title: Favorable outcome of intraoperative radiotherapy to the primary site in patients with metastatic prostate cancer.
abstract: BACKGROUND
  The aim of this study was to determine whether local radiotherapy to the prostate by intraoperative radiotherapy (IORT) increases the overall and cancer-specific survival rates of patients with metastatic prostate cancer.
  
  
  METHODS
  Between 1993 and 2000, 102 patients with prostate cancer were treated with a combination of (a) IORT of the prostate (25 or 30 Gy per fraction); (b) external beam radiotherapy of the prostate (30 Gy in 10 fractions), starting approximately 1 week post-operatively; and (c) endocrine treatment. Of these, 16 patients had stage D1 disease (D1 IORT group), 32 had stage D2 disease without visceral metastasis (D2 IORT group), and 38 had stage D2 disease without visceral metastasis and did not receive local therapy (D2 control group). Overall and cancer-specific survival rates were compared.
  
  
  RESULTS
  The 5- and 10-year cancer-specific survival rates were 75.9 and 52.7 %, respectively, in the (D1 + D2) IORT group and 45.8 and 33.5 %, respectively, in the D2 control group, with cancer-specific survival being significantly longer in the D2 IORT than in the D2 control group (P = 0.030). Univariate and multivariate reduced-rank regression analyses showed that extent of skeletal disease Grade 4 and non-regional lymph node metastasis were significantly prognostic of poorer cancer-specific survival (P < 0.001 each).
  
  
  CONCLUSIONS
  Local radiotherapy to the prostate by IORT in patients with metastatic prostate cancer may contribute to better survival, especially in patients without extent of skeletal disease Grade 4 or non-regional lymph node metastasis.
authors.affiliation: Department of Urology, Saitama Cancer Center, 780 Komuro, Ina, Kita-Adachi, Saitama, 362-0806, Japan. kanda@cancer-c.pref.saitama.jp.
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Kanda
authors.affiliation: Department of Urology, Saitama Cancer Center, 780 Komuro, Ina, Kita-Adachi, Saitama, 362-0806, Japan.
authors.forename: Syohei
authors.initials: S
authors.lastname: Fukuda
authors.affiliation: Department of Urology, Saitama Cancer Center, 780 Komuro, Ina, Kita-Adachi, Saitama, 362-0806, Japan.
authors.forename: Naotaka
authors.initials: N
authors.lastname: Fukui
authors.affiliation: Department of Radiotherapy, Saitama Cancer Center, 780 Komuro, Ina, Kita-Adachi, Saitama, 362-0806, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Ohkubo
authors.affiliation: Department of Radiotherapy, Saitama Cancer Center, 780 Komuro, Ina, Kita-Adachi, Saitama, 362-0806, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Kazumoto
authors.affiliation: Department of Radiotherapy, Saitama Cancer Center, 780 Komuro, Ina, Kita-Adachi, Saitama, 362-0806, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Saito
authors.affiliation: Department of Pathology, Saitama Cancer Center, 780 Komuro, Ina, Kita-Adachi, Saitama, 362-0806, Japan.
authors.forename: Ayataka
authors.initials: A
authors.lastname: Ishikawa
authors.affiliation: Department of Pathology, Saitama Cancer Center, 780 Komuro, Ina, Kita-Adachi, Saitama, 362-0806, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Kurosumi
authors.affiliation: Department of Urology, Saitama Cancer Center, 780 Komuro, Ina, Kita-Adachi, Saitama, 362-0806, Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Kageyama
authors.affiliation: Department of Urology, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Fujii
authors.affiliation: Department of Urology, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8510, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kihara
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D006801:Humans; D007432:Intraoperative Period; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D018714:Radiotherapy, Adjuvant; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen
keywords: Intraoperative radiotherapy; Local therapy; Metastatic prostate cancer