Multimodal Primary Treatment of Metastatic Prostate Cancer with Androgen Deprivation and Radiation.

We combined anti-androgen therapy with radiotherapy in a first-line setting for metastatic prostate cancer aiming to cause maximal cancer-cell death to delay the emergence of castration-resistant disease.

In this non-randomized retrospective series of 46 patients, the initial median prostate-specific antigen (PSA) was 98.5 μg/l (range=6.7-15,500), median Gleason score 9 and most men had at least T3N1M1 disease. All patients received luteinizing hormone releasing hormone analog or degarelix with bicalutamide. If PSA remained above 1 μg/l, docetaxel was initiated. At PSA nadir, all patients received radical radiotherapy of the prostate.

The median follow-up time was 4.38 years (range=0.36-11.24). Most radiotherapy-related adverse events were grade 1 and transient. There were no grade 4 events. Overall survival (OS) at 5 years was 81.3%.

The feasibility and safety of aggressive multimodality treatment were good resulting in an excellent median OS of 8.35 years.

Anticancer research. 2016 Dec [Epub]

Timo Joensuu, Greetta Joensuu, Kalevi Kairemo, Timo Kiljunen, Maigo Riener, Aili Aaltonen, Martti Ala-Opas, Aki Kangasmäki, Tuomo Alanko, Lauri Taipale, Petteri Hervonen, Anna Bützow, Irene Virgolini, Akseli Hemminki

Docrates Cancer Center, Helsinki, Finland ., Docrates Cancer Center, Helsinki, Finland., United MEDIX Laboratories Ltd., Espoo, Finland., Department of Nuclear Medicine, Medical University of Innsbruck, Innsbruck, Austria.