title: Results of combined radiotherapy and hormonal treatment of prostate cancer patients with initial PSA value >40 ng/ml.
abstract: OBJECTIVE
  To evaluate the outcome of prostate cancer patients with initial PSA value >40 ng/ml.
  
  
  BACKGROUND
  The outcome of prostate cancer patients with very high initial PSA value is not known and patients are frequently treated with palliative intent. We analyzed the outcome of radical combined hormonal treatment and radiotherapy in prostate cancer patients with initial PSA value >40 ng/ml.
  
  
  METHODS
  Between January 2003 and December 2007 we treated, with curative intent, 56 patients with non-metastatic prostate cancer and initial PSA value >40 ng/ml. The treatment consisted of two months of neoadjuvant hormonal treatment (LHRH analog), radical radiotherapy (68-78 Gy, conformal technique) and an optional two-year adjuvant hormonal treatment.
  
  
  RESULTS
  The median time of follow up was 61 months. 5-Year overall survival was 90%. 5-Year biochemical disease free survival was 62%. T stage, Gleason score, PSA value, and radiotherapy dose did not significantly influence the outcome. Late genitourinal and gastrointestinal toxicity was acceptable.
  
  
  CONCLUSIONS
  Radical treatment in combination with hormonal treatment and radiotherapy can be recommended for this subgroup of prostate cancer patients with good performance status and life expectancy.
authors.affiliation: Institute of Radiation Oncology, Faculty Hospital Na Bulovce and 1 Faculty of Medicine, Charles University, Budínova 2, Prague 8, 18000, Czech Republic.
authors.forename: Jiri
authors.initials: J
authors.lastname: Kubeš
authors.affiliation: Oncological Clinic, Faculty Hospital Ostrava, 17. listopadu 1790, Ostrava-Poruba 708 52, Czech Republic.
authors.forename: Cvek
authors.initials: C
authors.lastname: Jakub
authors.affiliation: Institute of Radiation Oncology, Faculty Hospital Na Bulovce and 1 Faculty of Medicine, Charles University, Budínova 2, Prague 8, 18000, Czech Republic.
authors.forename: Vondráček
authors.initials: V
authors.lastname: Vladimir
authors.affiliation: Institute of Radiation Oncology, Faculty Hospital Na Bulovce and 1 Faculty of Medicine, Charles University, Budínova 2, Prague 8, 18000, Czech Republic.
authors.forename: Dvořák
authors.initials: D
authors.lastname: Jan
authors.affiliation: Institute of Radiation Oncology, Faculty Hospital Na Bulovce and 1 Faculty of Medicine, Charles University, Budínova 2, Prague 8, 18000, Czech Republic.
authors.forename: Argalacsová
authors.initials: A
authors.lastname: Sona
authors.affiliation: Institute of Radiation Oncology, Faculty Hospital Na Bulovce and 1 Faculty of Medicine, Charles University, Budínova 2, Prague 8, 18000, Czech Republic.
authors.forename: Navrátil
authors.initials: N
authors.lastname: Matej
authors.affiliation: Institute of Radiation Oncology, Faculty Hospital Na Bulovce and 1 Faculty of Medicine, Charles University, Budínova 2, Prague 8, 18000, Czech Republic.
authors.forename: Buřil
authors.initials: B
authors.lastname: Jan
keywords: High risk; PSA; Prostate cancer; Radiotherapy