Multimodal Primary Treatment of Metastatic Prostate Cancer with Androgen Deprivation and Radiation

作者：Joensuu Timo^*; Joensuu Greetta; Kairemo Kalevi; Kiljunen Timo; Riener Maigo; Aaltonen Aili; Ala Opas Martti; Kangasmaki Aki; Alanko Tuomo; Taipale Lauri; Hervonen Petteri; Butzow Anna; Virgolini Irene; Hemminki Akseli

来源：Anticancer Research, 2016, 36(12): 6439-6447.

DOI：10.21873/anticanres.11242

• Retrospective
• non-randomized
• experimental approach
• metastatic prostate cancer
• multimodality
• radiotherapy
• VMAT
• HDR brachytherapy
• chemotherapy
• hormone therapy
• Sm-153
• Ra-223

Aim: We combined anti-androgen therapy with radiotherapy in a first-line setting for metastatic prostate cancer aiming to cause maximal cancer-cell death to delay the emergence of castration-resistant disease. Materials and Methods: In this non-randomized retrospective series of 46 patients, the initial median prostate-specific antigen (PSA) was 98.5 mu g/l (range=6.7-15,500), median Gleason score 9 and most men had at least T3N1M1 disease. All patients received luteinizing hormone releasing hormone analog or degarelix with bicalutamide. If PSA remained above 1 mu g/l, docetaxel was initiated. At PSA nadir, all patients received radical radiotherapy of the prostate. Results: The median follow-up time was 4.38 years (range=0.36-11.24). Most radiotherapy-related adverse events were grade 1 and transient. There were no grade 4 events. Overall survival (OS) at 5 years was 81.3%. Conclusion: The feasibility and safety of aggressive multimodality treatment were good resulting in an excellent median OS of 8.35 years.

• 出版日期2016-12