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Radiotherapy for early-stage prostate cancer in men under 70 years of age

Abstract

Aims

To demonstrate that radiotherapy (RT) is a valid alternative to surgery in men ≤70 years old with localized prostate cancer.

Methods

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.

Results

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.

Conclusions

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 2016; 102(2): 209 - 216

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.5301/tj.5000433

Authors

Rita Bellavita, Melissa Scricciolo, Vittorio Bini, Fabio Arcidiacono, Giampaolo Montesi, Valentina Lancellotta, Claudio Zucchetti, Marco Lupattelli, Isabella Palumbo, Cynthia Aristei

Article History

Disclosures

Financial support: None.
Conflict of interest: None.

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Authors

Affiliations

  • Institute of Radiation Oncology, General Hospital and University of Perugia, Perugia - Italy
  • Department of Radiotherapy, Ospedali Riuniti Ancona, Ancona - Italy
  • Department of Medicine, Endocrine and Metabolic Sciences Section, University of Perugia, Perugia - Italy
  • Department of Medical Physics, General Hospital of Perugia, Perugia - Italy

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