Early undetectable serum PSA is an independent predictive factor of progression-free survival (PFS) and bone metastases in patients with localized prostate cancer treated by androgen deprivation and radiotherapy

Abstract

4684 Background: Patients with locally-advanced prostate cancer are managed by androgen deprivation (AD) and radiation (RT). We attempted to identify early predictors of outcome in a large retrospective series with a long follow-up. Methods: From 1991 to 1998, 92 patients with locally-advanced prostate cancer were treated by AD and RT. Median pretreatment PSA level was 19 ng/mL (1.6–148). Clinical stage was T1 (4%), T2 (60%), and T3 (36%). Gleason score was 4–6 (46%), 7 (32%) and 8–10 (22%). Prognosis was classified as high risk (T3 and/or PSA>20 ng/mL and/or Gleason score > 7) (n= 59) or intermediate risk (n= 33). AD consisted in a complete androgen blockade (GnRH agonist and anti-androgen) (55 pts) or an anti-androgen as a single agent (37 pts) and was given for a median duration of 6 months (3–18). AD was usually initiated 3 months before RT. The prostate was to receive 65 Gy (2.5 Gy/day) (74 pts) or 70 Gy (2 Gy/day) (18 pts). The median follow-up was 70 months (14–126). Results: The 5-year PSA-PFS rat...