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. 2017 Dec;108(12):2422-2429.
doi: 10.1111/cas.13402. Epub 2017 Nov 3.

Cancer-specific mortality of high-risk prostate cancer after carbon-ion radiotherapy plus long-term androgen deprivation therapy

Goro Kasuya  1 , Hitoshi Ishikawa  2 , Hiroshi Tsuji  1 , Yasuo Haruyama  3 , Gen Kobashi  3 , Daniel K Ebner  1   4 , Koichiro Akakura  5 , Hiroyoshi Suzuki  6 , Tomohiko Ichikawa  7 , Jun Shimazaki  7 , Hirokazu Makishima  1 , Takuma Nomiya  8 , Tadashi Kamada  1 , Hirohiko Tsujii  1 ; Working Group for Genitourinary Tumors
Affiliations

Cancer-specific mortality of high-risk prostate cancer after carbon-ion radiotherapy plus long-term androgen deprivation therapy

Goro Kasuya et al. Cancer Sci. 2017 Dec.

Abstract

The treatment outcomes of patients with high-risk localized prostate cancer (PC) after carbon-ion radiotherapy (CIRT) combined with long-term androgen deprivation therapy (LTADT) were analyzed, and compared with those of other treatment modalities, focusing on PC-specific mortality (PCSM). A total of 1247 patients were enrolled in three phase II clinical trials of fixed-dose CIRT between 2000 and 2013. Excluding patients with T4 disease, 608 patients with high-risk or very-high-risk PC, according to the National Comprehensive Cancer Network classification system, who received CIRT with LTADT were evaluated. The median follow-up time was 88.4 months, and the 5-/10-year PCSM rates were 1.5%/4.3%, respectively. T3b disease, Gleason score of 9-10 and percentage of positive biopsy cores >75% were associated with significantly higher PCSM on univariate and multivariate analyses. The 10-year PCSM rates of patients having all three (n = 16), two (n = 74) or one of these risk factors (n = 217) were 27.1, 11.6 and 5.7%, respectively. Of the 301 patients with none of these factors, only 1 PCSM occurred over the 10-year follow-up (10-year PCSM rate, 0.3%), and significant differences were observed among the four stratified groups (P <0.001). CIRT combined with LTADT yielded relatively favorable treatment outcomes in patients with high-risk PC and very favorable results in patients without any of the three abovementioned factors for PCSM. Because a significant difference in PCSM among the high-risk PC patient groups was observed, new categorization and treatment intensity adjustment may be required for high-risk PC patients treated with CIRT.

Keywords: Adverse effect; carbon-ion radiotherapy; high-risk prostate cancer; mortality; risk factor.

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Figures

Figure 1
Figure 1
Study flow chart.
Figure 2
Figure 2
Prostate cancer‐specific mortality and non‐prostate cancer‐specific mortality of 608 high‐risk prostate cancer patients treated with carbon‐ion radiotherapy combined with long‐term androgen deprivation therapy.
Figure 3
Figure 3
Comparison of prostate cancer‐specific mortality among four patient groups stratified according to the number of unfavorable factors present (T3b disease, Gleason score of 9–10 and percentage of positive cores ≥75%).
See this image and copyright information in PMC

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