Safety and Feasibility of Radiation Therapy to the Primary Tumor in Patients With Metastatic Castration-resistant Prostate Cancer
| Autor: | Yuki Tobisawa, Shingo Hatakeyama, Kazuaki Yoshikawa, Atsushi Imai, Hiroyuki Ito, Yasuhiro Hashimoto, Tohru Yoneyama, Masaki Momota, Hayato Yamamoto, Yasushi Mariya, Takahiro Yoneyama, Chikara Ohyama, Naoki Fujita |
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| Rok vydání: | 2020 |
| Předmět: |
Oncology
Male medicine.medical_specialty Multivariate analysis Urology medicine.medical_treatment 030232 urology & nephrology 03 medical and health sciences Prostate cancer 0302 clinical medicine Internal medicine medicine Humans In patient Adverse effect Aged Retrospective Studies business.industry Common Terminology Criteria for Adverse Events Retrospective cohort study Prostate-Specific Antigen medicine.disease Primary tumor Radiation therapy Prostatic Neoplasms Castration-Resistant 030220 oncology & carcinogenesis Feasibility Studies Neoplasm Grading business |
| Zdroj: | Clinical genitourinary cancer. 18(5) |
| ISSN: | 1938-0682 |
| Popis: | Introduction The objective of this study was to evaluate the safety and feasibility of radiation therapy (RT) to the primary tumor in patients with metastatic castration-resistant prostate cancer (mCRPC). Patients and Methods This retrospective study included 105 patients with mCRPC who were treated between April 2004 and May 2019. We divided the patients into 2 groups: patients treated with RT to the primary tumor after they developed CRPC (RT group) and without (non-RT group). The primary purpose was safety assessed using the Common Terminology Criteria for Adverse Events. The secondary purpose included prostate-specific antigen (PSA) response, cancer-specific survival (CSS), and overall survival (OS). Background-adjusted multivariate analyses, with the inverse probability of treatment weighting (IPTW) method, were performed to evaluate impact of RT on CSS and OS. Results The median age at CRPC diagnosis was 75 years, and the median follow-up period after CRPC diagnosis was 21 months. The adverse events rates related to RT in any grade and grade ≥ 3 were 55% and 23%, respectively. Nine (29%) patients achieved ≥ 30% PSA decline with RT. In multivariate analyses with the IPTW method, the CSS and OS in the RT group were significantly longer than those in the non-RT group. In subgroup analyses with the IPTW method, RT was significantly associated with improved OS in patients aged ≥ 75 years and patients with initial PSA ≥ 500 ng/mL, cT4, Gleason score ≥ 8, and high-volume metastatic burden. Conclusions RT to the primary tumor is safe and feasible, and it has potential benefits on oncologic outcomes in patients with mCRPC. |
| Databáze: | OpenAIRE |
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