Alessandro Magli1, Marco Lorenzo Bonù2, Fabrizio Tonetto1, Eugenia Moretti3, Gioacchino DE Giorgi4, Luigi Spiazzi5, Marco Trovò1, Davide Tomasini6, Stefano Maria Magrini6, Luca Triggiani6. 1. Department of Radiation Oncology, University Hospital of Udine, Udine, Italy. 2. Istituto del Radio O. Alberti, Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Brescia, Italy; marco.bonu@unibs.it. 3. Department of Medical Physics, University Hospital of Udine, Udine, Italy. 4. Department of Urology, University Hospital of Udine, Udine, Italy. 5. Department of Medical Physics, University of Brescia and Spedali Civili Hospital, Brescia, Italy. 6. Istituto del Radio O. Alberti, Department of Radiation Oncology, University of Brescia and Spedali Civili Hospital, Brescia, Italy.
Abstract
BACKGROUND/AIM: Stereotactic radiotherapy (SRT) is an effective treatment for localized prostate cancer. However, is it not clear whether the addition of androgen deprivation therapy (ADT) to SRT is beneficial. The aim of this study was to analyze the outcomes of a series of patients treated with SRT plus ADT for localized prostate cancer. PATIENTS AND METHODS: Patients were treated with SRT with 42 Gy in 7 fractions with volumetric-modulated arc therapy plus Image Guided Radiotherapy (V-MAT IGRT) technique. ADT was administered to patients with intermediate unfavorable- and high-risk disease. Study endpoints were biochemical disease-free survival (bDFS), overall survival (OS), acute and late toxicity and patient-reported outcomes (PROs) using international prostate cancer symptoms scale (IPSS) and international index of erectile function (IIEF). RESULTS: A total of 170 consecutive patients were identified, of which 49 (28.8%) with low-risk, 15 (8.8%) with favorable intermediate-risk 76 (44.7%) with unfavorable intermediate-risk and 30 (17.6%) with high-risk class. All patients of unfavorable intermediate- and high-risk groups were administered LHRH analogue concurrently to SRT and for at least 6 months. Patients with unfavorable intermediate- and high-risk presented a 5-year bDFS of 81.7% and 76.9%, respectively. CONCLUSION: SRT consisting of 42 Gy in seven fractions with short-term ADT represents a safe and effective treatment for unfavorable intermediate and high risk prostate cancer. Our results support the need of high quality studies to test the efficacy of ADT combined with SRT for unfavorable intermediate- and high-risk localized prostate cancer.
BACKGROUND/AIM: Stereotactic radiotherapy (SRT) is an effective treatment for localized prostate cancer. However, is it not clear whether the addition of androgen deprivation therapy (ADT) to SRT is beneficial. The aim of this study was to analyze the outcomes of a series of patients treated with SRT plus ADT for localized prostate cancer. PATIENTS AND METHODS: Patients were treated with SRT with 42 Gy in 7 fractions with volumetric-modulated arc therapy plus Image Guided Radiotherapy (V-MAT IGRT) technique. ADT was administered to patients with intermediate unfavorable- and high-risk disease. Study endpoints were biochemical disease-free survival (bDFS), overall survival (OS), acute and late toxicity and patient-reported outcomes (PROs) using international prostate cancer symptoms scale (IPSS) and international index of erectile function (IIEF). RESULTS: A total of 170 consecutive patients were identified, of which 49 (28.8%) with low-risk, 15 (8.8%) with favorable intermediate-risk 76 (44.7%) with unfavorable intermediate-risk and 30 (17.6%) with high-risk class. All patients of unfavorable intermediate- and high-risk groups were administered LHRH analogue concurrently to SRT and for at least 6 months. Patients with unfavorable intermediate- and high-risk presented a 5-year bDFS of 81.7% and 76.9%, respectively. CONCLUSION: SRT consisting of 42 Gy in seven fractions with short-term ADT represents a safe and effective treatment for unfavorable intermediate and high risk prostate cancer. Our results support the need of high quality studies to test the efficacy of ADT combined with SRT for unfavorable intermediate- and high-risk localized prostate cancer.
Authors: Anders Widmark; Adalsteinn Gunnlaugsson; Lars Beckman; Camilla Thellenberg-Karlsson; Morten Hoyer; Magnus Lagerlund; Jon Kindblom; Claes Ginman; Bengt Johansson; Kirsten Björnlinger; Mihajl Seke; Måns Agrup; Per Fransson; Björn Tavelin; David Norman; Björn Zackrisson; Harald Anderson; Elisabeth Kjellén; Lars Franzén; Per Nilsson Journal: Lancet Date: 2019-06-18 Impact factor: 79.321
Authors: Charles N Catton; Himu Lukka; Chu-Shu Gu; Jarad M Martin; Stéphane Supiot; Peter W M Chung; Glenn S Bauman; Jean-Paul Bahary; Shahida Ahmed; Patrick Cheung; Keen Hun Tai; Jackson S Wu; Matthew B Parliament; Theodoros Tsakiridis; Tom B Corbett; Colin Tang; Ian S Dayes; Padraig Warde; Tim K Craig; Jim A Julian; Mark N Levine Journal: J Clin Oncol Date: 2017-03-15 Impact factor: 44.544
Authors: William C Jackson; Jessica Silva; Holly E Hartman; Robert T Dess; Amar U Kishan; Whitney H Beeler; Laila A Gharzai; Elizabeth M Jaworski; Rohit Mehra; Jason W D Hearn; Todd M Morgan; Simpa S Salami; Matthew R Cooperberg; Brandon A Mahal; Payal D Soni; Samuel Kaffenberger; Paul L Nguyen; Neil Desai; Felix Y Feng; Zachary S Zumsteg; Daniel E Spratt Journal: Int J Radiat Oncol Biol Phys Date: 2019-04-06 Impact factor: 7.038
Authors: Michel Bolla; Philippe Maingon; Christian Carrie; Salvador Villa; Petros Kitsios; Philip M P Poortmans; Santhanam Sundar; Elzbieta M van der Steen-Banasik; John Armstrong; Jean-François Bosset; Fernanda G Herrera; Bradley Pieters; Annerie Slot; Amit Bahl; Rahamim Ben-Yosef; Dirk Boehmer; Christopher Scrase; Laurette Renard; Emad Shash; Corneel Coens; Alphonsus C M van den Bergh; Laurence Collette Journal: J Clin Oncol Date: 2016-03-14 Impact factor: 44.544
Authors: Christopher R King; Debra Freeman; Irving Kaplan; Donald Fuller; Giampaolo Bolzicco; Sean Collins; Robert Meier; Jason Wang; Patrick Kupelian; Michael Steinberg; Alan Katz Journal: Radiother Oncol Date: 2013-09-20 Impact factor: 6.280
Authors: W Robert Lee; James J Dignam; Mahul B Amin; Deborah W Bruner; Daniel Low; Gregory P Swanson; Amit B Shah; David P D'Souza; Jeff M Michalski; Ian S Dayes; Samantha A Seaward; William A Hall; Paul L Nguyen; Thomas M Pisansky; Sergio L Faria; Yuhchyau Chen; Bridget F Koontz; Rebecca Paulus; Howard M Sandler Journal: J Clin Oncol Date: 2016-04-04 Impact factor: 44.544
Authors: Leszek Miszczyk; Agnieszka Namysł-Kaletka; Aleksandra Napieralska; Małgorzata Kraszkiewicz; Marcin Miszczyk; Grzegorz Woźniak; Małgorzata Stąpór-Fudzińska; Grzegorz Głowacki; Andrzej Tukiendorf Journal: Technol Cancer Res Treat Date: 2019-01-01
Authors: Francesco Cuccia; Stefanie Corradini; Rosario Mazzola; Luigi Spiazzi; Michele Rigo; Marco Lorenzo Bonù; Ruggero Ruggieri; Michela Buglione di Monale E Bastia; Stefano Maria Magrini; Filippo Alongi Journal: Cancers (Basel) Date: 2021-04-09 Impact factor: 6.639