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. 2010 Jul;40(7):652-7.
doi: 10.1093/jjco/hyq032. Epub 2010 Apr 8.

Outcome of patients with localized prostate cancer treated by radiotherapy after confirming the absence of lymph node invasion

Noriyuki Suzuki  1 , Masaki Shimbo, Yoshiyasu Amiya, Susumu Tomioka, Takayuki Shima, Shino Murakami, Hiroomi Nakatsu, Sayako Oota, Jun Shimazaki
Affiliations

Outcome of patients with localized prostate cancer treated by radiotherapy after confirming the absence of lymph node invasion

Noriyuki Suzuki et al. Jpn J Clin Oncol. 2010 Jul.

Abstract

Objective: Management of lymph nodes in radiotherapy for prostate cancer is an issue for curative intent. To find the influence of lymph nodes, patients with T1-T3 prostate cancer and surgically confirmed negative nodes were treated with radiotherapy.

Methods: After lymphadenectomy, 118 patients received photon beam radiotherapy with 66 Gy to the prostate. No adjuvant treatment was performed until biochemical failure. After failure, hormone therapy was administered. Follow-up period was 57 months (mean).

Results: Biochemical failure occurred in 47 patients. Few failures were observed in patients with low (24%) and intermediate risks (14%). In contrast, 64% of high-risk patients experienced failure, 97% of whom showed until 36 months. Most patients with failure responded well to hormone therapy. After 15 months (mean), a second biochemical failure occurred in 21% of patients who had the first failure, most of them were high risk. Factors involving failure were high initial and nadir prostate-specific antigen, advanced stage, short prostate-specific antigen-doubling time and duration between radiation and first failure. Failure showed an insufficient reduction in prostate-specific antigen after radiotherapy. Factor for second failure was prostate-specific antigen-doubling time at first failure.

Conclusions: Half of high-risk patients experienced biochemical failure, indicating one of the causes involves factors other than lymph nodes. Low-, intermediate- and the other half of high-risk patients did not need to take immediate hormone therapy after radiotherapy. After failure, delayed hormone therapy was effective. Prostate-specific antigen parameters were predictive factors for further outcome.

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Figures

Figure 1.
Figure 1.
Overall survival of patients who received radiotherapy after confirming no lymph node invasion (118 cases).
See this image and copyright information in PMC

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