title: Long-term outcomes of three-dimensional conformal radiation therapy combined with neoadjuvant hormonal therapy for Japanese patients with T1c-T2N0M0 prostate cancer.
abstract: BACKGROUND
  The outcomes of three-dimensional conformal radiation therapy (3D-CRT) combined with neoadjuvant hormonal therapy (NAHT) in Japanese patients with T1c-T2N0M0 prostate cancer, with initiation of salvage hormonal therapy (SHT) at a relatively early phase, were analyzed.
  
  
  METHODS
  Fifty-nine Japanese patients with T1c-T2N0M0 prostate cancer who received radical 3D-CRT between January 1999 and January 2003 were evaluated. The median age, initial prostate-specific antigen (PSA) level, and duration of NAHT were: 72 years, 9.4 ng/ml, and 6 months, respectively. Seventy Gy was given in 35 fractions confined to the prostate ± seminal vesicles. AHT was not administered after 3D-CRT in any patients.
  
  
  RESULTS
  The median follow-up period was 89 months. The median PSA value at the time of initiation of SHT was 4.7 ng/ml (range 0.1-21.6 ng/ml). The overall, disease-specific, PSA failure-free (based on the Phoenix definition), and SHT-free survival rates at 8 years were 82.8% (95% confidence interval [CI] 72.4-93.2), 100%, 62.4% (47.1-77.8), and 82.6% (71.3-94.0), respectively. Only one patient developed grade 3 late toxicity.
  
  
  CONCLUSIONS
  The PSA control rates in our series of Japanese patients with stage T1c-T2N0M0 prostate cancer treated with the standard dose of 3D-CRT combined with NAHT seemed at least comparable to those reported from Western countries; as well, the patients had excellent outcomes. The present outcomes can be used as basic data for evaluating the impact of dose escalation with intensity-modulated radiation therapy for Japanese patients with prostate cancer in the future.
authors.affiliation: Department of Radiation Oncology and Image-applied Therapy, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan. mizo@kuhp.kyoto-u.ac.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Mizowaki
authors.forename: Kenji
authors.initials: K
authors.lastname: Takayama
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Norihisa
authors.forename: Masakazu
authors.initials: M
authors.lastname: Ogura
authors.forename: Tomomi
authors.initials: T
authors.lastname: Kamba
authors.forename: Takahiro
authors.initials: T
authors.lastname: Inoue
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Shimizu
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Kamoto
authors.forename: Osamu
authors.initials: O
authors.lastname: Ogawa
authors.forename: Masahiro
authors.initials: M
authors.lastname: Hiraoka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D017430:Prostate-Specific Antigen / Q000378:metabolism; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods; D016879:Salvage Therapy; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D017430:Prostate-Specific Antigen