title: Optimal duration of androgen deprivation in combination with radiation therapy for Japanese men with high-risk prostate cancer.
abstract: OBJECTIVE
  To evaluate the efficacy and toxicity of external beam radiation therapy (EBRT) combined with androgen deprivation therapy (ADT) for Japanese high-risk prostate cancer (PCa) patients in a single institution.
  
  
  METHODS
  Seventy-five high-risk PCa patients were treated by three-dimensional conformal radiotherapy of 70 Gy combined with neoadjuvant, concurrent and adjuvant ADT.
  
  
  RESULTS
  Median age was 72 (59-82) years. Median initial serum prostate-specific antigen (PSA) was 19.0 (4.7-200) ng/ml. Median duration of the entire ADT was 27 (8-63) months. Median follow-up after initiating ADT and after completing EBRT was 66 (41-105) and 59 (36-94) months, respectively. Five-year overall, clinical progression-free, and biochemical progression-free survival rates were 98.3, 97.2, and 87.4%; 2 (2.7%) cancer deaths, 3 (4.0%) clinical progressions, and 11 (14.7%) biochemical progressions. Multivariate analysis suggested a total duration of ADT shorter than 24 months as an independent risk factor of biochemical progression (p = 0.01). Grade 3 toxicities related to EBRT were observed: 1 patient with proctitis and rectal bleeding and 1 patient with rectal bleeding.
  
  
  CONCLUSIONS
  It is suggested that 70 Gy EBRT combined with ADT confers disease-free survival benefit with tolerable adverse events for Japanese high-risk PCa patients. ADT of 24 months or longer might be recommended to minimize biochemical progression.
authors.affiliation: Department of Urology, Kyoto Prefectural University of Medicine, Kyoto, Japan. ntakaha @ koto.kpu-m.ac.jp
authors.forename: Natsuki
authors.initials: N
authors.lastname: Takaha
authors.forename: Koji
authors.initials: K
authors.lastname: Okihara
authors.forename: Kazumi
authors.initials: K
authors.lastname: Kamoi
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Kimura
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yamada
authors.forename: Akihiro
authors.initials: A
authors.lastname: Kawauchi
authors.forename: Kana
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Hideya
authors.initials: H
authors.lastname: Yamazaki
authors.forename: Tsunehiko
authors.initials: T
authors.lastname: Nishimura
authors.forename: Tsuneharu
authors.initials: T
authors.lastname: Miki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D044466:Asian People; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D004334:Drug Administration Schedule; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020360:Neoadjuvant Therapy; D016016:Proportional Hazards Models; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000208:ethnology / Q000276:immunology / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D011829:Radiation Dosage; D020266:Radiotherapy, Conformal / Q000009:adverse effects; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000726:Androgen Antagonists; D018931:Antineoplastic Agents, Hormonal; D017430:Prostate-Specific Antigen