title: Young age under 60 years is not a contraindication to treatment with definitive dose escalated radiotherapy for prostate cancer.
abstract: BACKGROUND
  It is widely believed that younger prostate cancer patients are at greater risk of recurrence following radiotherapy (RT).
  
  
  METHODS
  From 1992 to 2007, 2168 (395 age ≤ 60) men received conformal RT alone for prostate cancer at our institution (median dose=76 Gy, range: 72-80). Multivariable analysis (MVA) was used to identify significant predictors for BF and PCSM. Cumulative incidence was estimated using the competing risk method (Fine and Gray) for BF (Phoenix definition) and PCSM to account for the competing risk of death.
  
  
  RESULTS
  With a median follow-up of 72.2 months (range: 24.0-205.1), 8-year BF was 27.1% for age ≤ 60 vs. 23.7% for age >60 (p=0.29). Eight-year PCSM was 3.0% for age ≤ 60 vs. 2.0% for age >60 (p=0.52). MVA for BF identified initial PSA [adjusted HR=1.7 (PSA 10-20), 2.6 (PSA >20), p<0.01], Gleason score [adjusted HR=2.1 (G7), 1.9 (G8-10), p<0.01], T-stage [adjusted HR=1.7 (T2b-c), 2.6 (T3-4), p<0.01], and initial androgen deprivation therapy (ADT) [adjusted HR=0.38 (ADT >12 months), p<0.01] as significant, but not age or ADT <12 months. MVA for PCSM identified Gleason score [adjusted HR=3.0 (G8-10), p=0.01] and T-stage [adjusted HR=8.7 (T3-4), p<0.01] as significant, but not age, PSA, or ADT.
  
  
  CONCLUSIONS
  This is the largest, most mature study of younger men treated with RT for prostate cancer that confirms young age is not prognostic for BF.
authors: Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia 19111, United States.
authors: Tracy L
authors: TL
authors: Klayton
authors: Karen
authors: K
authors: Ruth
authors: Eric M
authors: EM
authors: Horwitz
authors: Robert G
authors: RG
authors: Uzzo
authors: Alexander
authors: A
authors: Kutikov
authors: David Y T
authors: DY
authors: Chen
authors: Mark
authors: M
authors: Sobczak
authors: Mark K
authors: MK
authors: Buyyounouski
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011471:Prostatic Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal / Q000379:methods*