Combined external radiotherapy and hormone therapy in patients with locally advanced prostate cancer: Predictive factors of genitourinary toxicity

• Published in: Actas urologicas españolas Vol. 35; no. 3; pp. 146 - 151
• Main Authors: Ferrandis, C, March, J.A, Martínez, J.M, Hernández, J, Diez, N, Morillo, V, García, F, Chuan, P
• Format: Journal Article
• Language: English; Spanish
• Published: Spain Elsevier España 2011
• Subjects: Adverse effects; Aged; Androgen Antagonists - adverse effects; Androgen Antagonists - therapeutic use; Combined Modality Therapy; Cáncer de próstata localmente avanzado; Efectos adversos; Efficacy; Eficacia; Gastrointestinal Diseases - chemically induced; Hormone therapy; Hormonoterapia; Humans; Locally advanced prostate cancer; Male; Male Urogenital Diseases - chemically induced; Neoplasm Staging; Prostatic Neoplasms - drug therapy; Prostatic Neoplasms - pathology; Prostatic Neoplasms - radiotherapy; Radioterapia; Radiotherapy; Recurrence; Recurrencia; Retrospective Studies; Urology; Recurrence; Efectos adversos; Recurrencia; Hormone therapy; Locally advanced prostate cancer; Hormonoterapia; Efficacy; Adverse effects; Radiotherapy; Cáncer de próstata localmente avanzado; Radioterapia; Eficacia
• ISSN: 2173-5786; 2173-5786; 1699-7980
• DOI: 10.1016/S2173-5786(11)70039-7

Abstract Introduction Radiotherapy and androgen deprivation are an established treatment option for locally advanced prostate cancer. We evaluate outcomes in efficacy and toxicity for patients treated with this combined therapy at our institution. Methods A retrospective study of 80 patients with locally advanced prostate cancer treated with radiotherapy combined with neo-adjuvant (2 months) and adjuvant (24 months) androgen deprivation. We studied the clinical variables and side effects. We evaluated treatment outcomes using PSA nadir and biochemical failure, and recorded acute and chronic gastrointestinal and urinary toxicity. We assessed the correlation between clinical variables and urinary toxicity by means of univariate and multivariate analyses (multiple logistic regression). Results The mean patient age was 68 ± 5.81 years; the initial PSA was 20.05 ± 16.27 ng/ml and the mean prostate volume 43.7 ± 27.57 cc. The clinical stage was T3a in 33% and T3b in 66%. The Gleason score was <7 in 39%, 7 in 46% and ≥8 in 15%. The mean follow-up was 44.4 months and biochemical failure was observed in 3 cases. Acute urinary toxicity was recorded in 90% of the patients (chronic in 35%) and acute gastrointestinal toxicity in 75% (late in 32%). In a univariate analysis, prostate volume and urinary symptoms were statistically correlated to acute and late urinary toxicity. Both prostate volume and urinary symptoms were independently associated with an increase in urinary toxicity in the logistic regression analysis. Conclusions Hormone-radiotherapy is a valid option to treat locally advanced prostate cancer with optimal short-term outcomes, although it is not devoid of side effects. Prostate volume and urinary symptoms before treatment can predict genitourinary toxicity.