title: Radiotherapy for patients with localized hormone-refractory prostate cancer: results of the Patterns of Care Study in Japan.
abstract: OBJECTIVE
  To evaluate the clinical results of radiotherapy (RT) for patients with regionally localized hormone-refractory prostate carcinoma (HRPC).
  
  
  METHODS
  As part of a Patterns of Care Study in Japan, a nationwide survey was conducted of RT for patients with prostate adenocarcinoma. We reviewed the detailed information of 140 patients with regionally localized HRPC who received RT between 1996 and 1998, and between 1999 and 2001, in 117 randomly selected institutes in Japan. The median (range) age of the patients was 74 (51-94) years, and their tumours were defined as well (14), moderately (51) or poorly (54) differentiated, or of unknown differentiation (21). The median (range) interval between hormonal therapy (HT) and RT was 32.5 (1.1-168.4) months. Ninety-five patients had T3-4 tumours and 28 had regional lymph node metastases before treatment. The median (range) prostate-specific antigen levels before the initial HT and before RT were 35.0 (1.5-276) and 10.0 (0.06-760.3) ng/mL, respectively. External beam RT was administered, with a median total dose of 66 Gy; 70 patients (50%) received pelvic irradiation.
  
  
  RESULTS
  At a median follow-up of 20.7 months, the 5-year overall and clinical progression-free survival rates (95% confidence interval) were 48.1 (36-60)% and 36.7 (26-47)%, respectively. Although there were distant metastases in 46 patients, only six had local progression. There was late morbidity of grade > or =3 in six patients.
  
  
  CONCLUSIONS
  To the best of our knowledge, this study comprises the largest series of regionally localized HRPC treated with RT reported to date. RT might have a limited role for HRPC, because in most patients RT failed, with distant metastasis.
authors.affiliation: Department of Radiology, National Kyushu Cancer Center, Fukuoka University, Fukuoka, Japan. tsasaki@nk-cc.go.jp
authors.forename: Tomonari
authors.initials: T
authors.lastname: Sasaki
authors.forename: Katsumasa
authors.initials: K
authors.lastname: Nakamura
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Ogawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Onishi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Okamoto
authors.forename: Masahiko
authors.initials: M
authors.lastname: Koizumi
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Shioyama
authors.forename: Michihide
authors.initials: M
authors.lastname: Mitsumori
authors.forename: Teruki
authors.initials: T
authors.lastname: Teshima
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use; D000728:Androgens / Q000378:metabolism; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D004812:Epidemiologic Methods; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D009376:Neoplasms, Hormone-Dependent / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D016896:Treatment Outcome
chemical_list: D000726:Androgen Antagonists; D000728:Androgens; D018931:Antineoplastic Agents, Hormonal; D017430:Prostate-Specific Antigen