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Vol. 87, No. 1, 2011
Issue release date: August 2011

Optimal Duration of Androgen Deprivation in Combination with Radiation Therapy for Japanese Men with High-Risk Prostate Cancer

Takaha N. · Okihara K. · Kamoi K. · Kimura Y. · Yamada T. · Kawauchi A. · Kobayashi K. · Yamazaki H. · Nishimura T. · Miki T.
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Objectives: To evaluate the efficacy and toxicity of external beam radiation therapy (EBRT) combined with androgen deprivation therapy (ADT) for Japanese high-risk prostate cancer (PCa) patients in a single institution. Methods: Seventy-five high-risk PCa patients were treated by three-dimensional conformal radiotherapy of 70 Gy combined with neoadjuvant, concurrent and adjuvant ADT. Results: Median age was 72 (59–82) years. Median initial serum prostate-specific antigen (PSA) was 19.0 (4.7–200) ng/ml. Median duration of the entire ADT was 27 (8–63) months. Median follow-up after initiating ADT and after completing EBRT was 66 (41–105) and 59 (36–94) months, respectively. Five-year overall, clinical progression-free, and biochemical progression-free survival rates were 98.3, 97.2, and 87.4%; 2 (2.7%) cancer deaths, 3 (4.0%) clinical progressions, and 11 (14.7%) biochemical progressions. Multivariate analysis suggested a total duration of ADT shorter than 24 months as an independent risk factor of biochemical progression (p = 0.01). Grade 3 toxicities related to EBRT were observed: 1 patient with proctitis and rectal bleeding and 1 patient with rectal bleeding. Conclusions: It is suggested that 70 Gy EBRT combined with ADT confers disease-free survival benefit with tolerable adverse events for Japanese high-risk PCa patients. ADT of 24 months or longer might be recommended to minimize biochemical progression.

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  1. Crawford ED: Epidemiology of prostate cancer. Urology 2003;62:3–12.
  2. Ajiki W, Tsukuma H, Oshima A: Cancer incidence and incidence rates in Japan in 1999: estimates based on data from 11 population-based cancer registries. Jpn J Clin Oncol 2004;34:352–356.
  3. Clinicopathological statistics on registered prostate cancer patients in Japan: 2000 report from the Japanese Urological Association. Int J Urol 2005;12:46–61.
  4. D’Amico AV, Whittington R, Malkowicz SB, Schultz D, Blank K, Broderick GA, Tomaszewski JE, Renshaw AA, Kaplan I, Beard CJ, Wein A: Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. JAMA 1998;280:969–974.
  5. Roach M 3rd, Hanks G, Thames H Jr, Schellhammer P, Shipley WU, Sokol GH, Sandler H: Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer: recommendations of the RTOG-ASTRO Phoenix Consensus Conference. Int J Radiat Oncol Biol Phys 2006;65:965–974.
  6. D’Amico AV, Manola J, Loffredo M, Renshaw AA, DellaCroce A, Kantoff PW: Six-month androgen suppression plus radiation therapy versus radiation therapy alone for patients with clinically localized prostate cancer: a randomized controlled trial. JAMA 2004;292:821–827.
  7. Pilepich MV, Winter K, John MJ, Mesic JB, Sause W, Rubin P, Lawton C, Machtay M, Grignon D: Phase III Radiation Therapy Oncology Group (RTOG) trial 86-10 of androgen deprivation adjuvant to definitive radiotherapy in locally advanced carcinoma of the prostate. Int J Radiat Oncol Biol Phys 2001;50:1243–1252.
  8. Shipley WU, Lu JD, Pilepich MV, Heydon K, Roach M, Wolkov HB, Sause WT, Rubin P, Lawton CA, Machtay M: Effect of a short course of neoadjuvant hormonal therapy on the response to subsequent androgen suppression in prostate cancer patients with relapse after radiotherapy: a secondary analysis of the randomized protocol RTOG 86-10. Int J Radiat Oncol Biol Phys 2002;54:1302–1310.
  9. Lawton CA, Winter K, Murray K, Machtay M, Mesic JB, Hanks GE, Coughlin CT, Pilepich MV: Updated results of the phase III Radiation Therapy Oncology Group (RTOG) trial 85-31 evaluating the potential benefit of androgen suppression following standard radiation therapy for unfavorable prognosis carcinoma of the prostate. Int J Radiat Oncol Biol Phys 2001;49:937–946.
  10. Bolla M, Collette L, Blank L, Warde P, Dubois JB, Mirimanoff RO, Storme G, Bernier J, Kuten A, Sternberg C, Mattelaer J, Lopez Torecilla J, Pfeffer JR, Lino Cutajar C, Zurlo A, Pierart M: Long-term results with immediate androgen suppression and external irradiation in patients with locally advanced prostate cancer (an EORTC study): a phase III randomised trial. Lancet 2002;360:103–106.
  11. Widmark A, Klepp O, Solberg A, Damber JE, Angelsen A, Fransson P, Lund JA, Tasdemir I, Hoyer M, Wiklund F, Fossa SD: Endocrine treatment, with or without radiotherapy, in locally advanced prostate cancer (SPCG-7/SFUO-3): an open randomised phase III trial. Lancet 2009;373:301–308.
  12. Milecki P, Kwias Z, Martenka DJ: Radiotherapy combined with hormonal therapy (RT-HT) in prostate cancer patients with low, intermediate, and high risk of biochemical recurrence: perspective and therapeutic gain analysis. Neoplasma 2007;54:7–15.
  13. Meng MV, Elkin EP, Latini DM, Duchane J, Carroll PR: Treatment of patients with high risk localized prostate cancer: results from Cancer of the Prostate Strategic Urological Research Endeavor (CaPSURE). J Urol 2005;173:1557–1561.

    External Resources

  14. Yoshioka Y, Suzuki O, Kobayashi K, Teshima T, Yamada Y, Kotsuma T, Koizumi M, Kagawa K, Chatani M, Shimamoto S, Tanaka E, Yamazaki H, Inoue T: External-beam radiotherapy for clinically localized prostate cancer in Osaka, Japan, 1995–2006: time trends, outcome, and risk stratification. Strahlenther Onkol 2009;185:446–452.

    External Resources

  15. Hanks GE, Pajak TF, Porter A, Grignon D, Brereton H, Venkatesan V, Horwitz EM, Lawton C, Rosenthal SA, Sandler HM, Shipley WU: Phase III trial of long-term adjuvant androgen deprivation after neoadjuvant hormonal cytoreduction and radiotherapy in locally advanced carcinoma of the prostate: the Radiation Therapy Oncology Group protocol 92-02. J Clin Oncol 2003;21:3972–3978.
  16. Fukagai T, Namiki TS, Carlile RG, Yoshida H, Namiki M: Comparison of the clinical outcome after hormonal therapy for prostate cancer between Japanese and Caucasian men. BJU Int 2006;97:1190–1193.
  17. Hinotsu S, Akaza H, Usami M, Ogawa O, Kagawa S, Kitamura T, Tsukamoto T, Naito S, Namiki M, Hirao Y, Murai M, Yamanaka H: Current status of endocrine therapy for prostate cancer in Japan analysis of primary androgen deprivation therapy on the basis of data collected by J-Cap. Jpn J Clin Oncol 2007;37:775–781.
  18. Meng MV, Carroll PR: Treatment of locally advanced prostate cancer; in Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA (eds): Campbell-Walsh Urology. Philadelphia, Saunders, 2007, pp 3063–3065.
  19. Horwitz EM, Bae K, Hanks GE, Porter A, Grignon DJ, Brereton HD, Venkatesan V, Lawton CA, Rosenthal SA, Sandler HM, Shipley WU: Ten-year follow-up of Radiation Therapy Oncology Group protocol 92-02: a phase III trial of the duration of elective androgen deprivation in locally advanced prostate cancer. J Clin Oncol 2008;26:2497–2504.
  20. Bolla M, de Reijke TM, Van Tienhoven G, Van den Bergh AC, Oddens J, Poortmans PM, Gez E, Kil P, Akdas A, Soete G, Kariakine O, van der Steen-Banasik EM, Musat E, Pierart M, Mauer ME, Collette L: Duration of androgen suppression in the treatment of prostate cancer. N Engl J Med 2009;360:2516–2527.

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