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• W2058961384 abstract "To analyze the long-term biochemical outcome of clinical stage T3 prostate cancer patients treated with high-dose radiotherapy (HDRT) and risk-adapted androgen deprivation (AD) in a single institution. To determine in this population of T3 disease the prognostic impact of pre-treatment PSA, Gleason score, radiation dose and length of AD. Between 1995 and 2008, 588 localized prostate cancer patients were treated in a radiation dose escalation program. For the present study, we selected the population of 209 patients with clinical stage T3 prostate cancer. The median ICRU radiation dose was 78,4 Gy (range 66,0 Gy - 84,1 Gy). Long-term AD (LTAD) was administered to 178 patients and short-term AD (STAD) was given to 31 patients. Phoenix (nadir+2ng/ml) consensus definition was used for biochemical control. Unfavourable pre-treatment PSA was defined as PSA level more than 10 ng/ml and unfavourable Gleason score was defined as more than 6. According to these factors, T3 disease was classified as low risk (LR) when there were not unfavourable PSA or Gleason score; intermediate risk (IR) when there was only one unfavourable factor (PSA or Gleason) and high risk (HR) when both unfavourable factors (PSA and Gleason) were present. Multivariate analysis (MVA) was performed to test the correlations between biochemical control and the above defined Gleason-PSA combined risk groups, radiation dose and length of AD. The median follow-up time was 70 months (range 12 to 171). The actuarial 5 and 10 years overall survival for T3 patients were 98% (standard error [SE]:1%) and 93% (SE:3%) respectively. The corresponding biochemical disease-free survival (bDFS) at 5 and 10 years were 92% (SE:2%) and 66% (SE: 6%) respectively. Twenty two (11%) patients had LR T3 disease, 92 (44%) patients had IR and 95 (45%) patients had HR disease. Ten-year bDFS was 89%, 75% and 49% for LR, IR and HR respectively. Cox MVA showed that patients with HR disease had 8-fold increased risk of biochemical failure compared to those with LR disease (p = 0,044). MVA also showed that higher radiation dose (p = 0,015) and the use of LTAD (p = 0,017) were significantly associated with an improvement in biochemical control. The present study confirms that HDRT combined with LTAD is an excellent treatment for T3 prostate cancer. However, the results are not satisfactory when T3 disease is associated with unfavourable Gleason score and pre-treatment PSA. Further efforts are needed to improve the treatment of these patients." @default.
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• W2058961384 date "2009-11-01" @default.
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• W2058961384 title "Ten Years Results with High-dose Radiotherapy and Risk-adapted Androgen Deprivation in Prostate Cancer: How Curable is T3 Disease?" @default.
• W2058961384 doi "https://doi.org/10.1016/j.ijrobp.2009.07.710" @default.
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