The aim of the study was to retrospectively compare outcome and complications
of prostate cancer patients treated with a curative and postoperative intent
using a pretreatment defined NCCN classification.
Material and methods
A total of 103 patients was treated curatively (RAD) and 94 postoperatively
(POST-OP). The mean age was higher in the RAD group (72.6 years; range,
56.4–85.1) than in the POST-OP group (65.4 years; range, 43.9–77) (P
<0.0001). According to the NCCN prognostic classification, 13 (12%)
patients were at low risk, 48 (47%) at intermediate risk and 42 (41%) at
high risk in the RAD group. In the POST-OP group, 13 (14%) patients were low
risk, 37 (40%) at intermediate risk and 44 (46%) at high risk. Hormone
therapy was used in 98 patients (95%) in the RAD group and 45 patients
(47.8%) in the POST-OP group. Patients were treated with three-dimensional
conformal radiotherapy. The prescription dose was 80 Gy in 2-Gy fractions in
the RAD group and 70 Gy in 2-Gy fractions in the POST-OP.
Results
No biochemical, clinical relapse was found in low-risk patients in the RAD
group and 1 relapse was found in the POST-OP group. The largest number of
relapses occurred (39%) and (33%) in intermediate-high risk in RAD and
POST-OP groups, respectively. In the cause-specific survival analysis, no
significant differences were found in the high-risk group between RAD and
POST-OP groups (P = 0.9). In the analysis of 5-year biochemical relapse-free
survival, no significant differences were found in the high-risk group
between RAD and POST-OP groups (P = 0.1020).
Conclusions
Radiotherapy in the RAD low-risk group was an excellent treatment. RAD and
POST-OP radiotherapy were well tolerated with very low toxicity. The
cause-specific survival at 5 years was 95% and 97% for the two treatment
groups, RAD and POST-OP, respectively (logrank test, P = 0.2908).
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