Adjuvant radiation therapy after radical prostatectomy
VICTOR DUQUE-SANTANA,
Spain
PO-1394
Abstract
Adjuvant radiation therapy after radical prostatectomy
Authors: VICTOR DUQUE SANTANA1, Jose Domínguez Rullán2, Asunción Hervás Morón3, Fernando López-Campos2, Carmen Vallejo Ocaña2, Mireia Valero Perena4, Margarita Martín Martín2, David Sevillano Martínez5, Juan David Garcia Fuentes5, Sonsoles Sancho García2
1Ramon y Cajal University Hospital, Radiation Oncology , Madrid, Spain; 2Ramon y Cajal University Hospital, Radiation Oncology, Madrid, Spain; 3Ramon y Cajal University Hospital, Radiation Oncology, Madrid , Spain; 4Ramon y Cajal University Hospital, Radiation Oncology, MAdrid, Spain; 5Ramon y Cajal University Hospital, Physics, Madrid, Spain
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Purpose or Objective
The purpose of the
study is to analyze the results of adjuvant radiotherapy after radical
prostatectomy and to determine prognostic factors of biochemical relapse free
survival (BRFS).
Material and Methods
120 consecutive patients were treated between 1997 and
2014 at our institution. Overall survival and biochemical relapse free survival
were calculated using
Kaplan-Meier method and the COX proportional hazard test was used to assess differences between groups. We also analyse the possible associations between the
quantitative and qualitative variables by Student's T analysis or the chi-squared
test (x2).
Results
Mean age at
diagnosis was 65 years (42-80). 51 (42.5%) patients were Gleason ≤ 6,
56 (46.7%) patients were Gleason 7 and 13 (9.7%) patients were Gleason ≥8. 55 (45.9%)
patients underwent radical prostatectomy combined with pelvic lymphadenectomy
and 65 (54.1%) patients underwent radical prostatectomy without pelvic
lymphadenectomy. 12 (10%) patients had
negative surgical margins, 104 (86.6%) patients had positive surgical margins
and 4 (3.3%) close surgical margins. 15 (12.5%) patients were treated with neoadjuvant
hormone therapy. 60 (50%) patients were pT2, 53 (44.2%) were pT3 and 7 (5.8%)
were pT4. Adjuvant RT was
performed in all patients. 23 (19.2%) patients received <70Gy and 97 (80.8%)
received ≥70Gy. 19 (16.1%)
patients experienced biochemical relapse.
8 (6.7%) developed local relapse. 14 (11.7%) developed nodal relapse. 11
(9.2%) developed metastatic relapse. After a median follow-up
of 114 months (10-239 months). Overall
survival at 5 and 10 years were 94.0% and 83.1%, respectively and BRFS at 5 and
10 years was 85.4% vs. 83.2%%, respectively.
Gleason at diagnosis was a significant prognosis factor of BRFS (p=0.003)
and radiotherapy at dose > 70Gy was not related with a better BRFS (p=0.830)
Conclusion
Postoperative
radiation therapy provides excellent long-term overall survival with good
biochemical relapse free survival. Dose
escalated radiotherapy up to >70Gy doesn´t improve the biochemical relapse
free survival in these patients.