OBJECTIVE: To evaluate the clinical results of
radiotherapy (RT) for patients with regionally localized hormone-refractory
prostate carcinoma (
HRPC). PATIENTS AND METHODS: As part of a Patterns of Care Study in Japan, a nationwide survey was conducted of RT for patients with
prostate adenocarcinoma. We reviewed the detailed information of 140 patients with regionally localized
HRPC who received RT between 1996 and 1998, and between 1999 and 2001, in 117
randomly selected institutes in Japan. The
median (range) age of the patients was 74 (51-94) years, and their
tumours were defined as well (14), moderately (51) or poorly (54) differentiated, or of unknown differentiation (21). The
median (range) interval between
hormonal therapy (HT) and RT was 32.5 (1.1-168.4) months. Ninety-five patients had T3-4
tumours and 28 had regional
lymph node metastases before treatment. The
median (range)
prostate-specific antigen levels before the initial HT and before RT were 35.0 (1.5-276) and 10.0 (0.06-760.3) ng/mL, respectively. External beam RT was administered, with a
median total dose of 66 Gy; 70 patients (50%) received
pelvic irradiation. RESULTS: At a
median follow-up of 20.7 months, the 5-year overall and clinical progression-free survival rates (95%
confidence interval) were 48.1 (36-60)% and 36.7 (26-47)%, respectively. Although there were distant
metastases in 46 patients, only six had local progression. There was late
morbidity of grade > or =3 in six patients. CONCLUSION: To the best of our knowledge, this study comprises the largest series of regionally localized
HRPC treated with RT reported to date. RT might have a limited role for
HRPC, because in most patients RT failed, with distant
metastasis.
