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Patterns of treatment failure in patients with prostate cancer treated with 76–80 Gy radiotherapy to the prostate and seminal vesicles ± hormonotherapy

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Abstract

Purpose

To assess the pattern of treatment failure in patients with prostate cancer (PCa) treated with radiotherapy (76–80 Gy) ± hormone therapy (HT). We also evaluated the influence of treatment failure on survival outcomes.

Methods

Retrospective study of patients with PCa (n = 302) treated with radiotherapy (RT) ± HT at our centre between November 1999 and July 2007. The mean patient age was 70.2 years (range 51–87). Distribution by NCCN risk group was low (n = 80, 26.5%), intermediate (n = 86, 28.5%), high (n = 77, 25.5%), and very high (n = 49, 16.2%). Most patients (n = 273, 90.4%) received IMRT at a dose of 76–80 Gy. HT was administered in 237 patients (78.5%), in most cases (n = 167, 55.3%) for < 7 months

Results

Survival rates at 10 years were: overall survival (OS), 64.3%; biochemical disease-free survival, 83.9%; disease-free survival, 92.5%; and metastasis-free survival (MFS), 94.3%. Biochemical failure (BF) was observed in 55 cases (18.2%), 32 of whom subsequently developed clinical recurrence: metastasis (n = 17, 5.6%), local failure (n = 11, 3.6%), and regional failure (n = 4, 1.3%). The cause of death (n = 159) was intercurrent disease in 115 cases (72.3%), second cancer in 27 (17.0%), and PCa in 17 (10.7%). Biochemical failure-free survival ≤ 24 months was significantly associated with worse OS and MFS (p = 0.0001). Late genitourinary and gastrointestinal toxicity grade ≥ 3 (RTOG) was observed in 18 (6.0%) and 7 (2.3%) patients, respectively.

Conclusions

The main type of treatment failure after 76–80 Gy of radiotherapy ± HT is local or metastatic. In all cases, biochemical failure occurred prior to treatment failure. BF within 24 months of treatment completion was significantly associated with worse OS and MFS.

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Acknowledgements

We thank Begoña Bordería, Jorge Buedo, Carmen Calatayud, Patricia Calatayud, Rafael Iñigo, Laura Leon, Laura Parreño, Frances Perruca, Patricia Prats, Patricia Martinez, Maria Muñoz, Rocio Sandoval, Elena Santos y Ana Serrano for their contribution to the treatment and monitoring of these patients, without their enthusiastic dedication to this work, it would not have been possible.

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Authors and Affiliations

  1. Department of Radiation Oncology, ERESA, Hospital General Universitario de Valencia, Av. Tres Cruces, 2, 46014, Valencia, Spain

    J. López-Torrecilla, J. Pastor-Peidro, D. González-Sanchis, A. Hernandez-Machancoses, P. Almendros-Blanco, E. García-Miragall, J. C. Gordo-Partearroyo & T. García-Hernández

  2. Medical Physics Department, ERESA, Hospital General Universitario de Valencia, Av. Tres Cruces, 2, 46014, Valencia, Spain

    A. Vicedo-González, T. García-Hernández, L. Brualla-González, D. Granero-Cabañero & J. Rosello-Ferrando

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  1. J. López-Torrecilla
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Correspondence to J. López-Torrecilla.

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López-Torrecilla, J., Pastor-Peidro, J., Vicedo-González, A. et al. Patterns of treatment failure in patients with prostate cancer treated with 76–80 Gy radiotherapy to the prostate and seminal vesicles ± hormonotherapy. Clin Transl Oncol 23, 481–490 (2021). https://doi.org/10.1007/s12094-020-02437-0

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