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Achieving PSA < 0.2 ng/ml before Radiation Therapy Is a Strong Predictor of Treatment Success in Patients with High-Risk Locally Advanced Prostate Cancer.
Kazama, Akira; Saito, Toshihiro; Takeda, Keisuke; Kobayashi, Kazuhiro; Tanikawa, Toshiki; Kanemoto, Ayae; Ayukawa, Fumio; Matsumoto, Yasuo; Sugita, Tadashi; Hara, Noboru; Tomita, Yoshihiko.
Afiliação
  • Kazama A; Department of Urology, Niigata Cancer Center Hospital, 2-15-3, Kawagishicho, Chuo-ku, Niigata 951-8133, Japan.
  • Saito T; Division of Urology, Department of Molecular Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757, Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan.
  • Takeda K; Department of Urology, Niigata Cancer Center Hospital, 2-15-3, Kawagishicho, Chuo-ku, Niigata 951-8133, Japan.
  • Kobayashi K; Department of Urology, Niigata Cancer Center Hospital, 2-15-3, Kawagishicho, Chuo-ku, Niigata 951-8133, Japan.
  • Tanikawa T; Division of Urology, Department of Molecular Oncology, Niigata University Graduate School of Medical and Dental Sciences, 1-757, Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan.
  • Kanemoto A; Department of Urology, Niigata Cancer Center Hospital, 2-15-3, Kawagishicho, Chuo-ku, Niigata 951-8133, Japan.
  • Ayukawa F; Department of Urology, Niigata Cancer Center Hospital, 2-15-3, Kawagishicho, Chuo-ku, Niigata 951-8133, Japan.
  • Matsumoto Y; Department of Radiation Therapy, Niigata Cancer Center Hospital, 2-15-3, Kawagishicho, Chuo-ku, Niigata 951-8133, Japan.
  • Sugita T; Department of Radiation Therapy, Niigata Cancer Center Hospital, 2-15-3, Kawagishicho, Chuo-ku, Niigata 951-8133, Japan.
  • Hara N; Department of Radiation Therapy, Niigata Cancer Center Hospital, 2-15-3, Kawagishicho, Chuo-ku, Niigata 951-8133, Japan.
  • Tomita Y; Department of Radiation Therapy, Niigata Cancer Center Hospital, 2-15-3, Kawagishicho, Chuo-ku, Niigata 951-8133, Japan.
Prostate Cancer ; 2019: 4050352, 2019.
Article em En | MEDLINE | ID: mdl-31772776
BACKGROUND: To predict long-term treatment outcome of radiation therapy (RT) plus androgen deprivation therapy (ADT) for high-risk locally advanced prostate cancer. METHODS: In total, 204 patients with the National Comprehensive Cancer Network (NCCN) high risk locally advanced prostate cancer (PSA > 20 ng/ml, Gleason score ≧ 8, clinical T stage ≧ 3a) were treated with definitive RT with ADT. Median follow up period was 113 months (IQR: 95-128). Median neoadjuvant ADT and total ADT duration were 7 months (IQR: 6-10) and 27 months (IQR: 14-38), respectively. RESULTS: PSA recurrence-free survival (PSA-RFS), cancer specific survival (CSS), and overall survival (OS) rates at 5 years were 84.1%, 98.5%, and 93.6%, respectively, and 67.9%, 91.2%, and 78.1%, respectively, at 10 years. Pre-RT PSA less than 0.2 ng/ml was associated with superior outcomes of PSA-RFS (HR = 0.42, 95% CI: 0.25-0.70, p = 0.001), CSS (HR = 0.27, 95% CI: 0.09-0.82, p = 0.013), and OS (HR = 0.48, 95% CI: 0.26-0.91, p = 0.021). On multivariate analysis, age (≥70 y.o.) and pre-RT PSA (≥0.2 ng/ml) were factors predictive of poorer OS (p = 0.032) , but iPSA, T stage, Gleason score, number of NCCN high-risk criteria, a combination with anti-androgen therapy and neoadjuvant ADT duration were not predictive of treatment outcome. CONCLUSION: In patient with high-risk prostate cancer, RT plus ADT achieved good oncologic outcomes. PSA < 0.2 ng/ml before radiation therapy is a strong independent predictor for long overall survival.

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Etiology_studies / Prognostic_studies / Risk_factors_studies Idioma: En Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Etiology_studies / Prognostic_studies / Risk_factors_studies Idioma: En Ano de publicação: 2019 Tipo de documento: Article