title: External beam radiotherapy for clinically localized hormone-refractory prostate cancer: clinical significance of Nadir prostate-specific antigen value within 12 months.
abstract: OBJECTIVE
  To analyze retrospectively the results of external beam radiotherapy for clinically localized hormone-refractory prostate cancer and investigate the clinical significance of nadir prostate-specific antigen (PSA) value within 12 months (nPSA12) as an early estimate of clinical outcomes after radiotherapy.
  
  
  METHODS
  Eighty-four patients with localized hormone-refractory prostate cancer treated with external beam radiotherapy were retrospectively reviewed. The total radiation doses ranged from 30 to 76 Gy (median, 66 Gy), and the median follow-up period for all 84 patients was 26.9 months (range, 2.7-77.3 months).
  
  
  RESULTS
  The 3-year actuarial overall survival, progression-free survival (PFS), and local control rates in all 84 patients after radiotherapy were 67%, 61%, and 93%, respectively. Although distant metastases and/or regional lymph node metastases developed in 34 patients (40%) after radiotherapy, local progression was observed in only 5 patients (6%). Of all 84 patients, the median nPSA12 in patients with clinical failure and in patients without clinical failure was 3.1 ng/mL and 0.5 ng/mL, respectively. When dividing patients according to low (<0.5 ng/mL) and high (>or=0.5 ng/mL) nPSA12 levels, the 3-year PFS rate in patients with low nPSA12 and in those with high nPSA12 was 96% and 44%, respectively (p < 0.0001). In univariate analysis, nPSA12 and pretreatment PSA value had a significant impact on PFS, and in multivariate analysis nPSA12 alone was an independent prognostic factor for PFS after radiotherapy.
  
  
  CONCLUSIONS
  External beam radiotherapy had an excellent local control rate for clinically localized hormone-refractory prostate cancer, and nPSA12 was predictive of clinical outcomes after radiotherapy.
authors.affiliation: Department of Radiology, University of the Ryukyus, Okinawa, Osaka, Japan. kogawa@med.u-ryukyu.ac.jp
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Ogawa
authors.forename: Katsumasa
authors.initials: K
authors.lastname: Nakamura
authors.forename: Tomonari
authors.initials: T
authors.lastname: Sasaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Onishi
authors.forename: Masahiko
authors.initials: M
authors.lastname: Koizumi
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Shioyama
authors.forename: Masayuki
authors.initials: M
authors.lastname: Araya
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Mukumoto
authors.forename: Michihide
authors.initials: M
authors.lastname: Mitsumori
authors.forename: Teruki
authors.initials: T
authors.lastname: Teshima