International Journal of Hematology and Oncology 2019, Vol 29, Num 2 Page(s): 107-117
Three Dimensional Conformal Radiotherapy and Androgen Deprivation Therapy in Patients with Clinically Localized Prostate Cancer; Hacettepe University Experience

Yurday OZDEMIR1,2, Fadil AKYOL1, Gokhan OZYIGIT1, Pervin HURMUZ1, Cem ONAL2, Ugur SELEK3, Erdem KARABULUT4

1Hacettepe University Faculty of Medicine, Department of Radiation Oncology, Ankara, TURKEY
2Başkent University Faculty of Medicine, Department of Radiation Oncology, Adana, TURKEY
3Koç University Faculty of Medicine, Department of Radiation Oncology, İstanbul, TURKEY
4Hacettepe University Faculty of Medicine, Department of Biostatistics, Ankara, TURKEY

Keywords: Prostate cancer, Conformal radiotherapy, Androgen deprivation therapy
The aim of this study is to evaluate the treatment results of three dimensional conformal radiotherapy (3DCRT) and androgen deprivation therapy (ADT) in patients with clinically localized prostate cancer (CLPC). Between June 1998 and December 2011, 577 patients with the diagnosis of CLPC were treated. ADT was started 3 months prior to radiotherapy (RT). 3DCRT was delivered to prostate and the seminal vesicles (SV) to a total dose of 70Gy. Additionally, patients with lymph node (LN) positivity received 50.4Gy RT to pelvic LN’s. Median follow up time was 65 months. Five-ten years overall survival (OS), cause specific survival (CSS), PSA relapse-free survival (PSA-RFS) and distant metastasis-free survival (DMFS) rates were 92-74%, 97-91%, 77-55% and 94-88%, respectively. OS was negatively affected from LN positivity (p< 0.001). In the subgroup of patients with GS≥ 8, there was no significant difference between < 1 years and ≥ 1 years of ADT in terms of CSS, PSA-RFS and DMFS. OS was better in patients with < 1 years of ADT (p= 0.01). Five year OS (p= 0.02), CSS (p= 0.05), PSA-RFS (p= 0.01) and DMFS (p= 0.07) rates were inferior in the high risk group patients that used ADT ≥ 1 year. Acute and late RTOG grade III/IV gastrointestinal system toxicity rates were 1.7% and 5% and acute and chronic RTOG grade III/IV genitourinary system toxicity rates were 1.4% and 5%, respectively. 3DCRT and ADT combination is an effective treatment modality with acceptable toxicities in patients with clinically localized prostate cancer.