Efficacy analysis of hypofractionated intensity-modulated radiation therapy combined with hormonal therapy for pelvic lymph node metastatic prostate cancer
Yao Lihong1,2, Liu Yueping1, Li Yexiong1, Wang Shulian1, Jin Jing1, Fang Hui1, Song Yongwen1, Tang Yu1, Tang Yuan1, Yang Yong1, Qi Shunan1, Chen Bo1, Lu Ningning1, Yu Zihao1
1Department of Radiation Oncology, National Cancer Center/National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China; 2Department of Gynecologic Oncology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100006, China
Abstract：Objective To investigate the efficacy and prognosis of hypofractionated intensity-modulated radiation therapy combined with hormonal therapy in the treatment of pelvic lymph node metastatic prostate cancer. Methods Clinical data of 42 IVA prostate cancer patients who received hypofractionated intensity-modulated radiation therapy combined with hormonal therapy in Cancer Hospital of Chinese Academy of Medical Sciences between 2006 and 2018 were retrospectively analyzed. The total irradiation doses to the prostate and seminal vesicles were 67.5Gy/25f,2.7Gy/f. The prophylactic irradiation doses to the pelvic lymph nodes were 45-50Gy with a daily fraction dose of 1.8-2.0Gy. Thirty-three patients with residual lymph nodes were boosted to 60.0-67.5Gy for the residual area, 2.4-2.7Gy/f. Androgen deprivation therapy included surgical castration or luteinizing hormone-releasing hormone agonists combined with antiandrogens. Survival rate was calculated using Kaplan-Meier method. The differences between two groups were analyzed by log-rank test. Prognostic factors were identified by univariate and multivariate analyses. Results The median follow-up was 65.5 months (range, 5 to 150 months). The 5-year and 10-year failure-free survival (FFS) rates in the whole group were 67% and 45%, respectively. No clinical recurrence was observed in the irradiation field. The 5-year and 10-year prostate cancer-specific survival/overall survival (PCSS/OS) rates were 85% and 60%, respectively. Gleason score (≥8 and<8) and duration of hormonal therapy impacted the FFS (both P<0.05). The duration of hormonal therapy was an independent prognostic factor for PCSS/OS (P=0.003). Conclusions Hypofractionated intensity-modulated radiotherapy combined with hormonal therapy yields optimistic clinical efficacy in the treatment of pelvic lymph node metastatic prostate cancer. Gleason score (≥8 and <8) and duration of hormonal therapy are critical prognostic factors.
Yao Lihong,Liu Yueping,Li Yexiong et al. Efficacy analysis of hypofractionated intensity-modulated radiation therapy combined with hormonal therapy for pelvic lymph node metastatic prostate cancer[J]. Chinese Journal of Radiation Oncology, 2021, 30(1): 42-46.
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