Radiation therapy for clinically localized prostate cancer: Long-term results of 469 patients from a single institution in the era of dose escalation - Abstract

AIMS: The aim of the following study is to analyze the long-term results of veterans treated with dose escalated radiation therapy for prostate cancer.

MATERIALS AND METHODS: This retrospective study analyzed 469 patients who were treated between 2003 and 2010 with dose escalated radiation therapy to a minimum dose of 7560 cGy for prostate cancer at the New York Harbor Department of Veterans Affairs. Biochemical failure-free survival (bFFS) and distant metastatic-free survival (DMFS) were compared using the Kaplan-Meier method. Univariate and multivariate Cox Regression were used to measure the impact of covariates on biochemical control.

RESULTS: The median follow-up was 61 months and 95.3% of patients were followed at least 2 years. The 5-year bFFS for National Cancer Care Network low, intermediate and high risk disease were 90.3%, 86.9% and 77.3% respectively (P = 0.001). Patients with high risk disease were more likely to develop metastatic disease. The 5-year DMFS was 99.1% for low risk, 98.8% for intermediate risk and 94.5% for high-risk (P < 0.001). There were 8 prostate cancer related deaths, of which 6 had high risk disease and 2 had intermediate risk disease. The 5-year prostate cancer specific survival was 98.4%. Toxicities were generally mild, however there were two genitourinary toxicity related deaths, though in both patients there were confounding medical issues that may have contributed to their deaths.

CONCLUSIONS: Dose escalated radiation in the treatment of United States Veterans appears to be well-tolerated with results in line with prior reports. Further follow-up is necessary to identify any additional late toxicities as well as to assess the durability of their biochemical control beyond 5 years.

Written by:
Surapaneni A, Schwartz D, Nwokedi E, Rineer J, Rotman M, Schreiber D.   Are you the author?
Department of Veterans Affairs, New York Harbor Healthcare System; Department of Radiation Oncology, SUNY Downstate Medical Center, Brooklyn, NY, USA.

Reference: J Cancer Res Ther. 2014 Oct-Dec;10(4):951-6.
doi: 10.4103/0973-1482.138096

PubMed Abstract
PMID: 25579535

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