Long-term outcomes of intensity-modulated radiation therapy combined with neoadjuvant androgen deprivation therapy under an early salvage policy for patients with T3-T4N0M0 prostate cancer

Abstract

High-dose IMRT, combined with NA-ADT for LAPC, was associated with favorable long-term disease-specific and overall survival outcomes, despite non-provision of A-ADT under the early S-ADT provision policy. This approach may represent a viable alternative to uniform provision of long-term A-ADT, because two-thirds of the patients maintained ADT-free status over an 8-year period after IMRT. Prospective trials will be required.

Cancer‐specific mortality of high‐risk prostate cancer after carbon‐ion radiotherapy plus long‐term androgen deprivation therapy

“…In addition, there were few long-term follow-up results after IMRT at the time of writing. However, Mizowaki et al demonstrated a favorable PCSM rate (8-year PCSM rate, 3.4%) for T3-4 high-risk PC patients who had undergone high-dose IMRT (78 Gy) combined with neoadjuvant ADT (median duration, 6 months) plus s-ADT if the PSA value was >4 ng/mL, (40) which was comparable with the results of the present study (Table 4). There are several common points between their study and ours, including the early use of s-ADT, a mainly Japanese study population, use of neoadjuvant ADT and a high irradiation dose.…”

“…Table 4 summarizes the PCSM rates for patients with highrisk PC from previous reports. (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(38)(39)(40) The 10-year PCSM rates after RP and EBRT including IMRT were 5-9% (7-11) and 8-12%, (13,39) respectively. The PCSM rate after CIRT (Figs S1 and S2).…”

Ten-year outcomes of intensity-modulated radiation therapy combined with neoadjuvant hormonal therapy for intermediate- and high-risk patients with T1c-T2N0M0 prostate cancer

“…Because the prognoses of locally advanced cases are generally worse than those of localized disease cases, the impact of long-term A-HT may be smaller in cases with localized diseases alone. Second, the timing of initiating S-HT was not defined and was speculated to be delayed [9]. It is reported that delayed initiation (at a PSA value >10-20 ng/ml) of S-HT resulted in worse survival outcomes [26][27][28].…”

“…4. In fact, the same approach has also led to the maintenance of an 8-year hormone-free status after IMRT in approximately two-thirds of 120 Japanese patients with T3-T4N0M0 prostate cancer, as well as satisfactory survival outcomes (8-year PCSS, 96.6 %; OS, 89.1 %) [9].…”

“…Among them, 120 patients were classified as T3-T4NM0, and the long-term outcomes of the cohort have already been reported previously [9]. Therefore, the remaining 50 patients, who were classified as T1c-T2N0M0 and were treated by NA-HT followed by highdose IMRT, were analyzed in this study.…”