ADJUVANT RADIOTHERAPY FOR HIGH-RISK PATIENTS AFTER RADICAL PROSTATECTOMY: BENEFITS AND TOXICITY IN OUR EXPERIENCE

• Published in: Anticancer research 2011-05, Vol.31 (5), p.1886-1886
• Main Authors: Spagnoletti, G, Marchese, R, Nardella, G, Oriolo, V, De Nobili, G, Bove, G
• Format: Article
• Language: English
• ISSN: 0250-7005

Introduction and Aim: Adjuvant radiotherapy has been associated with improved freedom from biochemical failure as compared with radical prostatectomy alone and it is often delivered after surgery for high-risk patients (1,2). The aim of this study was to assess the benefit and the toxicity of postoperative radiotherapy after surgery for prostate cancer. Patients and Methods: We retrospectively analyzed 80 men treated with adjuvant radiotherapy at the Radiotherapy Department of Foggia from 2006 to 2009. All patients underwent radical prostatectomy and pelvic lymphadenectomy. Median age was 65 years (range: 43-77). Analysis of histologic specimens showed positive margins in 68 patients (85%), extracapsular spread in 50 patients (62.5%) and nodal involvement in 2 patients (2.5%). Median pre-surgery PSA was 9.5 ng/mL and median Gleason score was 7. Hormonal therapy was prescribed for 51 patients (63.7%) of whom 28 (55%) received total androgen deprivation and 23 (45%) received bicalutamide alone (150 mg/die). Radiotherapy was delivered at a median dose of 68 Gy (2 Gy/die). Disease Free Survival and Overall Survival were calculated and toxicity was assessed with RTOG scale. Results: Median follow-up was 25 months. Median PSA value after adjuvant radiotherapy was 0.07 ng/mL. Radiotherapy treatment was well-tolerated, only one patient interrupted his treatment due to rectal bleeding. Acute toxicity included rectal (G0, 66.2%; G1, 30%; G2, 3.8%) and urinary events (G0, 50%; G1, 22.5%; G2, 27.5%). Late toxicity included rectal (G0, 96.3%; G1, 2.5%; G2, 1.2%) and urinary events (G0, 73.8%; G1, 22.5%; G2, 3.7%). Three-year Overall Survival and Disease Free Survival were 93.5% and 85%. Fiveyear Overall Survival and Disease Free Survival were 89.5% and 80.5%, respectively. Discussion and Conclusion: This study showed good results in terms of OS and DFS and also acute and late toxicities were acceptable. Radiotherapy should be considered as adjuvant treatment for high-risk prostate cancer, especially with positive margins or extracapsular spread, since it is a safe and well-tolerated treatment.