Intensity-modulated Radiotherapy Combined with Endocrine Therapy for Intermediate and Advanced Prostate Cancer: Long-term Outcome of Chinese Patients

Abstract

Aim: The aim of this study was to evaluate acute adverse events and efficacy of three-dimensional intensitymodulatedradiotherapy (IMRT) combined with endocrine therapy for intermediate and advanced prostatecancer. <br/><b>Methods</b>: Sixty-seven patients were treated with three-dimensional IMRT combined with maximumandrogen blockade. The correlation between radiation-induced rectal injury and clinical factors was furtheranalyzed. <br/><b>Results</b>: After treatment, 21 patients had complete remission (CR), 37 had partial remission (PR), andnine had stable disease (SD), with an overall response rate of 86.5%. The follow-up period ranged from 12.5 to99.6 months. Thirty-nine patients had a follow-up time of ≥ five years. In this group, three-year and five-yearoverall survival rates were 89% and 89.5%, respectively; three-year and five-year progression-free survival rateswere 72% and 63%. In univariate analyses, gross tumor volume was found to be prognostic for survival (χ2 =5.70, P = 0.037). Rates of leucopenia and anemia were 91.1% and 89.5%, respectively. Two patients developedacute liver injury, and a majority of patients developed acute radiation proctitis and cystitis, mainly grade 1/2.Tumor volume before treatment was the only prognostic factor influencing the severity of acute radiation proctitis(P < 0.05). <br/><b>Conclusions</b>: IMRT combined with endocrine therapy demonstrated promising efficacy and was welltolerated in patients with intermediate and advanced prostate cancer.