To demonstrate that radiotherapy (RT) is a valid alternative to surgery in men ≤70 years old with localized prostate cancer.
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From 1988 to 2009, 214 patients with T1-2 N0 M0 prostate cancer were treated with RT.
The effects of patient- and treatment-related risk factors on toxicity were investigated.
Median follow-up was 105 months (range 14. 2-180). The 5-, 10-, and 15-year biochemical relapse-free survival for all 214 patients was 80%, 61. 9%, and 57. 5%, respectively. In bivariate analysis, age (≤65 vs 65-70 years) was not a significant factor for biochemical relapse, while radiation dose was (p = 0. 05) in multivariate analysis. Cancer-specific survival rates at 5, 10, and 15 years were 98. 4%, 93. 2%, and 69. 7%, respectively. Median overall survival (OS) was 167 months (95% confidence interval 147. 3-186. 7). The OS rates at 5, 10, and 15 years were 91. 8%, 75. 8%, and 42. 5%, respectively. Acute genitourinary (GU) and gastrointestinal (GI) toxicities occurred in 105 (49%) and 98 patients (45. 8%), respectively, with only 2 cases of grade III GI toxicity. Late GU and GI toxicities occurred in 17 (7. 9%) and 20 (9. 3%) patients, respectively, with 1 grade III GI toxicity and 2 grade III GU toxicities. Risk factors for late toxicity were age and RT dose and technique, which were unrelated to acute toxicity.
Age ≤70 years does not consistently confer a negative prognosis for localized prostate cancer. Radiotherapy appears to be a viable alternative to surgery, offering excellent long-term cancer control.
Tumori. 2015 Sep 26 [Epub ahead of print]
Rita Bellavita, Melissa Scricciolo, Vittorio Bini, Fabio Arcidiacono, Giampaolo Montesi, Valentina Lancellotta, Claudio Zucchetti, Marco Lupattelli, Isabella Palumbo, Cynthia Aristei
Institute of Radiation Oncology, General Hospital and University of Perugia, Perugia - Italy.