Jiri Kubeš1, Cvek Jakub2, Vondráček Vladimir1, Dvořák Jan1, Argalacsová Sona1, Navrátil Matej1, Buřil Jan1. 1. Institute of Radiation Oncology, Faculty Hospital Na Bulovce and 1 Faculty of Medicine, Charles University, Budínova 2, Prague 8, 18000, Czech Republic. 2. Oncological Clinic, Faculty Hospital Ostrava, 17. listopadu 1790, Ostrava-Poruba 708 52, Czech Republic.
Abstract
AIM: To evaluate the outcome of prostate cancer patients with initial PSA value >40 ng/ml. BACKGROUND: The outcome of prostate cancer patients with very high initial PSA value is not known and patients are frequently treated with palliative intent. We analyzed the outcome of radical combined hormonal treatment and radiotherapy in prostate cancer patients with initial PSA value >40 ng/ml. METHODS: Between January 2003 and December 2007 we treated, with curative intent, 56 patients with non-metastatic prostate cancer and initial PSA value >40 ng/ml. The treatment consisted of two months of neoadjuvant hormonal treatment (LHRH analog), radical radiotherapy (68-78 Gy, conformal technique) and an optional two-year adjuvant hormonal treatment. RESULTS: The median time of follow up was 61 months. 5-Year overall survival was 90%. 5-Year biochemical disease free survival was 62%. T stage, Gleason score, PSA value, and radiotherapy dose did not significantly influence the outcome. Late genitourinal and gastrointestinal toxicity was acceptable. CONCLUSION: Radical treatment in combination with hormonal treatment and radiotherapy can be recommended for this subgroup of prostate cancer patients with good performance status and life expectancy.
AIM: To evaluate the outcome of prostate cancerpatients with initial PSA value >40 ng/ml. BACKGROUND: The outcome of prostate cancerpatients with very high initial PSA value is not known and patients are frequently treated with palliative intent. We analyzed the outcome of radical combined hormonal treatment and radiotherapy in prostate cancerpatients with initial PSA value >40 ng/ml. METHODS: Between January 2003 and December 2007 we treated, with curative intent, 56 patients with non-metastatic prostate cancer and initial PSA value >40 ng/ml. The treatment consisted of two months of neoadjuvant hormonal treatment (LHRH analog), radical radiotherapy (68-78 Gy, conformal technique) and an optional two-year adjuvant hormonal treatment. RESULTS: The median time of follow up was 61 months. 5-Year overall survival was 90%. 5-Year biochemical disease free survival was 62%. T stage, Gleason score, PSA value, and radiotherapy dose did not significantly influence the outcome. Late genitourinal and gastrointestinal toxicity was acceptable. CONCLUSION: Radical treatment in combination with hormonal treatment and radiotherapy can be recommended for this subgroup of prostate cancerpatients with good performance status and life expectancy.
Entities:
Keywords:
High risk; PSA; Prostate cancer; Radiotherapy
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