Radiat Oncol J.
2014 Dec;32(4):247-255. 10.3857/roj.2014.32.4.247.
Is neoadjuvant androgen deprivation therapy beneficial in prostate cancer treated with definitive radiotherapy?
- Affiliations
-
- 1Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Korea. swha@snu.ac.kr
- 2Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, Korea.
- 3Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
- 4Department of Urology, Seoul National University College of Medicine, Seoul, Korea.
- 5Department of Urology, Seoul National University Bundang Hospital, Seongam, Korea.
- KMID: 1842052
- DOI: http://doi.org/10.3857/roj.2014.32.4.247
Abstract
- PURPOSE
To determine whether neoadjuvant androgen deprivation therapy (NADT) improves clinical outcomes in patients with prostate cancer treated with definitive radiotherapy.
MATERIALS AND METHODS
We retrospectively reviewed medical records of 201 patients with prostate cancer treated with radiotherapy between January 1991 and December 2008. Of these, 156 patients with more than 3 years of follow-up were the subjects of this study. The median duration of follow-up was 91.2 months. NADT was given in 103 patients (66%) with median duration of 3.3 months (range, 1.0 to 7.7 months). Radiation dose was escalated gradually from 64 Gy to 81 Gy using intensity-modulated radiotherapy technique.
RESULTS
Biochemical relapse-free survival (BCRFS) and overall survival (OS) of all patients were 72.6% and 90.7% at 5 years, respectively. BCRFS and OS of NADT group were 79.5% and 89.8% at 5 years and those of radiotherapy alone group were 58.8% and 92.3% at 5 years, respectively. Risk group (p = 0.010) and radiation dose > or =70 Gy (p = 0.017) affected BCRFS independently. NADT was a significant prognostic factor in univariate analysis, but not in multivariate analysis (p = 0.073). Radiation dose > or =70 Gy was only an independent factor for OS (p = 0.007; hazard ratio, 0.261; 95% confidence interval, 0.071-0.963).
CONCLUSION
NADT prior to definitive radiotherapy did not result in significant benefit in terms of BCRFS and OS. NADT should not be performed routinely in the era of dose-escalated radiotherapy.
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