M.D.
Fulya Yaman Agaoglu, M.D.
Aylin Fidan Korcum, M.D.
Deniz Yuce, M.D., Ph.D.
Serdar Ozkok, M.D.
Emin Darendeliler, M.D.
Fadil Akyol, M.D.
Publication date
01-10-2019
Publisher
Springer Berlin Heidelberg
Published in
Strahlentherapie und Onkologie / Issue 10/2019
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI
https://doi.org/10.1007/s00066-019-01476-z

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