title: Radiotherapy for early-stage prostate cancer in men under 70 years of age.
abstract: OBJECTIVE
  To demonstrate that radiotherapy (RT) is a valid alternative to surgery in men ≤70 years old with localized prostate cancer.
  
  
  METHODS
  From 1988 to 2009, 214 patients with T1-2 N0 M0 prostate cancer were treated with RT. The effects of patient- and treatment-related risk factors on toxicity were investigated.
  
  
  RESULTS
  Median follow-up was 105 months (range 14.2-180). The 5-, 10-, and 15-year biochemical relapse-free survival for all 214 patients was 80%, 61.9%, and 57.5%, respectively. In bivariate analysis, age (≤65 vs 65-70 years) was not a significant factor for biochemical relapse, while radiation dose was (p = 0.05) in multivariate analysis. Cancer-specific survival rates at 5, 10, and 15 years were 98.4%, 93.2%, and 69.7%, respectively. Median overall survival (OS) was 167 months (95% confidence interval 147.3-186.7). The OS rates at 5, 10, and 15 years were 91.8%, 75.8%, and 42.5%, respectively. Acute genitourinary (GU) and gastrointestinal (GI) toxicities occurred in 105 (49%) and 98 patients (45.8%), respectively, with only 2 cases of grade III GI toxicity. Late GU and GI toxicities occurred in 17 (7.9%) and 20 (9.3%) patients, respectively, with 1 grade III GI toxicity and 2 grade III GU toxicities. Risk factors for late toxicity were age and RT dose and technique, which were unrelated to acute toxicity.
  
  
  CONCLUSIONS
  Age ≤70 years does not consistently confer a negative prognosis for localized prostate cancer. Radiotherapy appears to be a viable alternative to surgery, offering excellent long-term cancer control.
authors.affiliation: Institute of Radiation Oncology, General Hospital and University of Perugia, Perugia - Italy.
authors.forename: Rita
authors.initials: R
authors.lastname: Bellavita
authors.affiliation: Department of Radiotherapy, Ospedali Riuniti Ancona, Ancona - Italy.
authors.forename: Melissa
authors.initials: M
authors.lastname: Scricciolo
authors.affiliation: Department of Medicine, Endocrine and Metabolic Sciences Section, University of Perugia, Perugia - Italy.
authors.forename: Vittorio
authors.initials: V
authors.lastname: Bini
authors.affiliation: Institute of Radiation Oncology, General Hospital and University of Perugia, Perugia - Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Arcidiacono
authors.affiliation: Institute of Radiation Oncology, General Hospital and University of Perugia, Perugia - Italy.
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Montesi
authors.affiliation: Institute of Radiation Oncology, General Hospital and University of Perugia, Perugia - Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Lancellotta
authors.affiliation: Department of Medical Physics, General Hospital of Perugia, Perugia - Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Zucchetti
authors.affiliation: Institute of Radiation Oncology, General Hospital and University of Perugia, Perugia - Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Lupattelli
authors.affiliation: Institute of Radiation Oncology, General Hospital and University of Perugia, Perugia - Italy.
authors.forename: Isabella
authors.initials: I
authors.lastname: Palumbo
authors.affiliation: Institute of Radiation Oncology, General Hospital and University of Perugia, Perugia - Italy.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Aristei
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy*; D000367:Age Factors; D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood*; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D041981:Gastrointestinal Tract / Q000528:radiation effects; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D020266:Radiotherapy, Conformal / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014566:Urogenital System / Q000528:radiation effects
chemical_list: D018931:Antineoplastic Agents, Hormonal; D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen