title: Multimodal Primary Treatment of Metastatic Prostate Cancer with Androgen Deprivation and Radiation.
abstract: We combined anti-androgen therapy with radiotherapy in a first-line setting for metastatic prostate cancer aiming to cause maximal cancer-cell death to delay the emergence of castration-resistant disease.
  
  
  
  In this non-randomized retrospective series of 46 patients, the initial median prostate-specific antigen (PSA) was 98.5 μg/l (range=6.7-15,500), median Gleason score 9 and most men had at least T3N1M1disease. All patients received luteinizing hormone releasing hormone analog or degarelix with bicalutamide. If PSA remained above 1 μg/l, docetaxel was initiated. At PSA nadir, all patients received radical radiotherapy of the prostate.
  
  
  
  The median follow-up time was 4.38 years (range=0.36-11.24). Most radiotherapy-related adverse events were grade 1 and transient. There were no grade 4 events. Overall survival (OS) at 5 years was 81.3%.
  
  
  
  The feasibility and safety of aggressive multimodality treatment were good resulting in an excellent median OS of 8.35 years.
authors.affiliation: Docrates Cancer Center, Helsinki, Finland timo.joensuu@docrates.com.
authors.forename: Timo
authors.initials: T
authors.lastname: Joensuu
authors.affiliation: Docrates Cancer Center, Helsinki, Finland.|Doctoral Programme of Clinical Research, University of Helsinki, Biomedicum Helsinki, Helsinki, Finland.
authors.forename: Greetta
authors.initials: G
authors.lastname: Joensuu
authors.affiliation: Docrates Cancer Center, Helsinki, Finland.|Department of Nuclear Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, U.S.A.
authors.forename: Kalevi
authors.initials: K
authors.lastname: Kairemo
authors.affiliation: Docrates Cancer Center, Helsinki, Finland.
authors.forename: Timo
authors.initials: T
authors.lastname: Kiljunen
authors.affiliation: Docrates Cancer Center, Helsinki, Finland.
authors.forename: Maigo
authors.initials: M
authors.lastname: Riener
authors.affiliation: Docrates Cancer Center, Helsinki, Finland.
authors.forename: Aili
authors.initials: A
authors.lastname: Aaltonen
authors.affiliation: Docrates Cancer Center, Helsinki, Finland.
authors.forename: Martti
authors.initials: M
authors.lastname: Ala-Opas
authors.affiliation: Docrates Cancer Center, Helsinki, Finland.
authors.forename: Aki
authors.initials: A
authors.lastname: Kangasmäki
authors.affiliation: Docrates Cancer Center, Helsinki, Finland.
authors.forename: Tuomo
authors.initials: T
authors.lastname: Alanko
authors.affiliation: Docrates Cancer Center, Helsinki, Finland.|Department of Oncology, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: Lauri
authors.initials: L
authors.lastname: Taipale
authors.affiliation: Docrates Cancer Center, Helsinki, Finland.|Department of Oncology, Tampere University Hospital, Tampere, Finland.
authors.forename: Petteri
authors.initials: P
authors.lastname: Hervonen
authors.affiliation: United MEDIX Laboratories Ltd., Espoo, Finland.
authors.forename: Anna
authors.initials: A
authors.lastname: Bützow
authors.affiliation: Department of Nuclear Medicine, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Irene
authors.initials: I
authors.lastname: Virgolini
authors.affiliation: Docrates Cancer Center, Helsinki, Finland.|Department of Oncology, Helsinki University Central Hospital, Helsinki, Finland.|Cancer Gene Therapy Group, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
authors.forename: Akseli
authors.initials: A
authors.lastname: Hemminki
mesh_terms: D000328:Adult; D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy*; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000726:Androgen Antagonists
keywords: HDR brachytherapy; Ra-223; Retrospective; Sm-153; VMAT; chemotherapy; experimental approach; hormone therapy; metastatic prostate cancer; multimodality; non-randomized; radiotherapy