Hypofractionated radiation therapy combined with androgen deprivation therapy for clinically node-positive prostate cancer
- Author:
Tae Hoon LEE
1
;
Hongryull PYO
;
Gyu Sang YOO
;
Seong Soo JEON
;
Seong Il SEO
;
Byong Chang JEONG
;
Hwang Gyun JEON
;
Hyun Hwan SUNG
;
Minyong KANG
;
Wan SONG
;
Jae Hoon CHUNG
;
Bong Kyung BAE
;
Won PARK
Author Information
- Publication Type:Original Article
- From:Radiation Oncology Journal 2024;42(2):139-147
- CountryRepublic of Korea
- Language:English
-
Abstract:
Purpose:This study aimed to analyze the treatment outcomes of combined definitive radiation therapy (RT) and androgen deprivation therapy (ADT) for clinically node-positive prostate cancer.
Materials and Methods:Medical records of 60 patients with clinically suspected metastatic lymph nodes on radiological examination were retrospectively analyzed. Eight patients (13.3%) were suspected to have metastatic common iliac or para-aortic lymph nodes. All patients underwent definitive RT with a dose fractionation of 70 Gy in 28 fractions. ADT was initiated 2–3 months before RT and continued for at least 2 years. Biochemical failure rate (BFR), clinical failure rate (CFR), overall survival (OS), and prostate cancer-specific survival (PCSS) were calculated, and genitourinary and gastrointestinal adverse events were recorded.
Results:The median follow-up period was 5.47 years. The 5-year BFR, CFR, OS, and PCSS rates were 19.1%, 11.3%, 89.0%, and 98.2%, respectively. The median duration of ADT was 2.30 years. BFR and CFR increased after 3 years, and 11 out of 14 biochemical failures occurred after the cessation of ADT. Grade 2 and beyond late genitourinary and gastrointestinal toxicity rates were 5.0% and 13.3%, respectively. However, only two grade 3 adverse events were reported, and no grade 4–5 adverse events were reported. Patients with non-regional lymph node metastases did not have worse BFR, CFR, or adverse event rates.
Conclusion:This study reported the efficacy and tolerable toxicity of hypofractionated definitive RT combined with ADT for clinically node-positive prostate cancer. Additionally, selected patients with adjacent non-regional lymph node metastases might be able to undergo definitive RT combined with ADT.
