Achieving PSA < 0.2 ng/ml before Radiation Therapy Is a Strong Predictor of Treatment Success in Patients with High-Risk Locally Advanced Prostate Cancer. (9th October 2019)

• Record Type: Journal Article
• Authors: Kazama, Akira; Saito, Toshihiro; Takeda, Keisuke; Kobayashi, Kazuhiro; Tanikawa, Toshiki; Kanemoto, Ayae; Ayukawa, Fumio; Matsumoto, Yasuo; Sugita, Tadashi; Hara, Noboru; Tomita, Yoshihiko
• Other Names: Magi-Galluzzi Cristina Academic Editor.
• Is Part Of: Prostate cancer. Volume 2019(2019)
• Publication Date: 2019-10-09
• Subjects: Prostate -- Cancer -- Periodicals; Prostate -- Cancer -- Surgery -- Periodicals; 616.99463
• DOI: 10.1155/2019/4050352
• Languages: English
• ISSNs: 2090-3111

Abstract

Abstract : Background . To predict long-term treatment outcome of radiation therapy (RT) plus androgen deprivation therapy (ADT) for high-risk locally advanced prostate cancer. Methods . In total, 204 patients with the National Comprehensive Cancer Network (NCCN) high risk locally advanced prostate cancer (PSA &gt; 20 ng/ml, Gleason score ≧ 8, clinical T stage ≧ 3a) were treated with definitive RT with ADT. Median follow up period was 113 months (IQR: 95–128). Median neoadjuvant ADT and total ADT duration were 7 months (IQR: 6–10) and 27 months (IQR: 14–38), respectively. Results . PSA recurrence-free survival (PSA-RFS), cancer specific survival (CSS), and overall survival (OS) rates at 5 years were 84.1%, 98.5%, and 93.6%, respectively, and 67.9%, 91.2%, and 78.1%, respectively, at 10 years. Pre-RT PSA less than 0.2 ng/ml was associated with superior outcomes of PSA-RFS (HR = 0.42, 95% CI: 0.25–0.70, p = 0.001 ), CSS (HR = 0.27, 95% CI: 0.09–0.82, p = 0.013 ), and OS (HR = 0.48, 95% CI: 0.26–0.91, p = 0.021 ). On multivariate analysis, age (≥70 y.o.) and pre-RT PSA (≥0.2 ng/ml) were factors predictive of poorer OS (p = 0.032 ), but iPSA, T stage, Gleason score, number of NCCN high-risk criteria, a combination with anti-androgen therapy and neoadjuvant ADT duration were not predictive of treatment outcome. Conclusion . In patient with high-risk prostate cancer, RT plus ADT achieved good oncologic outcomes. PSA &lt; 0.2 ng/ml before radiation therapy is a strong independent predictor for long overall survival.