Radiation Oncology Journal

The Korean Society for Radiation Oncology (대한방사선종양학회)
권호 표지
DOI QR코드

DOI QR Code

Outcome of postoperative radiotherapy following radical prostatectomy: a single institutional experience

  • Lee, Sea-Won (Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea College of Medicine) ;
  • Hwang, Tae-Kon (Department of Urology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Hong, Sung-Hoo (Department of Urology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Lee, Ji-Youl (Department of Urology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Chung, Mi Joo (Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea College of Medicine) ;
  • Jeong, Song Mi (Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea College of Medicine) ;
  • Kim, Sung Hwan (Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea College of Medicine) ;
  • Lee, Jong Hoon (Department of Radiation Oncology, St. Vincent's Hospital, The Catholic University of Korea College of Medicine) ;
  • Jang, Hong Seok (Department of Radiation Oncology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Yoon, Sei Chul (Department of Radiation Oncology, Bucheon St. Mary's Hospital, The Catholic University of Korea College of Medicine)
  • Received : 2014.04.25
  • Accepted : 2014.07.04
  • Published : 2014.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: This single institutional study is aimed to observe the outcome of patients who received postoperative radiotherapy after radical prostatectomy. Materials and Methods: A total of 59 men with histologically identified prostate adenocarcinoma who had received postoperative radiation after radical prostatectomy from August 2005 to July 2011 in Seoul St. Mary's Hospital of the Catholic University of Korea, was included. They received 45-50 Gy to the pelvis and boost on the prostate bed was given up to total dose of 63-72 Gy (median, 64.8 Gy) in conventional fractionation. The proportion of patients given hormonal therapy and the pattern in which it was given were analyzed. Primary endpoint was biochemical relapse-free survival (bRFS) after radiotherapy completion. Secondary endpoint was overall survival (OS). Biochemical relapse was defined as a prostate-specific antigen level above 0.2 ng/mL. Results: After median follow-up of 53 months (range, 0 to 104 months), the 5-year bRFS of all patients was estimated 80.4%. The 5-year OS was estimated 96.6%. Patients who were given androgen deprivation therapy had a 5-year bRFS of 95.1% while the ones who were not given any had that of 40.0% (p < 0.01). However, the statistical significance in survival difference did not persist in multivariate analysis. The 3-year actuarial grade 3 chronic toxicity was 1.7% and no grade 3 acute toxicity was observed. Conclusion: The biochemical and toxicity outcome of post-radical prostatectomy radiotherapy in our institution is favorable and comparable to those of other studies.

Keywords

References

  1. Jung KW, Won YJ, Kong HJ, Oh CM, Seo HG, Lee JS. Cancer statistics in Korea: incidence, mortality, survival and prevalence in 2010. Cancer Res Treat 2013;45:1-14. https://doi.org/10.4143/crt.2013.45.1.1
  2. Swanson GP, Riggs M, Hermans M. Pathologic findings at radical prostatectomy: risk factors for failure and death. Urol Oncol 2007;25:110-4. https://doi.org/10.1016/j.urolonc.2006.06.003
  3. Thompson IM Jr, Tangen CM, Paradelo J, et al. Adjuvant radiotherapy for pathologically advanced prostate cancer: a randomized clinical trial. JAMA 2006;296:2329-35. https://doi.org/10.1001/jama.296.19.2329
  4. Wiegel T, Bottke D, Steiner U, et al. Phase III postoperative adjuvant radiotherapy after radical prostatectomy compared with radical prostatectomy alone in pT3 prostate cancer with postoperative undetectable prostate-specific antigen: ARO 96-02/AUO AP 09/95. J Clin Oncol 2009;27:2924-30. https://doi.org/10.1200/JCO.2008.18.9563
  5. Thompson IM, Tangen CM, Paradelo J, et al. Adjuvant radiotherapy for pathological T3N0M0 prostate cancer significantly reduces risk of metastases and improves survival: long-term followup of a randomized clinical trial. J Urol 2009;181:956-62. https://doi.org/10.1016/j.juro.2008.11.032
  6. Bolla M, van Poppel H, Collette L, et al. Postoperative radiotherapy after radical prostatectomy: a randomised controlled trial (EORTC trial 22911). Lancet 2005;366:572-8. https://doi.org/10.1016/S0140-6736(05)67101-2
  7. Bolla M, van Poppel H, Tombal B, et al. Postoperative radiotherapy after radical prostatectomy for high-risk prostate cancer: long-term results of a randomised controlled trial (EORTC trial 22911). Lancet 2012;380:2018-27. https://doi.org/10.1016/S0140-6736(12)61253-7
  8. Horwitz EM, Bae K, Hanks GE, et al. Ten-year follow-up of radiation therapy oncology group protocol 92-02: a phase III trial of the duration of elective androgen deprivation in locally advanced prostate cancer. J Clin Oncol 2008;26:2497-504. https://doi.org/10.1200/JCO.2007.14.9021
  9. Pilepich MV, Winter K, John MJ, et al. Phase III radiation therapy oncology group (RTOG) trial 86-10 of androgen deprivation adjuvant to definitive radiotherapy in locally advanced carcinoma of the prostate. Int J Radiat Oncol Biol Phys 2001;50:1243-52. https://doi.org/10.1016/S0360-3016(01)01579-6
  10. Bolla M, van Tienhoven G, de Reijke, et al. Concomitant and adjuvant androgen deprivation (ADT) with external beam irradiation (RT) for locally advanced prostate cancer: 6 months versus 3 years ADT: results of the randomized EORTC Phase III trial 22961 [abstract]. J Clin Oncol 2007;25(18S):5014.
  11. Glare P. Clinical predictors of survival in advanced cancer. J Support Oncol 2005;3:331-9.
  12. Michalski JM, Lawton C, El Naqa I, et al. Development of RTOG consensus guidelines for the definition of the clinical target volume for postoperative conformal radiation therapy for prostate cancer. Int J Radiat Oncol Biol Phys 2010;76:361-8. https://doi.org/10.1016/j.ijrobp.2009.02.006
  13. Stephenson AJ, Kattan MW, Eastham JA, et al. Defining biochemical recurrence of prostate cancer after radical prostatectomy: a proposal for a standardized definition. J Clin Oncol 2006;24:3973-8. https://doi.org/10.1200/JCO.2005.04.0756
  14. Parker C, Clarke N, Logue J, et al. RADICALS (Radiotherapy and Androgen Deprivation in Combination after Local Surgery). Clin Oncol (R Coll Radiol) 2007;19:167-71. https://doi.org/10.1016/j.clon.2007.01.001
  15. Halperin EC, Wazer DE, Perez CA, Brady LW. Perez and Brady's principles and practice of radiation oncology. 6th ed. Philadelphia, PA: Wolters Kluwer/Lippincott Williams & Wilkins; 2013.
  16. Eulau SM, Tate DJ, Stamey TA, Bagshaw MA, Hancock SL. Effect of combined transient androgen deprivation and irradiation following radical prostatectomy for prostatic cancer. Int J Radiat Oncol Biol Phys 1998;41:735-40. https://doi.org/10.1016/S0360-3016(98)00127-8
  17. King CR, Presti JC Jr, Gill H, Brooks J, Hancock SL. Radiotherapy after radical prostatectomy: does transient androgen suppression improve outcomes? Int J Radiat Oncol Biol Phys 2004;59:341-7. https://doi.org/10.1016/j.ijrobp.2003.10.015
  18. Denham JW, Steigler A, Lamb DS, et al. Short-term neoadjuvant androgen deprivation and radiotherapy for locally advanced prostate cancer: 10-year data from the TROG 96.01 randomised trial. Lancet Oncol 2011;12:451-9. https://doi.org/10.1016/S1470-2045(11)70063-8
  19. Lawton CA, Winter K, Murray K, et al. Updated results of the phase III Radiation Therapy Oncology Group (RTOG) trial 85-31 evaluating the potential benefit of androgen suppression following standard radiation therapy for unfavorable prognosis carcinoma of the prostate. Int J Radiat Oncol Biol Phys 2001;49:937-46. https://doi.org/10.1016/S0360-3016(00)01516-9
  20. Bolla M, Van Tienhoven G, Warde P, et al. External irradiation with or without long-term androgen suppression for prostate cancer with high metastatic risk: 10-year results of an EORTC randomised study. Lancet Oncol 2010;11:1066-73. https://doi.org/10.1016/S1470-2045(10)70223-0

Cited by

  1. Postoperative carcinoembryonic antigen level has a prognostic value for distant metastasis and survival in rectal cancer patients who receive preoperative chemoradiotherapy and curative surgery: a ret vol.33, pp.8, 2014, https://doi.org/10.1007/s10585-016-9818-6
  2. Displacement of Surgical Clips during Postoperative Radiotherapy in Breast Cancer Patients Who Received Breast-Conserving Surgery vol.19, pp.4, 2016, https://doi.org/10.4048/jbc.2016.19.4.417
  3. Analysis of Geometric Shifts and Proper Setup-Margin in Prostate Cancer Patients Treated With Pelvic Intensity-Modulated Radiotherapy Using Endorectal Ballooning and Daily Enema for Prostate Immobiliz vol.95, pp.2, 2016, https://doi.org/10.1097/md.0000000000002387
  4. Simple Prediction Model of Axillary Lymph Node Positivity After Analyzing Molecular and Clinical Factors in Early Breast Cancer vol.95, pp.20, 2016, https://doi.org/10.1097/md.0000000000003689
  5. Outcomes of post‐prostatectomy radiotherapy at a Regional Cancer Centre vol.64, pp.4, 2017, https://doi.org/10.1002/jmrs.240
  6. Salvage radiotherapy for biochemical recurrence after radical prostatectomy: does the outcome depend on the prostate cancer characteristics? vol.45, pp.2, 2014, https://doi.org/10.1590/s1677-5538.ibju.2018.0039