Anne-Laure Couderc1,2, Emanuel Nicolas3,4, Romain Boissier2,5, Mohammed Boucekine6, Cyrille Bastide2,7, Delphine Badinand8, Dominique Rossi2,7, Benedicte Mugnier1, Patrick Villani1,2, Gilles Karsenty2,5, Didier Cowen2,8, Eric Lechevallier2,5, Xavier Muracciole8. 1. Internal Medicine, Geriatric and Therapeutic Unit, Assistance Publique-Hôpitaux de Marseille (AP-HM), and Coordination Unit for Geriatric Oncology (UCOG), PACA West, 13009 Marseille, France. 2. Medical School, Aix-Marseille University, 13005 Marseille, France. 3. Department of Medical Oncology, University Hospital of Nimes, 30000 Nimes, France. 4. IDESP Institute Desbrest of Epidemiology and Public Health, Research Unit INSERM, University of Montpellier, 34000 Montpellier, France. 5. Urology Department, Conception Hospital, AP-HM, 13005 Marseille, France. 6. Department of Public Health, EA 3279 Self-Perceveid Health Assessment Research Unit, Medical School, Aix-Marseille University, 13005 Marseille, France. 7. Urology Department, Nord Hospital, AP-HM, 13015 Marseille, France. 8. Radiotherapy Department, La Timone Hospital, AP-HM, 13005 Marseille, France.
Abstract
PURPOSE/ OBJECTIVE: The association of 3D Conformal External Beam Radiotherapy (3D-CEBRT) with adjuvant Androgen Deprivation Therapy (ADT) proved to treat patients with intermediate- and high-risk localized prostate cancer (IR and HR). However, older patients were underrepresented in literature. We aimed to report the oncological results and morbidity 3D-CEBRT +ADT in ≥80 years patients. MATERIAL AND METHODS: From June 1998 to July 2017, 101 patients ≥80 years were included in a tertiary center. The median age was 82 years. ADT was initiated 3 months prior 3D-CEBRT in all patients, with a total duration of 6 months for IR prostate cancer (group A; n = 41) and 15 months for HR prostate cancer (group B; n = 60). Endpoints included overall survival (OS), metastasis-free survival (DMFS), biochemical recurrence-free survival (BRFS) and toxicity. RESULTS: Five years-OS was 95% and 86.7% in groups A and B, respectively. Cardiovascular events occurred in 22.8% of ≥80 years patients with no impact on OS. In the multivariate analysis, age <82 years, Karnofsky index and normalization of testosterone levels were significantly associated with better OS. CONCLUSION: Age ≥80 years should not be a limitation for the treatment of IR and HR prostate cancer patients with 3D-CEBRT and ADT, but cardiovascular monitoring and prevention are mandatory.
PURPOSE/ OBJECTIVE: The association of 3D Conformal External Beam Radiotherapy (3D-CEBRT) with adjuvant Androgen Deprivation Therapy (ADT) proved to treat patients with intermediate- and high-risk localized prostate cancer (IR and HR). However, older patients were underrepresented in literature. We aimed to report the oncological results and morbidity 3D-CEBRT +ADT in ≥80 years patients. MATERIAL AND METHODS: From June 1998 to July 2017, 101 patients ≥80 years were included in a tertiary center. The median age was 82 years. ADT was initiated 3 months prior 3D-CEBRT in all patients, with a total duration of 6 months for IR prostate cancer (group A; n = 41) and 15 months for HR prostate cancer (group B; n = 60). Endpoints included overall survival (OS), metastasis-free survival (DMFS), biochemical recurrence-free survival (BRFS) and toxicity. RESULTS: Five years-OS was 95% and 86.7% in groups A and B, respectively. Cardiovascular events occurred in 22.8% of ≥80 years patients with no impact on OS. In the multivariate analysis, age <82 years, Karnofsky index and normalization of testosterone levels were significantly associated with better OS. CONCLUSION:Age ≥80 years should not be a limitation for the treatment of IR and HR prostate cancerpatients with 3D-CEBRT and ADT, but cardiovascular monitoring and prevention are mandatory.
Authors: Maxim E Menyailo; Ustinia A Bokova; Elena E Ivanyuk; Anna A Khozyainova; Evgeny V Denisov Journal: Mol Diagn Ther Date: 2021-07-21 Impact factor: 4.074