OBJECTIVES:The aim of this study is to analyze the outcomes obtained after External-Beam Radiotherapy (3D EBRT)in patients with prostate cancer.
METHODS: The study includes 503 patients (p) treated at the Hospital General Universitario Gregorio Marañón in Madrid, diagnosed between 2000-2007, with low, intermediate or high risk prostate cancer (D'Amico risk groups), treated with 3D EBRT. Biochemical recurrence (BR) was defined as nadir +2 following Phoenix's criterion. The median follow-up was 59 months (range 3.4-104.2).
RESULTS: Biochemical relapse-free survival (bRFS) rates at 5 and 8 years were 88 ± 2% and 76 ± 3%, respectively. Multivariate analysis indicated initial PSA (p < 0.02), perineural invasion in biopsy specimen (p < 0.00), EBRT dose (p = 0.01) and the use of androgen deprivation therapy (ADT)(p = 0.00) to be independent predictors of relapse. Nadir PSA value < 0.3 ng/ml was associated with the best 5-year bRFS (96.6% versus 56.5% if nadir PSA > 1.3 ng/ml). Late urinary and rectal toxicity ≥ 3 was lower than 5%. Active rescue treatment was indicated in 85% of patients. Only 10 patients died of prostate cancer.
CONCLUSION: The biochemical failure rate is determined by classical pretreatment features (initial PSA level, risk group, perineural invasion) and low- dose EBRT (≤ 72 Gy), nadir PSA value and the use of ADT in intermediate and high risk groups.
San Segundo CG, Miranda JA, González AA. Are you the author?
Servicio de Oncología Radioterápica, Hospital General Universitario Gregorio Marañón, Madrid, España.
Reference: Arch Esp Urol. 2012 Jan-Feb;65(1):166-75.
Article in Spanish.