External Beam Radiotherapy for Clinically Localized Hormone-Refractory Prostate Cancer: Clinical Significance of Nadir Prostate-Specific Antigen Value Within 12 Months
- Department of Radiology, University of the Ryukyus, Okinawa, Osaka (Japan)
- Department of Clinical Radiology, Fukuoka University, Fukuoka (Japan)
- Department of Radiation Oncology, National Kyushu Center, Fukuoka (Japan)
- Department of Radiology, Yamanashi University, Yamanashi (Japan)
- Department of Radiation Oncology, Osaka University, Osaka (Japan)
- Department of Clinical Radiology, Kyushu University, Fukuoka (Japan)
- Department of Medical Physics and Engineering, Osaka University, Osaka (Japan)
- Department of Radiation Oncology and Image-Applied Therapy, Kyoto University, Kyoto (Japan)
Purpose: To analyze retrospectively the results of external beam radiotherapy for clinically localized hormone-refractory prostate cancer and investigate the clinical significance of nadir prostate-specific antigen (PSA) value within 12 months (nPSA12) as an early estimate of clinical outcomes after radiotherapy. Methods and Materials: Eighty-four patients with localized hormone-refractory prostate cancer treated with external beam radiotherapy were retrospectively reviewed. The total radiation doses ranged from 30 to 76 Gy (median, 66 Gy), and the median follow-up period for all 84 patients was 26.9 months (range, 2.7-77.3 months). Results: The 3-year actuarial overall survival, progression-free survival (PFS), and local control rates in all 84 patients after radiotherapy were 67%, 61%, and 93%, respectively. Although distant metastases and/or regional lymph node metastases developed in 34 patients (40%) after radiotherapy, local progression was observed in only 5 patients (6%). Of all 84 patients, the median nPSA12 in patients with clinical failure and in patients without clinical failure was 3.1 ng/mL and 0.5 ng/mL, respectively. When dividing patients according to low (<0.5 ng/mL) and high ({>=}0.5 ng/mL) nPSA12 levels, the 3-year PFS rate in patients with low nPSA12 and in those with high nPSA12 was 96% and 44%, respectively (p < 0.0001). In univariate analysis, nPSA12 and pretreatment PSA value had a significant impact on PFS, and in multivariate analysis nPSA12 alone was an independent prognostic factor for PFS after radiotherapy. Conclusions: External beam radiotherapy had an excellent local control rate for clinically localized hormone-refractory prostate cancer, and nPSA12 was predictive of clinical outcomes after radiotherapy.
- OSTI ID:
- 21276861
- Journal Information:
- International Journal of Radiation Oncology, Biology and Physics, Vol. 74, Issue 3; Other Information: DOI: 10.1016/j.ijrobp.2008.08.067; PII: S0360-3016(08)03533-5; Copyright (c) 2009 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); ISSN 0360-3016
- Country of Publication:
- United States
- Language:
- English
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