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Effectiveness of adjuvant intermittent endocrine therapy following neoadjuvant endocrine therapy and external beam radiation therapy in men with locally advanced prostate cancer
Author(s) -
Yamanaka Hidetoshi,
Ito Kazuto,
Naito Seiji,
Tsukamoto Taiji,
Usami Michiyuki,
Fujimoto Hiroyuki,
Matsuoka Naoki,
Fukui Iwao,
Harada Masaoki,
Ohashi Yasuo,
Kotake Toshihiko,
Kakizoe Tadao
Publication year - 2005
Publication title -
the prostate
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.295
H-Index - 123
eISSN - 1097-0045
pISSN - 0270-4137
DOI - 10.1002/pros.20171
Subject(s) - medicine , prostate cancer , urology , radiation therapy , endocrine system , external beam radiotherapy , hormonal therapy , antiandrogen , androgen suppression , prostate , androgen , cancer , androgen deprivation therapy , surgery , hormone
PURPOSE To clarify the optimal duration and methods for adjuvant endocrine therapy after external beam radiation therapy (EBRT) in patients with locally advanced prostate cancer. MATERIALS AND METHODS Between 2001 and 2003, 215 patients with locally advanced prostate cancer were enrolled in the study. Patients were registered as primary candidates of the study and were treated with 6 months of LHRH agonist, with short‐term of antiandrogen treatment for flare‐up prevention. Patients with PSA levels below 10 ng/ml after the 6‐month endocrine treatment were randomly divided into two arms. Then, a total dose of 72 Gy was given to the prostate. After 14 months of the protocol treatment, patients were treated with continuous androgen ablation (arm 1) or intermittent androgen ablation (arm 2). RESULTS A total of 188 cases (87%) remained in the protocol. The median PSA level at entry was 25.3 ng/ml. The Gleason score was 2–6 in 32 cases (16%), 7 in 94 cases (48%), and 8–10 in 68 cases (35%). The median PSA level showed a remarkable decrease to 1.1, 0.2, and 0.1 ng/ml, after 6, 8, and 14 months of the protocol treatment, respectively. Of the 157 cases treated with EBRT, 153 cases (97.5%) had no biochemical failure in the mean follow‐up of 17.3 months. CONCLUSIONS The present study may reveal the possibilities of intermittent endocrine therapy after EBRT. However, the follow‐up interval is short and little can be said about the results observed so far, exception of acute tolerance and patient acceptance of the protocol. © 2004 Wiley‐Liss, Inc.