| BackgroundThe incidence of prostate cancer is increasing in our country. Some patients were intolerant to surgery for the relative elderly ages or poor health and radiotherapy(RT) is an effective method in treating prostate cancer.So RT became the main treatment method for prostate cancer. As the intensity-modulated radiotherapy(IMRT) were conducted only a few years in our country and the relative lower incidence of prostate cancer than abroad, only a few studies were reported and the sample size is small. The aim of this study was to evaluate the efficacy and toxicity of RT combined with androgen deprivation therapy(ADT) for prostate cancer, and identify the prognostic factors influencing the survival furtherly. In addition, we also evaluated the efficacy of local RT for bone oligometastases after systemic treatment.MethodsA total of 71 patients diagnosed with localized prostate cancer and 30 patients with bone oligometastases were retrospectively analyzed in our institute, from April 2005 to July 2016. Age, Gleason score,prostate specific antigen(PSA) before RT, PSA nadir(n PSA) after RT,T staging, N staging, ADT duration, risk groups, RT doses, RT method and RT region were analyzed to identify prognostic factors associated with thebiochemical recurrence free survival(BRFS) and the overall survival(OS) rates for localized prostate cancer, respectively. Age, Gleason score, the number of oligometastases, RT doses, localization of metastases, initial treatmentand Zoledronic acidwere analyzed to identify prognostic factors associated with the overall survival(OS) rate and theprogression free survival(PFS)for prostate cancer diagnosed with bone oligometastases,respectively. Survival rate was analyzedusing the Kaplan-Meier method and compared using Log-Rank tests. Statistical analysis was conducted using SPSS, version 17.0.ResultsThe follow-up rate was 90.5%, with a median follow-up time of 75 months(range, 2-136 months). Among the 71 patients, risk groups were as follows: low grade 2(2.8%), middle grade 17(23.9%), high grade 52(73.3%).The T staging was as follows: T 1-2 18(25.3%), T3 37(52.1%), T4 16(22.5%). The N stagingwas as follows: N0 50(70.4%), N1 21(29.6%). Gleason score: ?6 score 31(43.6%), > 6 score 40(56.4%).The 1, 3, and 5-year BRFS were 90.6%(95% CI, 97.8%–82.9%), 84.8%(95%CI, 91.6%–75.8%)and 71%(95% CI, 80.1%–63.4%), respectively. The 1, 3 and 5-year OS for the whole group were 100.0%(95%CI,100.0%–93.4%), 89.2%(95% CI, 95.7%–81.5%) and 80.6%(95% CI, 86.5%–74.4%), respectively. The univariate analyses showed that PSA before RT, n PSA,T staging, RT doses and Gleason score were significantly associated with OS(P<0.05, respectively). PSA before RTand n PSA after RT were significantly associated with BRFS(P<0.05, respectively).There were 30 prostate cancer patients who received local radiotherapy for bone oligometastases after systemic treatment. We found that the number of oligometastases and the RT doses were associated with OS. Most patients with pain gained relief within 1 month after RT.ConclusionsRT combined with ADT was effective and welltoleratedin localized prostate cancer patients. Monitor of PSA after radiotherapy would be beneficial for prognosis evaluation.Prostate cancer patients diagnosed with bone oligometastasesmight benefit from the combination of RT and systemic treatment. |
PDF Full Text Request